Home⇛Journal of Interdisciplinary Perspectives⇛vol. 3 no. 8 (2025)

Ideation Model for Healthcare Workforce Management in the Philippine Context

Jose C. Abantao, Jr. | Jose Marlon J. Refuncion Jr. | Marife M. Lacaba

Discipline: health studies

 

Abstract:

Global nurse migration remains a significant challenge, particularly for the Philippines, a leading exporter of nursing professionals. Despite this trend, there are limited empirical models to explain migration ideation across career stages. This study aimed to develop an Ideation Model for Healthcare Workforce Management by exploring and quantifying factors influencing migration ideation among overseas Filipino workers (OFW) nurses, local nurses, and nursing students. A sequential exploratory mixed-methods design was used. Phase 1 involved semi-structured interviews with 46 participants analyzed through the Futures Triangle framework. OFW nurses emphasized systemic failures, poor working conditions, and limited growth opportunities. Local nurses cited burnout, unsafe staffing, and stagnant salaries, while students shared aspirations shaped by mentors and global opportunities. Across all groups, persistent push-pull factors shaped ideation, with emotional and cultural ties delaying—but rarely deterring—migration. In Phase 2, a validated survey was administered to 151 respondents. Salary emerged as the most influential factor, with 88.7% rating it “highly influential.” Career advancement (82.1%) and working conditions (79.5%) were the next most important factors. Spearman’s rho showed significant correlations between migration ideation and income (ρ = .548, p < .001), employment status (ρ = –.421, p < .01), and years in service (ρ = .368, p < .05). Female respondents were more likely to cite inadequate salary, limited career pathways, and weak institutional support as motivations. Younger nurses and students expressed stronger ideation, driven by fewer family responsibilities and higher aspirations. Meanwhile, seasoned nurses indicated ideation influenced more by family needs and less by financial factors, suggesting adaptation or established support systems. These findings highlight the need for gender-responsive, career-enabling, and retention-focused policies. The proposed Ideation Model integrates personal, institutional, and policy-level determinants, offering a strategic framework to address workforce attrition and guide long-term health human resource planning in the Philippines.



References:

  1.  Abarcar, P., & Theoharides, C. (2020). The effects of temporary migration on native wages and labor supply: Evidence from the Philippines. American Economic Journal: Applied Economics, 12(1), 1–27. 
  2. Adhikari, R., & Melia, K. M. (2015). The (mis) management of migrant nurses in the UK: a sociological study. Journal of nursing management, 23(3), 359-367.  https://doi.org/10.1111/jonm.12141
  3. Alam, M. M., Sultana, M., & Huq, M. (2014). Factors influencing the migration of healthcare professionals from developing countries: A review. International Journal of Public Health Science, 3(2), 113–124.
  4. Alibudbud, R. (2022). The impact of nurse migration on the Philippines' healthcare system. Journal of Global Health, 12(1), 45–56.
  5. Alibudbud, R. (2023). Addressing the Burnout and Shortage of Nurses in the Philippines. SAGE Open Nursing, 9, 23779608231195737. https://doi.org/10.1177/23779608231195737
  6. Baral, R., & Sapkota, S. (2015). Factors influencing migration among Nepalese nurses. Journal of Chitwan Medical College, 5, 25-29. https://doi.org/10.3126/JCMC.V5I2.13151
  7. Bernardo, M. A., & Santos, R. J. (2024). Economic and Professional Drivers of Nurse Migration: A Philippine Perspective. Journal of Global Health Workforce, 12(1), 45–60. 
  8. Bourgeault, I. L., Vivien Runnels, V., Atanackovic, J. (2020). Hiding in plain sight: Gendered dimensions of health worker migration from ‘Source’ country perspectives. https://doi.org/10.21203/rs.3.rs-27542/v1 
  9. Brush, B. L., Sochalski, J., & Berger, A. M. (2004). Imported care: Recruiting foreign nurses to U.S. health care facilities. Health Affairs, 23(3), 78–87. https://doi.org/10.1377/hlthaff.23.3.78
  10. Brush, B. L., & Sochalski, J. (2007). International nurse migration: Lessons from the Philippines. Policy, Politics, & Nursing Practice, 8(3), 37S–46S. 
  11. Buchan, J., Parkin, T., & Sochalski, J. (2003). International nurse mobility: Trends and policy implications. World Health Organization
  12. Castles, S., de Haas, H., & Miller, M. J. (2014). The Age of Migration: International Population Movements in the Modern World. Palgrave Macmillan.
  13. Castro-Palaganas, E., Spitzer, D. L., Kabamalan, M. M. M., Sanchez, M. C., Caricativo, R., Runnels, V., ... & Bourgeault, I. L. (2017). An examination of the causes, consequences, and policy responses to the migration of highly trained health personnel from the Philippines: the high cost of living/leaving—a mixed method study. Human resources for health, 15, 1-14. https://doi.org/10.1186/s12960-017-0198-z 
  14. Cherry, S. M. (2022). Importing Care, Faithful Service: Filipino and Indian American Nurses at a Veterans Hospital. Rutgers University Press.
  15. Cohen, J. H., & Sirkeci, I. (2021). Cultures of Migration: The Social Dynamics of Migration Aspirations. Comparative Migration Studies, 9(1), 4. 
  16. Cottle-Quinn, A., Tower, M., & Eley, R. (2022). Factors that impact Australian early career nurses' intentions to remain in their position and the profession: A prospective cohort study. Journal of Nursing Management, 30(7), 3419–3429. https://doi.org/10.1111/jonm.13803
  17. Creswell, J. W., & Plano Clark, V. L. (2018). Designing and conducting mixed methods research. Thousand Oaks, CA: SAGE.
  18. de Haas, H. (2010). The internal dynamics of migration processes: A theoretical inquiry. Journal of Ethnic and Migration Studies, 36(10), 1587–1617. https://doi.org/10.1080/1369183X.2010.489361
  19. Duffy, J. R. (2022). Quality caring in nursing and health systems: Implications for clinicians, educators, and leaders (3rd ed.). Springer Publishing Company.
  20. Eugenio, L. J. (2024). The mass emigration of Filipino nurses to the United States. Harvard International Review. https://tinyurl.com/msvbj43c 
  21. Henriksen, H. (2022). Understanding ideation: Cognitive and emotional precursors in decision-making processes. Journal of Mental Health and Migration Studies, 14(2), 85–97. 
  22. Hospital Management Asia. (2024). Tackling the ‘nursing exodus’ in the Philippines. https://tinyurl.com/bdhbtsks 
  23. Inayatullah, S. (2008). Six pillars: Futures thinking for transforming. Foresight, 10(1), 4–21.
  24. Kingma, M. (2018). Nurses on the move: Migration and the global health care economy. Cornell University Press.
  25. Kingma, M., (2008) "Nurses on the Move: Historical Perspective and Current Issues" OJIN: The Online Journal of Issues in Nursing. Volumn 13, No 2, Manuscript 1.
  26. Kingma, M. (2006). Nurses on the move: Migration and the global health care economy. Cornell University Press. • Likupe, G. (2015). Experiences of African nurses and the perception of their managers in the NHS. Journal of Nursing Management, 23(2), 231–241. 
  27. Kirkpatrick, D. L., & Kirkpatrick, J. D. (2006). Evaluating Training Programs: The Four Levels. Berrett-Koehler Publishers.
  28. Konlan, K. D., Kombian, S. B., Aarah-Bapuah, M., & Doat, A. R. (2023). Push and pull factors influencing migration intentions of nurses in Northern Ghana. BMC Nursing, 22, Article 15. 
  29. Labrague, L. J., McEnroe-Petitte, D. M., & Leocadio, M. C. (2019). Factors influencing on career decision-making among nursing students: A cross-sectional study. Journal of Nursing Education and Practice, 9(7), 90–96. 
  30. Lange, B., Dijkstra, A., & van der Linden, D. (2019). Career mobility and migration: A longitudinal analysis of nurses' employment patterns. Journal of Nursing Management, 27(4), 839-848. 
  31. Lange, T., Ott, M., & Mackey, S. (2019). Institutional support and career intent in nursing students: A cross-sectional study. Nurse Education Today, 79, 79–84. 
  32. Laslett, P. (1991). A fresh map of life: The emergence of the Third Age. Harvard University Press.
  33. Lawshe, C. H. (1975). A quantitative approach to content validity. Personnel Psychology, 28(4), 563–575. https://doi.org/10.1111/j.1744-6570.1975.tb01393.x 
  34. Lee, E. S. (1966). A theory of migration. Demography, 3(1), 47–57. https://doi.org/10.2307/2060063
  35. Li, H., Nie, W., & Li, J. (2017). The benefits and caveats of international nurse migration. International Journal of Nursing Sciences, 4(3), 317–320. 
  36. Li, H., Nie, W., & Li, J. (2014). The roles of collectivism in motivating nurses’ international migration: A study of Filipino and Chinese nurses. International Journal of Nursing Studies, 51(4), 604–613. 
  37. Likupe, G. (2015). Migration of nurses: A literature review. Journal of Nursing and Health Science, 4(1), 1–6.
  38. Lorenzo, F. M. E., Galvez-Tan, J., Icamina, K., & Javier, L. (2007). Nurse migration from a source country perspective: Philippine country case study. Health Services Research, 42(3), 1406–1418.
  39. Meadus, R. J., & Twomey, J. C. (2011). Men student nurses: The nursing education experience. Nursing Forum, 46(4), 269–279. https://doi.org/10.1111/j.1744-6198.2011.00239.x
  40. Ortiga, Y. Y. (2018). Emigration, employability, and higher education in the Philippines. Routledge.
  41. Ortiga, Y. Y., & Macabasag, R. L. A. (2021). Understanding international immobility through internal migration:“Left behind” nurses in the Philippines. International Migration Review, 55(2), 460-481.
  42. Palinkas, L. A., Horwitz, S. M., Green, C. A., Wisdom, J. P., Duan, N., & Hoagwood, K. (2015). Purposeful sampling for qualitative data collection and analysis in mixed method implementation research. Administration and Policy in Mental Health and Mental Health Services Research, 42(5), 533–544. https://doi.org/10.1007/s10488-013-0528-y 
  43. Park B., Kim SY. (2017). Patterns and Influential Factors of Inter-Regional Migration of New and Experienced Nurses in 2011~2015. J Korean Acad Nurs ;47(5):676-688. https://doi.org/10.4040/jkan.2017.47.5.676
  44. Park, Y., & Kim, Y. (2017). Predictors of migration intentions among nurses: The role of professional experience and working conditions. Journal of Nursing Management, 25(4), 342-348.
  45. Peña-Alfaro, B. S., & Torres Díaz, N. V. (2024). Intention, Motivations, and Barriers to Emigration of Nursing Students in Colombia. Investigación y Educación en Enfermería, 42(3).
  46. Pressley, C., Newton, D., Garside, J., Simkhada, P., & Simkhada, B. (2022). Global migration and factors that support acculturation and retention of international nurses: A systematic review. International Journal of Nursing Studies Advances, 4, 100083. https://doi.org/10.1016/j.ijnsa.2022.100083
  47. Robredo, J. P. G., Ong, B., Eala, M. A. B., & Naguit, R. J. (2022). Outmigration and unequal distribution of Filipino physicians and nurses: An urgent call for investment in health human resource and systemic reform. The Lancet Regional Health – Western Pacific, 25, 100512. https://doi.org/10.1016/j.lanwpc.2022.100512
  48. Salmon, M. E., Yan, J., Hewitt, H., & Guisinger, V. (2007). Managed migration: The Caribbean approach to addressing nursing services capacity. Health Services Research, 42(3p2), 1354–1372. 
  49. Shah, M., Gandhvi, D., & Ameen, R. (2020). Professional growth and international migration of nurses: A qualitative perspective. Journal of Nursing Management, 28(2), 210–219. 
  50. Shah, J., Ahmar, A. S., & Saleem, F. (2020). Professional dissatisfaction and migration intentions among nurses in developing countries. Journal of Health Management, 22(4), 541–553.
  51. Singh, A. S., & Masuku, M. B. (2014). Sampling techniques & determination of sample size in applied statistics research: An overview. International Journal of Economics, Commerce and Management, 2(11), 1–22.
  52. Siow, E.K., & Ng, J.S. (2013). Internal migration of nurses in the United States: migratory prompts and difference in job satisfaction between migrants and non-migrants. Nursing economic$, 31 3, 128-36.
  53. Shields, M. A., & Ward, M. (2001). Improving nurse retention in the National Health Service in England: The impact of job satisfaction on intentions to quit. Journal of Health Economics, 20(5), 677–701. https://doi.org/10.1016/S0167-6296(01)00092-3
  54. Theoharides, C. (2018). Manila to Malaysia: Brain drain, education, and wage gains. Journal of Human Resources, 53(2), 313–346. 
  55. World Health Organization. (2020). State of the world's nursing 2020: Investing in education, jobs and leadership. https://www.who.int/publications/i/item/9789240003279
  56. World Health Organization. (2024). Health workforce migration. World Health Organization. https://www.who.int/teams/health-workforce/migration
  57. Xu, Y., & Kwak, C. (2005). A comparative study of domestic and international nurses’ intent to leave. Journal of Nursing Scholarship, 37(2), 147–154. 
  58. Yin, R. K. (2018). Case study research and applications: Design and methods (6th ed.). SAGE Publications

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