African Female Physicians and Nurses in the Global Care Chain: Qualitative Explorations from Five Destination Countries

Abstract

Migration of health professionals is an important policy issue for both source and destination countries around the world. The majority of migrant care workers in industrialized countries today are women. However, the dimension of mobility of highly skilled females from countries of the global south has been almost entirely neglected for many years. This paper explores the experiences of high-skilled female African migrant health-workers (MHW) utilising the framework of Global Care Chain (GCC) research. In the frame of the EU-project HURAPRIM (Human Resources for Primary Health Care in Africa), the research team conducted 88 semi-structured interviews with female and male African MHWs in five countries (Botswana, South Africa, Belgium, Austria, UK) from July 2011 until April 2012. For this paper we analysed the 34 interviews with female physicians and nurses using the qualitative framework analysis approach and the software atlas.ti. In terms of the effect of the migration on their career, almost all of the respondents experienced short-term, long-term or permanent inability to work as health-care professionals; few however also reported a positive career development post-migration. Discrimination based on a foreign nationality, race or gender was reported by many of our respondents, physicians and nurses alike, whether they worked in an African or a European country. Our study shows that in addition to the phenomenon of deskilling often reported in GCC research, many female MHW are unable to work according to their qualifications due to the fact that their diplomas are not recognized in the country of destination. Policy strategies are needed regarding integration of migrants in the labour market and working against discrimination based on race and gender.

Downward occupational mobility of baccalaureate‐prepared, internationally educated nurses to licensed practical nurses

“…Given the aforementioned barriers, emerging research suggests that IENs are often deskilled upon migration to destination countries (Alexis & Shillingford ; Wojczewski et al. ) and often work as lower‐skilled care workers in destination countries (Cuban ; Hawkins ; Salami et al. ,b; Wojczewski et al.…”

The Challenges Experienced by Zimbabwean Social Workers Practising in Gauteng Townships

“…In as much as this process was deemed to be important in terms of establishing competences, the process was found to be unnecessarily lengthy and costly. These frustrations, as a result of temporary deskilling, with the wait for registration, were also noted in the study on female physicians and nurses by Wojczewski et al (2015). In a study by Pullen-Sansfacon, Brown, Graham and Michaud (2014) the frustrations reported by internationally educated social workers were linked to labour mobility and immigration policies.…”

“…The social work profession strives to improve individuals' and families' quality of life as well as uplift and contribute towards functional communities and promote social justice. The unfriendly behaviour reported in the finding is based on the attitude of the co-workers and it further shows that, even though social workers are trained to fight social injustices, no environment is safe from hostile behaviour and oppression (Hanna & Lyons, 2014;Wojczewski et al, 2015). Indeed, knowingly and/or unknowingly, social workers themselves can be perpetrators of the same injustices they are supposed to be fighting and such perceptions can explicitly or subtly find their way into policies (Roestenburg, 2013).…”

“…International migration flows seem to have increased considerably over the past few years (Wojczewski et al, 2015) and this continues to be a crucial aspect of global agendas as it has vast socio-economic and cultural implications for both sending and receiving countries (Kul, n.d.). The mobility of workers worldwide, as in South Africa, is an increasingly important phenomenon and social workers are part of this global trend.…”

Does improved postgraduate capacity shift the balance of power for nurse specialists in a low‐income country: A mixed methods study

“…Resistance by the medical profession is identified as one of the reasons for variations in task‐shifting (Maier & Aiken, ) that may lead to strained doctor–nurse relationships. Dominance of the medical profession over nursing is well‐known—this can be seen in the retention of doctor‐led healthcare teams (Nardi, ; Wojczewski et al, ), overlapping and contested clinical work (Bruce et al, ; Nardi, ) and opposition from doctors (Parker & Hill, ). Furthermore, the status conferred on medicine by the employing institution, legitimized by its rules and regulations (Engleberg & Wynn, ; McKay & Narasimhan, ) creates an imbalance of power between physicians and nurse specialists.…”