Policy Determinants of Nurse Workforce Retention and Migration in the Middle East and North Africa (MENA): A Mixed-Methods Policy Analysis (2000–2025)

This study, conducted by Dr. Fernan N. Torreno (St. Paul University Manila) and Famiela N. Torreno, LPT, MEd (Universidad de Dagupan), examines the policy and organizational determinants of nurse retention and migration across 18 Middle East and North Africa (MENA) countries between 2000 and 2025. Using a mixed-methods policy analysis, the research integrates quantitative workforce indicators and qualitative stakeholder perspectives guided by a Policy Determinants Framework adapted from Walt and Gilson.

Thirty empirical and policy studies were systematically synthesized following PRISMA 2020 and ENTREQ standards, complemented by 20 anonymized stakeholder interviews. The analysis identified governance quality, wage parity, professional autonomy, and education investment as the strongest predictors of retention. A cross-regional comparison between GCC and non-GCC countries revealed that governance coherence and salary parity drive sustained localization and workforce stability.

The findings provide actionable insights for policymakers, emphasizing the creation of national nursing councils, equitable pay systems, and continuing-education pathways. The study contributes to global health-policy reform by proposing a regional roadmap for achieving sustainable nurse retention and ethical workforce mobility across low- and middle-income contexts.

本研究由马尼拉圣保罗大学Fernan N. Torreno博士与达古潘大学Famiela N. Torreno（持照专业教师（Licensed Professional Teacher, LPT）、教育学硕士（Master of Education, MEd））共同开展，聚焦2000—2025年期间18个中东与北非（Middle East and North Africa, MENA）国家的护士留存与移民现象的政策及组织决定因素。本研究采用混合方法政策分析框架，整合了基于Walt与Gilson改编的政策决定因素框架（Policy Determinants Framework）所指引的量化劳动力指标与质性利益相关者视角。

本研究遵循PRISMA 2020与ENTREQ标准，对30项实证研究与政策研究开展系统综合，并辅以20份匿名化利益相关者访谈。分析结果显示，治理质量、薪酬均等、职业自主权与教育投入是影响护士留存的最强预测因子。针对海湾合作委员会（Gulf Cooperation Council, GCC）与非GCC国家开展的跨区域比较表明，治理连贯性与薪酬均等性可推动持续的本土化进程与劳动力稳定性。

本研究结果为政策制定者提供了可落地的实践启示，强调需建立国家护理委员会、构建公平薪酬体系与完善继续教育路径。本研究通过提出面向中低收入地区的护士可持续留存与合乎伦理的劳动力流动区域路线图，为全球卫生政策改革贡献了有益支撑。