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Journal ArticleDOI

Return migration of nurses: a concept analysis

01 Sep 2018-Indian Journal of Public Health Research and Development (IndianJournals.com)-Vol. 9, Iss: 9, pp 199-203

TL;DR: This concept analysis has clarified current understandings and enhance the clarity of return migration concept and recognises the centrality of return as a component in migration stage that needs a comprehensive approach.
Abstract: Background: Return migration is a complex, challenging phenomenon and to date it remains a concept that is not well understood. A concept analysis would help to clarify what is meant by return migration. This paper aims to report on an analysis of the concept of return migration of nurses. Design: Concept analysis using the Walker and Avant approach. Data Sources: Google Scholar, Pubmed, EBSCO, JSTOR and Web of Science databases were searched without a timeframe. Twenty-one articles meeting the inclusion criteria were included. Method: This study employs eight steps of Walker and Avant’s method to conduct the concept analysis. Results: Return migration of nurses can be defined by five attributes: the motivation and decisions of migrant nurse, return as human right, resource mobilisation, reintegration and return itineraries. Antecedents of return migration include the economic, social, geographical, political, family and life cycle that comprise the cause and eRect framework. With regards to return migration, the consequences are beneficial or detrimental depend on the point of view migrant nurses, source country, receiving country, nursing profession and country health system. Empirical referents have been identified and support potential area to undertake a research on return migration. Conclusion: This concept analysis has clarified current understandings and enhance the clarity of return migration concept. It recognises the centrality of return as a component in migration stage that needs a comprehensive approach.

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Return Migration of Nurses: A Concept Analysis
Ferry Efendi
1
, Anna Kurniati
2
, Eileen Savage
3
, Nursalam Nursalam
4
, Ah. Yusuf
5
, Kusnanto Kusnanto
5
1
Lecturer, Faculty of Nursing, Universitas Airlangga, Surabaya, Indonesia;
2
Health planner specialist,
Center for Planning and Management of Human Resources for Health, BPPSDMK, Ministry of Health,
Indonesia;
3
Professor, School of Nursing, University College Cork, Ireland;
4
Professor,
5
Lecturer, Faculty
of Nursing, Universitas Airlangga, Surabaya, Indonesia
ABSTRACT
Background: 5HWXUQPLJUDWLRQLVDFRPSOH[FKDOOHQJLQJSKHQRPHQRQDQGWRGDWHLWUHPDLQVDFRQFHSWWKDW
is not well understood. A concept analysis would help to clarify what is meant by return migration. This
paper aims to report on an analysis of the concept of return migration of nurses.
Design: &RQFHSWDQDO\VLVXVLQJWKH:DONHUDQG$YDQWDSSURDFK
Data Sources: *RRJOH 6FKRODU3XEPHG (%6&2 -6725DQG:HE RI 6FLHQFH GDWDEDVHVZHUHVHDUFKHG
ZLWKRXWDWLPHIUDPH7ZHQW\RQHDUWLFOHVPHHWLQJWKHLQFOXVLRQFULWHULDZHUHLQFOXGHG
Method:7KLVVWXG\HPSOR\VHLJKWVWHSVRI:DONHUDQG$YDQW¶VPHWKRGWRFRQGXFWWKHFRQFHSWDQDO\VLV
Results:5HWXUQPLJUDWLRQRIQXUVHVFDQEHGH¿QHGE\¿YHDWWULEXWHVWKHPRWLYDWLRQDQGGHFLVLRQVRIPLJUDQW
nurse, return as human right, resource mobilisation, reintegration and return itineraries. Antecedents of
return migration include the economic, social, geographical, political, family and life cycle that comprise the
FDXVHDQGH൵HFWIUDPHZRUN:LWKUHJDUGVWRUHWXUQPLJUDWLRQWKHFRQVHTXHQFHVDUHEHQH¿FLDORUGHWULPHQWDO
depend on the point of view migrant nurses, source country, receiving country, nursing profession and
FRXQWU\KHDOWKV\VWHP(PSLULFDOUHIHUHQWVKDYHEHHQLGHQWL¿HGDQGVXSSRUWSRWHQWLDODUHDWRXQGHUWDNHD
research on return migration.
Conclusion:7KLVFRQFHSWDQDO\VLVKDVFODUL¿HGFXUUHQWXQGHUVWDQGLQJVDQGHQKDQFHWKHFODULW\RIUHWXUQ
migration concept. It recognises the centrality of return as a component in migration stage that needs a
comprehensive approach.
Keywords: concept analysis, return migration, nurse migration, brain gain.
INTRODUCTION
Migration of skilled health workers in a global
FRQWH[W KDV LQFUHDVHG VLJQL¿FDQWO\ RYHU WKH ODVW WZR
decades.
1,2
Nurses as a large part of professional health
FDUHZRUNIRUFHKDYHFRQWULEXWHGWRWKHVLJQL¿FDQWÀRZV
of this migration movement.
3–5
Migration has long been
assumed as a one direction process,
6
such that migrants
who emigrated would permanently stay in the destination
FRXQWU\+RZHYHUWKHUHLVLQFUHDVLQJHYLGHQFHVKRZLQJ
that the migrants are returning to their country of origin
known as return migration.
7–9
Acknowledging the importance of return migration,
The International Centre of Nurse Migration recognised
WKLVPRYHPHQWDVDPHDQVRIEHQH¿WLQJWKHFRXQWULHVRI
origin and called for serious attention.
10
The International
2UJDQL]DWLRQIRU0LJUDWLRQ,20DOVRVXSSRUWWKLVLGHD
by emphasising on the need for comprehensive and
cooperative approaches to managing return as a part of
the human movement.
11
The issue of return has become
LQFUHDVLQJO\VLJQL¿FDQW DPRQJ LPPLJUDQWVDOWKRXJKLQ
the absence of statistical data. The study pointed out the
need for global attention on the nurses’ return migration
WKDW LV KLJKO\ FRPSOH[ DQG QHHGV IXUWKHU DFWLRQ IURP
nursing profession.
10
&RQFHSW DQDO\VLV DV :DONHU DQG $YDQW  KDV
argued can provide a knowledge base to get a clear picture
RISKHQRPHQRQREMHFWRULGHD
12
The aim of this concept
DQDO\VLVZDVWRH[DPLQHWKHFRQFHSWRIUHWXUQPLJUDWLRQDV
it is used in global nurses’ migration, to provide a brighter
understanding of the phenomenon and suggestion for
future study can be developed and measured.
DOI Number: 10.5958/0976-5506.2018.00994.4

200 Indian Journal of Public Health Research & Development, September 2018, Vol.9, No. 9
Data sources: An electronic search using the keyword
“return migration nurse”, “return emigrant nurse”,
“return immigrants nurse” was undertaken using
databases relevant to nursing, medicine and social
VFLHQFHV3XEPHG(%6&2-6725:HERI6FLHQFHDQG
Google Scholar.
Data Selection and Analysis: 7KH ¿QDOVDPSOH RI 
documents was selected with inclusion criteria for
WKH VHOHFWLRQ RI SDSHUV ZHUH D UHSRUWHG RQ PLJUDQWV
returning or having returned to their country of origin;
DQGEIRFXVHGRQTXDOL¿HGQXUVHV
RESULTS
Uses of the concept in literature: There is no available
GH¿QLWLRQRIUHWXUQPLJUDWLRQIURPFRPPRQO\UHIHUUHG
GLFWLRQDULHV 2[IRUG DQG 0HUULDP:HEVWHU GLFWLRQDU\
7KH ¿UVW GH¿QLWLRQ RI UHWXUQ PLJUDWLRQ SURSRVHG E\
%RYHQNHUNZKLFKGH¿QHDVWKHUHWXUQRISHRSOH
DIWHU HPLJUDWLQJ WR RULJLQ FRXQWU\ IRU WKH ¿UVW WLPH
13
$ERYHWHUPVKDYHYDULRXVLQWHUSUHWDWLRQV)RUH[DPSOH
with regards to the movement, Dumont and Spielvogel
GH¿QHWKHPRYHPHQWDVWKHLQLWLDOPLJUDWLRQRQO\
to be called return migration.
14
'H¿QLQJDWWULEXWHV
Motivation and decisions of nurse migrant: Individual
motivation and decision for going back to the country
of origin is one of key distinctive associated with return
nurse migration. It has been argued that individual
decision to return home as a response of personal factor,
career path and others.
15,10
Individual initiatives to return
has been decided on the early stage of migration or
during they stay in foreign country.
16,17
Motivation to
UHWXUQKRPHZDVUHSRUWHGLQÀXHQFHGWKHZLOOLQJQHVVDQG
readiness of migrant which consider the circumstances
in both, home and host countries.
18
Return as human right: Freedom of return under the
umbrella of migration was described in the literature
RQ UHWXUQ KRPH 5HFRJQLVLQJ WKH VLJQL¿FDQW PRELOLW\
RQ KHDOWK SURIHVVLRQDO WKH :+2 LVVXHG WKH JOREDO
code by recommending the Member States to take
into account individual right to migrate and leave any
country.
19
5HFDOOLQJUHVROXWLRQ:+$LQZKLFK WKH
:RUOG+HDOWK$VVHPEO\UHTXHVWHGWKH'LUHFWRU*HQHUDO
to develop a voluntary code of practice on the international
recruitment of health personnel in consultation with all
relevant partners; Responding to the calls of the Kampala
'HFODUDWLRQDGRSWHGDWWKH)LUVW*OREDO)RUXPRQ+XPDQ
5HVRXUFHVIRU+HDOWK.DPSDOD?X0DUFK
Back to the past, referring to the article 13 section 2 of
7KH8QLYHUVDO'HFODUDWLRQRQ+XPDQ5LJKWVVWDWHGWKDW
“Everyone has the right to return to his country”.
20
The
positions statement by International Council of Nurses
UHFRJQLVHWKHSRWHQWLDOEHQH¿WRIPLJUDWLRQDQG
call for support to nurse who wishes to return home by
putting the nurses right on priority.
Resource mobilization: Bringing resources back to
the countries of origin marked the character of return
migration. Nurse returnees not only bringing the
¿QDQFLDOFDSLWDOEXWDOVRKXPDQDQGVRFLDOFDSLWDO
10
It
LV XQGHQLDEOH WKDW WKH ÀRZ RI UHPLWWDQFHV WR WKH ORZ
DQG PLGGOH LQFRPH FRXQWULHV SOD\V D VLJQL¿FDQW UROH
in the nation’s development.
21
Even though we are a
lack of data on the impact of remittances from nursing
workforce, evidence showed that in Philippine as a
source country of nurses share 10% remittances of
*URVV'RPHVWLF3URGXFWIRU-DPDLFDDQGIRU
Uganda.
22
%UDLQ JDLQ LV WKH PRVW H[SHFWHG RI UHWXUQHG
migrants which brings new skill, knowledge and idea to
contribute to the advancement of their origin’s country.
23
6WXGLHVRIUHWXUQPLJUDWLRQLQ-DPDLFDDQG3DFL¿F,VODQG
countries described that most returnees have gained new
or additional capabilities.
21,16
Reintegration: Return migration was characterised by
reintegration phase into the family, group and society in
KLVRUKHUFRXQWU\5HLQWHJUDWLRQIRXQGTXLWHFRPSOH[
dynamic and challenging aspect of return migration.
11
5HLQWHJUDWLRQWREHLQÀXHQFHGE\VLWXDWLRQDQGFRQGLWLRQ
in both countries.
24
:KHQPLJUDQWVIHHO WKDW WKH\ KDYH
achieved their goals, they are more ready to reintegrate
into the home country.
18
&RPSOH[ UHLQWHJUDWLRQ
problems have been investigated by Arowolo for
LQVWDQFH MREOHVVQHVV VRFLDO PDODGMXVWPHQW ERUHGRP
DQGIUXVWUDWLRQDPRQJQRQQXUVHVPLJUDQWV
25
This study
consistent with research of nurses migrant who returns
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DQGIDFHGGL൶FXOW\LQEXLOGLQJDFDUHHU
26
Return itineraries: 7KH MRXUQH\ RI UHWXUQ ZDV
FRPSOH[ ZKLFK JHQHUDOO\ GLYLGHG LQWR YROXQWDULO\
DQG LQYROXQWDULO\ 7KHVH W\SHV ZHUH H[SODLQHG LQ WKH
OLWHUDWXUH RI UHWXUQ PLJUDWLRQ RI QXUVHV 0DMRULW\ WKH
VWXGLHV VXSSRUW WKH EHQH¿WV RI YROXQWDULO\ UHWXUQ DV D
form to contribute in the nation development.
27
Voluntary
return due to the completion of work contract, and goals
achievement was reported by another study.
16
+RZHYHU
some study also noted that forced return migration might
become the push factor from country of residence to
make them back home.
10

Indian Journal of Public Health Research & Development, September 2018, Vol.9, No. 9 2 0 1
Model case of return migration of nurses: In the
:DONHUDQG$YDQWPHWKRGPRGHOFDVHZDVFRQVWUXFWHG
to further clarify the concept. The case may be derived
from our real life, invented or found in published
document.
12
A model case adapted from return migration
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a bachelors degree in nursing. She has been working
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QXUVHVLQ-DSDQDOORZVKHUWRHDUQDURXQG86'SHU
PRQWK HLJKW WLPHV KLJKHU WKDQ ,QGRQHVLD +DYLQJ WKLV
wage, she was thinking to return home after she reaches
her personal goals. She also sent the money back to
home country for her family. After Tsunami disaster hit
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and tried to persuade her for return. Even though she has
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:KLOHZDLWLQJIRUWKHMRELQWHUYLHZVKHZDVUXQQLQJD
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rebuild her career from zero as a new nurse.
All attributes arise in this case describe the
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individual motivation in her decision to return home.
+HU UHWXUQ ZDV LQÀXHQFHG E\ WKH DFKLHYHPHQW RI KHU
personal goals, crisis, and her family. Financial capital
was obviously observed from her situation to support
KHU IDPLO\ DQG KHUVHOI DW KRPH FRXQWU\ /DVWO\ UHWXUQ
KRPHSRVLWLRQHGKHURQWKHGL൶FXOW\¿QGLQJDMREDQG
struggles to seek a new vacancy for her future.
Additional cases: related case: There is one case
related to return migration concept of which have some
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'HQLDV 3VHXGRQ\P ZDV OHIW KLV MRE WR PLJUDWH
to Australia because of the war happened in his home
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found him without a legal document. Only two months
ahead of his arrival date, the Australian government has
decided to deport him back to his country of origin.
Denias case only has one attribute, his return
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KRVW FRXQWU\ LQYROXQWDU\ UHWXUQ PLJUDWLRQ 7KLV W\SH
of return repeatedly showed by refugees and asylum
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Antecedents: 7KH FDXVH DQG H൵HFW PRGHO LV WKH PRVW
SUHYDOHQWIUDPHZRUNIRUH[SODLQLQJUHWXUQPLJUDWLRQRI
nurses.
10
The antecedents for return migration of nurses
are social, economic, geographical, political, family or
life cycle.
6
&DXVHDQGH൵HFWIDFWRUVGULYHQXUVHVWRUHWXUQ
WRWKHFRXQWU\RIRULJLQZKLFKD൵HFWHGE\FLUFXPVWDQFHV
in the host and home country.
6
Economic motives for
H[DPSOHZKHQWKHMREDUUDQJHPHQWUHDFKHVWKHHQGRIWKH
contract, it might be a cause factor to leave host country.
8
On the other side, enough saving in country of origin
PLJKW EHFRPH DQ H൵HFW IDFWRU WR UHWXUQ KRPH 1RQ
HFRQRPLFFRQVLGHUDWLRQDOVRKDYLQJPRUHLQÀXHQFHGIRU
return home than economic reason.
6
Consequences: Mount evidence showed the positive
and negative impact of return migration on various
players on this movement.
10
The players include migrant
nurses, nursing profession, host and home country. For
instance, developing countries who have a surplus of
QXUVLQJ ZRUNIRUFH FRXOG JDLQ EHQH¿W IRU WKH UHWXUQ RI
PLJUDQWQXUVHV7KHEUDLQJDLQLVPXFKPRUHH[SHFWHG
WKDQEUDLQGUDLQSDUWLFXODUO\ IURPWKHPLGGOHDQGORZ
income countries.
Table 1: Concept on return migration of nurse: antecedent, attributes and consequences
Antecedents Attributes Consequences
'ULYHUVLQÀXHQFLQJPRWLYDWLRQWR
UHWXUQFDXVHDQGH൵HFW
Motivation and decisions of nurse
migrant
%HQH¿FLDODQGGHWULPHQWDO
depending on:
Social Return as human right Individual
Economic Resource mobilization Source country
Geographical Reintegration Receiving country
Political Return itineraries Nursing profession
)DPLO\/LIH&\FOH National health system

202 Indian Journal of Public Health Research & Development, September 2018, Vol.9, No. 9
Empirical referents: Measuring return migration can be
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and data availability as well.
28
+RZZDVFRXQWU\GHDOLQJ
with this issue by lack of system to track the returnee
obviously appeared on the published literature.
29
Mostly
country relies on the census, survey, population registries,
labour force survey, country social survey, and data from
employment services.
28
A study from most developed
countries conveys a message that there is a need of
established tools to measure the return migration.
7KH DWWULEXWHV DQWHFHGHQWV DQG FRQVHTXHQFHV RI
UHWXUQPLJUDWLRQRIQXUVHVFDQEHVFUXWLQLVHGXVLQJPL[HG
PHWKRGV HLWKHU TXDQWLWDWLYH RU TXDOLWDWLYH 7KH QHHG WR
develop instrument or scale to measure return migration is
necessary particularly for the standard measurement among
countries to allow greater understanding of this issues.
DISCUSSION
In this concept analysis, the discourse of return
migration on nurses has been elaborated in the systematic
approach with implication on nursing research, education,
DQGSUDFWLFH$FFRUGLQJWRWKLVDQDO\VLVZHQHHGDVSHFL¿F
scale to measure this phenomenon in standard ways. This
study also highlights that return migration in nursing
societies is occasionally approached in a holistic manner.
International organisation in nursing has proposed a
position statement on the important aspect addressing
the global nurse migration.
30
In the global connectedness
and interdependence between countries on the issues of
migration, return issue will become more prevalent.
A concept analysis of return migration was
challenging in the absence of available data, particularly
on nursing perspective. By this, nursing profession
needs to take action by implementing some measures to
deal with the underlying problem.
CONCLUSION
This article provides an analysis of the concept of
return migration of nurses found in published literature.
The analysis proposed that return migration of nurses
KDV EHHQ LGHQWL¿HG DV KDYLQJ FKDUDFWHUV LQGLYLGXDO¶V
motivation and decision, universal human right, resource
mobilisation, reintegration and return itineraries.
Countries involved in this program should promote
orderly and regulated return migration of nurses using a
comprehensive approach.
&RQÀLFWRI,QWHUHVW Authors declared that we have no
FRQÀLFWRILQWHUHVW
Acknowledgment: None
Source of Funding: NA
Ethical Clearance: NA
REFERENCES
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Codes of practice and the international migration
of skilled health workers. World Med. Heal. policy
3,±
:LVPDU00DLHU&%*OLQRV,$'XVVDXOW
*)LJXHUDV-Health professional mobility and
health systems. Evidence from 17,:RUOG+HDOWK
2UJDQL]DWLRQ
%XFKDQ-$LNHQ/6ROYLQJQXUVLQJVKRUWDJHV
a common priority. J. Clin. Nurs. 17, 3262–3268

(IHQGL)&KHQ&01XUVDODP1,QGDUZDWL
58O¿DQD(/LYHGH[SHULHQFHRI,QGRQHVLDQ
QXUVHVLQ-DSDQ$SKHQRPHQRORJLFDOVWXG\Japan
J. Nurs. Sci. 13,±
5. Efendi, F., Nursalam, N. N., Kurniati, A. &
*XQDZDQ-1XUVLQJTXDOL¿FDWLRQDQGZRUNIRUFH
for the Association of Southeast Asian Nations
Economic Community. Nurs. Forum±
GRLQXI
6. King, R. Generalizations from the history of
return migration. Return Migr. Journey hope or
despair±
7. Blouin, C. & Debnath, P. CARICOM return
migration and brain circulation: case study of
&DULEEHDQERUQ QXUVHV Can. Foreign Policy J.
17,±
.XUQLDWL$&KHQ&00(IHQGL)2JDZD
5$GHVNLOOLQJDQGFKDOOHQJLQJMRXUQH\WKHOLYHG
H[SHULHQFH RI ,QGRQHVLDQ QXUVH UHWXUQHHV Int.
Nurs. Rev.QDQDGRLLQU
9. Efendi, F. et al. ,-(3$ *UD\ $UHD IRU +HDOWK
Policy and International Nurse Migration. Nurs.
Ethics 24,±
+DRXU.QLSH 0 'DYLHV $  ,&10 Return
Migration of Nurses. 2015, (International Centre
RQ1XUVH0LJUDWLRQ

Indian Journal of Public Health Research & Development, September 2018, Vol.9, No. 9 2 0 3
11. IOM. Return Migration: Challenges and
Opportunities. 2015,
:DONHU/2$YDQW.&Strategies for theory
construction in nursing $SSOHWRQ  /DQJH
1RUZDON&7
13. Bovenkerk, F. The sociology of return migration:
a bibliographic essay0DUWLQXV1LMKR൵
'XPRQW-&6SLHOYRJHO*5HWXUQPLJUDWLRQ
A new perspective. Organ. Econ. Coop. Dev.
(OECD), Int. Migr. Outlook, Annu. Rep.
%URZQ&RQQHO-%URZQ53&&RQQHOO-
The migration of doctors and nurses from South
3DFL¿F,VODQG1DWLRQVSoc. Sci. Med. 58, 2193–

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and its Development Potential. Int. Migr. 37, 183–

7UR\ 3 + :\QHVV / $  0F$XOL൵H (
1XUVHV¶H[SHULHQFHVRIUHFUXLWPHQWDQGPLJUDWLRQ
from developing countries: a phenomenological
approach. Hum. Resour. Health 5,
&DVVDULQR-37KHRULVLQJUHWXUQPLJUDWLRQ7KH
conceptual approach to return migrants revisited.
Int. J. Multicult. Soc. 6,±
:RUOG +HDOWK 2UJDQL]DWLRQ 8VHUV JXLGH WR WKH
:+2JOREDOFRGHRISUDFWLFHRQWKHLQWHUQDWLRQDO
recruitment of health personnel. 2014,
20. United Nations. Universal declaration of human
rights. 2015,
%URZQ 5 3& &RQQHOO -%URZQ  &RQQHOO
- 2FFXSDWLRQVSHFL¿F DQDO\VLV RI PLJUDWLRQ DQG
UHPLWWDQFH EHKDYLRXU 3DFL¿F ,VODQG QXUVHV LQ
$XVWUDOLDDQG1HZ=HDODQGAsia Pac. Viewp. 47,
±
22. ICNM. International Nurse Migration and
Remittances. 2015,
23. Ammassari, S. & Black, R. Harnessing the
potential of migration and return to promote
development: applying concepts to West Africa.
,QWHUQDWLRQDO2UJDQL]DWLRQRI0LJUDWLRQ
24. Adzei, F. A. & Sakyi, E. K. Drivers of return
migration of Ghanaian health professionals:
Perspectives from doctors and nurses in urban
Ghana. Int. J. Migr. Heal. Soc. Care 10, 102–120

25. Arowolo, O. O. Return migration and the problem
of reintegration. Int. Migr. 38,±
26. Efendi, F. et al. Return migration of Indonesian
QXUVHV IURP -DSDQ :KHUH VKRXOG WKH\ JR" J.
Nurs. Educ. Pract. 3,S
/RUHQ]R)0(*DOYH]7DQ-,FDPLQD.
-DYLHU/1XUVHPLJUDWLRQIURPDVRXUFHFRXQWU\
perspective: Philippine country case study. Health
Serv. Res. 42,±
6PROLQHU 6 )|UVFKQHU 0 +RFKJHUQHU - 
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Trends in Central Europe. Re-Turn, Cent. Soc.
Innov. Vienna
'XVWPDQQ &  :HLVV < 5HWXUQ PLJUDWLRQ
theory and empirical evidence from the UK. Br. J.
Ind. Relations 45,±
30. ICN, FNIF & Burdett Trust for Nursing. The
Global Nursing Shortage: Priority Areas for
Intervention. 2014,
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Journal ArticleDOI
Anna Kurniati1, Ching Min Chen1, Ferry Efendi1, Ferry Efendi2  +1 moreInstitutions (3)
TL;DR: The lived experiences of nurse returnees experienced deskilling and struggled to re-enter the nursing profession or to find other non-nursing jobs when they got back to the country of origin.
Abstract: Aim: To illuminate the lived experiences of Indonesian nurses who previously worked as caregivers in Japanese residential care facilities, by exploring the journey of becoming returnees. Background: The creation of bilateral agreements between Indonesia and Japan has facilitated the movement of Indonesian nurses to work as caregivers in Japan since 2008. While this decision raised concerns with regard to the degradation of nursing skills, little is known about this issue from the perspective of nurse returnees and how the experience affects their life. Method: A hermeneutic phenomenological method was employed for this study. A purposive sample of 15 Indonesian nurse returnees participated in this study. Semi-structured interviews were conducted in four of Indonesia's provinces between August and October 2015. Data were analysed thematically, supported by QSR NVIVO 10 software. Findings: Four key themes emerged from the data analysis: (i) returning home; (ii) going back to zero; (iii) walking through a difficult journey; and (iv) overcoming barriers. These findings described the lived experiences of nurse returnees when they got back to the country of origin. Conclusion: Indonesian nurse returnees experienced deskilling and struggled to re-enter the nursing profession or to find other non-nursing jobs. The significant impact of this migration on individual nurses with regard to maximizing the benefits of return migration deserves further investigation. Implication for nursing and health policy: The Indonesian government, jointly with other stakeholders, should develop a brain gain strategy to align returnees� expertise with the needs of the national labour market. The public-private partnership should be strengthened to utilize returnees in healthcare services. © 2017 International Council of Nurses

24 citations


Cites background from "Return migration of nurses: a conce..."

  • ...Haour-Knipe & Davies (2008) emphasized the important role of government in developing such a mechanism....

    [...]

  • ...This is parallel with the global pattern of nurse migration in which returnees bring back financial, human and social capitals (Haour-Knipe & Davies 2008)....

    [...]


05 Jun 2019-
Abstract: Historically, international migration has been considered to be both unidirectional and permanent; however, return-migration is an emergent phenomenon that has been drawing more attention, particularly in healthcare. According to Efendi et al. the global migration of healthcare workers continues to increase, yet “there is increasing evidence showing that migrants are returning to their country of origin” (2018, p. 199), an observation that calls for further study. Return-migration has brought about tension for overseas Filipino nurses as they consider various conditions that motivate their return to the Philippines. This comparative case-study examined demographic variables and environmental conditions which influence the magnitude and direction of return migration for Filipino nurses employed in the North-America Sub-Group (U.S./Canada) and the Middle-East Sub-Group (KSA/UAE). Data from the annual Survey of Overseas Filipino Workers (SOF) was used to create a three-block logistic regression model to identify demographic variables that influence return migration. The models implied (1) that an older person was more likely to return; (2) the head of the household is more likely to return than the other members of the household; (3) a migrantworker deployed to the Middle-East Sub-Group is 2.4 times more likely to return than a migrantworker going to the North-America Sub-Group; (4) a migrant-worker who receives in-kind good is more like to return than the person who did not receive any goods; and (5) a migrant who received financial remittance is less likely to return. Although the logistic regression models are statistically significant, the models do not very accurately explain a nurse returning to the Philippines. Rather the models are much better at explaining why nurses do not return to the

9 citations


Cites background from "Return migration of nurses: a conce..."

  • ...29 Most countries “lack a system to track returnees;” however, “countries convey a message that there is a need of established tools to measure the return migration” (Efendi et al., 2018, p. 202)....

    [...]

  • ...…study of return- migration highlights an emergent phenomenon that differentiates international migration today from that of the previous century, where migration was assumed to be permanent and 2 unidirectional (Agunias, 2006; Dustmann & Weiss, 2007; Efendi et al., 2018; Iredale, 2001; Lee, 1966)....

    [...]

  • ...…for Filipino nurses employed in the United States (US), Canada, the Kingdom of Saudi Arabia (KSA), and the United Arab Emirates (UAE) (Castro-Palaganas et al., 2017; Cortés & Pan, 2012; Cortez, Del Rosario, & Diño, 2016; Efendi et al., 2018; Lorenzo, Galvez-Tan, Icamina, & Javier, 2007)....

    [...]


Journal ArticleDOI
31 Aug 2020-
Abstract: Introduction: Nurse turnover is a problem linked to low job satisfaction and organizational commitment; therefore, appropriate nurse retention strategy from nursing managers and human resource is needed. This study aims to explain the effects of job satisfaction and organizational commitment on nurse retention. Methods: This systematic review uses registration protocol from The Joanna Briggs Institute Guideline as a guide in the quality assessment of the summarized studies. Studies using the PICOS Framework were sourced from the following databases: Scopus, ScienceDirect, PubMed, EBSCOhost, JSTOR, SAGE, and ProQuest, published between 2010-2020, the study design was limited to cross-sectional, quasi-experiment, and randomized control trials. The feasibility study assessment used the Joanna Briggs Institute Critical Appraisal; the search keywords were adjusted according to the Medical Subject Headings and Boolean operators. The selection results are displayed in the PRISMA flow chart. Results: The initial search of the entire database found 8059 articles, then several duplication screenings of titles 30 articles were extracted. A feasibility assessment was carried out so that the remaining 25 articles were divided into two themes, namely job satisfaction and organizational commitment, each of which can affect nurse retention. According to this study, organizational commitment has a broader dimension of job satisfaction. Conclusion: Job satisfaction and organizational commitment have an influence on nurse retention; both are of concern for nurse managers to create effective nurse retention strategy.

2 citations


Cites background from "Return migration of nurses: a conce..."

  • ...One of the causes of nurse turnover is low nurse job satisfaction, triggering nurses to look for other work alternatives or moving workplaces to obtain satisfaction and comfort at work (Dotson, 2014; Efendi et al., 2018; Kovner, Brewer, Fatehi, & Jun, 2014; North et al., 2013; Osuji et al., 2014)....

    [...]


Journal ArticleDOI
Ferry Efendi1, Lisa McKenna2, Sonia Reisenhofer2, Anna Kurniati  +1 moreInstitutions (2)
Abstract: Background International migration of healthcare workers is a global phenomenon driven by growing demand in developed countries and expectations of healthcare workers from developing countries to have improved employment and lives. This migration has been understood to impact both the individuals and countries involved, with positive and negative consequences. However, little is known about returnees' experiences that could be used to address challenges and optimize benefits. The aim of this review was to understand what is known about experiences of migrant health workers after returning to their home countries. Methods A scoping review of primary research addressing experiences of migrant health workers upon their return to their homelands. A range of database were searched including Career and Technical Education Database via ProQuest, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Education database via ProQuest, Excerpta Medica Care (EMCare) via Ovid, Education Resources Information Center (ERIC), Excerpta Medica database (EMBASE) via Ovid, MEDLINE and Scopus. A systematic process was performed guided by the work of Arksey and O'Malley. Eight databases were searched and 226 articles were retrieved. After screening articles and abstracts, 15 full-texts were assessed for eligibility, and finally seven studies were further analyzed and synthesized. Results Five qualitative studies, one quantitative study and one mixed methods study met inclusion criteria. Five themes emerged: (1) reasons to return, (2) upskilling and deskilling, (3) impact on human, financial, and social capital, (4) challenges and opportunities in the home country, and (5) facilitation supports. Conclusion Return migration is portrayed as a complex situation experienced by returnees. Structured policy and supports are required to help healthcare worker returnees prepare, and to adjust to life after their return. This study highlights the importance of comprehensive approach in return migration stage. Return migration policy should support healthcare worker returnees in their home country and facilitate utilization of their skills. Multi-stakeholder partnerships are vital to develop platforms for helping and facilitating returnees in the reintegration process at their home countries.

Journal ArticleDOI
Abstract: Introduction: Pasung intervention of people with mental disorder still happened in the society. “Pasung Free Program” which has already designed in Indonesia since 2014 did not effective to wipe out Pasung behavior. There are still many people who are abused by Pasung behavior in Kulon Progo, Java Island, Indonesia with the various perception of society. The aims of this study examined the public perception of Pasung behavior in people with mental disorders. Method: This study used quantitative method by using symbolism interaction approach. There were 9 people who experienced pasung in their surroundings that became samples. Data was collected by using in-depth interviewing and socio-demographic questionnaire. Method that was used to analyze was analysis method such as 6 stages of Creswell analysis that was suitable with the used method. Result: The result of this study could become a theme. There were 8 themes came from two different perceptions. Perception of society resulted two themes namely 1) opinion about pasung behavior and 2) conclusion about pasung. External perception resulted six themes namely 1) the reason why pasung is allowed, 2) the reason why pasung is not acceptable, 3) pemasungan idea, 4) pemasungan method, 5) the society’s hope about people with mental disorder, and 6) the obstacle of health service. Conclusion: Society perception about mental disorder still not acceptable. Pasung program planning should be in line with free people with mental disorders program. The appearance of pasung behavior related to the increase of people with mental disorders.

References
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Journal ArticleDOI
14 Feb 2019-Radical Teacher
Abstract: In a senior seminar on Globalization, Human Rights, and Citizenship, this 1948 document surprises and attracts students with its broad, progressive vision

1,059 citations


Book Chapter
01 Jan 2001-

239 citations


Journal ArticleDOI
TL;DR: There is new interest in the Philippines in identifying ways to mitigate the costs to the health system of nurse emigration, and many of the policy options being debated involve collaboration with countries recruiting Filipino nurses.
Abstract: Objectives: To describe nurse migration patterns in the Philippines and their benefits and costs. Principal Findings: The Philippines is a job-scarce environment and even for those with jobs in the health care sector poor working conditions often motivate nurses to seek employment overseas. The country has also become dependent on labor migration to ease the tight domestic labor market. National opinion has generally focused on the improved quality of life for individual migrants and their families and on the benefits of remittances to the nation. However a shortage of highly skilled nurses and the massive retraining of physicians to become nurses elsewhere has created severe problems for the Filipino health system including the closure of many hospitals. As a result policymakers are debating the need for new policies to manage migration such that benefits are also returned to the educational institutions and hospitals that are producing the emigrant nurses. Conclusions and Recommendations: There is new interest in the Philippines in identifying ways to mitigate the costs to the health system of nurse emigration. Many of the policy options being debated involve collaboration with those countries recruiting Filipino nurses. Bilateral agreements are essential for managing migration in such a way that both sending and receiving countries derive benefit from the exchange. (authors)

221 citations


Journal ArticleDOI
Richard P. C. Brown1, John Connell2Institutions (2)
TL;DR: Key determinants of both present migration status and future migration intentions were analyzed using econometric methods, and nurses' and doctors' propensities to migrate are influenced by both income and non-income factors, including ownership of businesses and houses.
Abstract: Little is known of the structure of the international migration of skilled health professionals. Accelerated migration of doctors and nurses from the Pacific island states of Fiji, Samoa and Tonga to the Pacific periphery is part of the globalization of health care. The findings from a recent survey of 251 doctors and nurses from the three island countries are reported here. Key determinants of both present migration status and future migration intentions were analyzed using econometric methods. Nurses' and doctors' propensities to migrate are influenced by both income and non-income factors, including ownership of businesses and houses. Migrants also tend to have more close relatives overseas, to have trained there, and so experienced superior working conditions. Migration propensities vary between countries, and between nurses and doctors within countries. Tongan nurses have a higher propensity to migrate, mainly because of greater relative earnings differentials, but are also more likely to return home. The role of kinship ties, relative income differentials and working conditions is evident in other developing country contexts. Remittances and return migration, alongside business investment, bring some benefits to compensate for the skill drain. National development policies should focus on encouraging return migration, alongside retention and recruitment, but are unlikely to prevent out migration.

130 citations


Journal ArticleDOI
Elizabeth Thomas-Hope1Institutions (1)
TL;DR: Two factors have had an impact on return migration to Jamaica: 1) the characteristics of the migrants in terms of skill level, experience, and attitudes and 2) the social and economic condition of the country itself.
Abstract: Return migration to Jamaica is associated closely with the existence and nature of the transnational linkages established between migrants and their home country, especially at the level of the household and family. Remittances invariably precede, accompany and follow the actual return of migrants and comprise money as well as a range of consumer goods. Data on the number of returning migrants to Jamaica have been collected officially only since 1992; other information is derived from field studies. The figures show that the US is the source of most return migrants to Jamaica, with the United Kingdom second. Likewise, there are few official statistics on remittances, especially of those entering the country through informal channels. Nevertheless, data on the receipt of money through the Bank of Jamaica, indicate that during the 1990s remittances as a percentage of GDP exceeded that of the traditional foreign currency earners of bauxite and sugar. Growing awareness of the potential of the Jamaican overseas community has led the Government of Jamaica to establish programmes, including The Return of Talent programme, supported by the International Organization for Migration (IOM), to encourage the return of nationals. Different types of return migrants have the potential to make different kinds of contributions to national development – some through their skills, educational and professional experience, others through the financial capital which they transfer for investment or as retirement income. However, the most significant development potential of return lies in the social and economic conditions in Jamaica itself. If confidence levels are high, there will be little difficulty in attracting persons to return and financial transfers and investments will increase. Furthermore, the social and economic environment largely conditions the extent to which skills and talent as well as the financial capital are effectively utilized.

126 citations


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