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An Analysis of Factors Influencing the International Migration of Indian Nurses

Abstract

Based on our survey conducted in Tamil Nadu, this paper analyses the characteristics of Indian migrant nurses and the factors influencing their migration. India is considered the second largest exporter of nurses after the Philippines. Many Indian nurses have migrated to work in OECD countries, the Gulf countries and some ASEAN countries. While Indian nurses are migrating overseas to fill shortages at their destinations, India has itself been suffering from an acute scarcity of nurses since its independence in 1947. Therefore, the large scale of nurse migration is a serious threat to the Indian healthcare system. The results of the survey imply that international migration by nurses can be explained in part by the gap between the private sector and the public sector in terms of salary and working environment. Since the impact of social status on the migration decisions of nurses has lessened, economic factors are the crucial determinant of international migration of nurses. Policy intervention in this area is the necessary first step to solving this long-standing problem. The priority in any policies formulated should be given to nurses working in the private sector whose salaries are considerably lower than those in the public sector and whose voices are unheard.

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Notes

  1. This tendency might be changing. Efforts have been made to train nurses locally in the United Arab Emirates (UAE) as part of the Emiratization of the health workforce (Hannawi and Al-Salmi 2013, Brownie et al. 2015).

  2. It is at least the second source country of nurses to OECD countries (OECD 2015).

  3. Figures were from Nurse and Midwifery in India, Ministry of Health and Family Welfare. http://nursingandmidwifery.gov.in/state_nursing_councils.html#.WMa9x2-LT3h (Data extracted on Mar. 5, 2017).

  4. For a comprehensive review of literature on nurse migration from India, see Garner et al. (2015).

  5. Figures were extracted from the Health Workforce Migration section of OECD. Stat. http://stats.oecd.org/ (Data extracted on March 10, 2016).

  6. See Tsujita et al. (2017) for the case of Kerala.

  7. See Prescott and Nichter (2014) for their criticism on push-pull analyses of migration.

  8. http://www.tamilnadunursingcouncil.com/snregistered.php

  9. http://www.tamilnadunursingcouncil.com/syw04.php

  10. https://www.tamilnadunursingcouncil.com/snp03.php and https://www.tamilnadunursingcouncil.com/snp04.php

  11. During the British colonial era, a substantial number of Tamil workers were sent to Malaysia to work in plantations by the British authority (Irudaya Rajan et al. 2016). Most Malaysian Indians and Singaporean Indians are of Tamil descent, and Tamil language is one of Singapore official languages.

  12. For example, our ongoing project on Indian nurses in Singapore suggests that the overwhelming majority of nurses who were born and educated in India and currently work in Singapore are placed there through private recruitment agencies.

  13. This information was obtained during interviews with nurses in Chennai. Times of India (2017a) reported that nurses working in government hospitals are paid Rs. 33,045 per month on average, which corroborates the information provided by the interviewed nurses.

  14. Some private hospitals pay well, but the pay is not on a par with the salary paid to nurses at government facilities, other than the very few who work as part of a specialized operation and treatments team. Rather, we came across cases of young nurses absconding from well-known hospitals in big cities in India because of their low salary and poor working conditions.

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Acknowledgements

We thank two anonymous reviewers for their many insightful comments and suggestions, which helped us to improve the quality of our paper. We would like to thank Father A. M. Francis Jayapathy S. J. and Dr. Bernard D’Sami of Loyola College, Chennai, Tamil Nadu for their support in conducting surveys. Without their assistance, we could not have completed our study. We also benefitted from comments by at the workshop on Human Resource Development and Mobility of Skilled Labour in Southeast Asia, held at Faculty of Nursing, Chulalongkorn University in Bangkok on Feb. 6–7, 2017. We are grateful to Institute of Developing Economies (IDE-JETRO) for funding this research. Any error remains solely our responsibility.

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Correspondence to Hisaya Oda.

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Oda, H., Tsujita, Y. & Irudaya Rajan, S. An Analysis of Factors Influencing the International Migration of Indian Nurses. Int. Migration & Integration 19, 607–624 (2018). https://doi.org/10.1007/s12134-018-0548-2

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  • DOI: https://doi.org/10.1007/s12134-018-0548-2

Keywords

  • Nurses
  • International migration
  • India
  • Global shortage of nurses
  • Determinants of migration
  • Tamil Nadu
  • Private school
  • Government school
  • Social status