International Migration of Nurses: A Comparison of Filipino and Indian Nurses
Published in March 2018
This chapter explores the rapidly growing business process outsourcing (BPO) industry, particularly call centers, as a major employment destination for nursing graduates in the Philippines, especially for those who took the course from around mid-2000s when the US and UK stopped actively recruiting foreign nurses. Specifically, it gives light on why call centers attract nursing graduates, and whether they want to return to the profession in the future. After presenting an overview of the expansion and contribution of the industry to the Philippine economy, it presents the partial results of a survey (n=208) implemented to nursing graduates. Our results show that they prefer to work in call centers mainly because of inter-industry wage gaps. Other reasons cited were perceptions towards the job as tough, influence of peers and motivation in taking up the nursing course. Many of the respondents also expressed their unwillingness to work as nurses even in the future.
The BPO industry has indeed played an important role as a major “buffer” to mitigate the negative impact of huge unemployment of nursing graduates. On a larger scale, it has become one of the pillars of economic growth in the country. However, while international demand for health- related BPO services increases, rapid advances in AI technology also threatens to replace workers especially in process-driven jobs in call centers. Under these circumstances, the crucial and pressing challenge for the Philippine society, therefore, is how to create a pool of flexible nursing graduates who can respond to changing international labor market demands and technology in this industry.
India has been facing a severe shortage of domestic nurses. There is an estimated shortfall of 2.4 million nurses in India. The shortage is partly explained by international migration of Indian nurses. It is reported that more than 640,000 Indian nurses are working abroad. From a policy perspective, it is important to understand how the situation evolved and to identify factors that influence the intention of international migration among nurses. This paper examines the relationship between nurses’ intentions to migrate and their characteristics based on our survey data from Tamil Nadu, which is located in South India where nursing education is active. Around 18% of sample nurses have an intention to migrate overseas. Most of them are nurses working in private hospitals. Because of the gap in salaries between public medical facilities and private hospitals, nurses in private hospitals have incentives to go abroad for higher wages. Nurses who are young, single and belong to SC caste group also have intentions to migrate. In order to mitigate the shortage of domestic nurses, the government’s policy intervention, such as the introduction of a scheme that raises the wage level of nurses in private hospitals, is absolutely necessary.
The international mobility of nurses has recently increased. As India is estimated to be the second largest ‘exporter’ of nurses to developed countries under the current internationalised nurse labour market, this paper discusses the socio-economic background, motivations to become nurses and future career prospects of nursing students in India. BSc students are more likely to be Christians, urban and relatively well-off than diploma students. Less than half of the students chose to study nursing of their own will, and ease of finding a job is the most popular reason to study nursing. Religion, caste, course and some motivation factors seem to affect their career prospects.