Health Workers’ Migration Intentions: Causes and Implications in Nepal

Abstract

Despite substantial public investment in health professional education, Nepal continues to experience persistent emigration of skilled health workers. This study examines the key push and pull factors shaping Nepali health workers’ intentions to emigrate and assesses the perceived impact of this migration on the domestic healthcare system. Drawing on primary data collected from 64 health workers in Kathmandu and employing a descriptive qualitative approach, the findings identify inadequate wages relative to living costs, limited career advancement opportunities, political instability, lack of job security, and unfair recruitment practices as major push factors. Key pull factors include higher remuneration, improved working conditions, access to advanced medical technologies, a quality of life, and expectations of greater job security in destination countries. The out-migration of health workers has exacerbated staffing shortages, increased workloads, delayed service delivery, and contributed to a decline in the quality of care. The ongoing brain drain threatens progress towards universal health coverage. Without targeted interventions, Nepal may continue to struggle to retain skilled healthcare workers and ensure equitable healthcare access for all citizens. The study highlights the need for competitive compensation, improved working conditions, and transparent career pathways to strengthen health worker retention in Nepal.