INFLUENCE OF HUMAN RESOURCE STANDARDS AND SOCIO-COGNITIVE FACTORS ON THE INTENTION TO EMIGRATE AMONG NURSES WORKING IN NAKURU WEST SUB-COUNTY, KENYA

Abstract

Nurse emigration is a growing challenge in Kenya, attributed to deficits in Human resource standards. This high level of emigration imposes additional costs on the government and taxpayers due to repeated training cycles and disrupts the delivery of quality healthcare services. Beyond HR-related factors, demographic, psychological, and psychosocial dimensions also play a critical role. Understanding these factors alongside HR standards is essential to improving healthcare delivery and workforce stability. This study addressed key research gaps by investigating nurses' intention to emigrate within the context of Kenya's devolved health system and the evolving healthcare landscape. In a recent estimate, Kenya accounted for 6.5% of all nurses who had applied to emigrate to the USA for work contracts. This study was carried out on a sample of 150 nurses employed across 17 health facilities in Nakuru West Sub-County. Guided by the Social Exchange and Social Cognitive theories, the study adopted a cross-sectional design to explore the effects of Human resource standards and socio-cognitive factors on the intention to emigrate among Nurses working in Nakuru West Sub-County. Data were analysed using descriptive and inferential statistics, including multiple regression models and correlation analyses. Results revealed that 80.7% (121/150) of nurses intend to emigrate, with 74.7% (112/150) already enrolled in the emigration processes. The United States, at 66% (99/150), was the most preferred destination, followed by the United Kingdom at 18.7% (28/150), Australia at 10.7% (16/150), and Canada at 4.7% (7/150). Socio-cognitive factors significantly predicted emigration intention: motivation (β = 0.353, p < .05), attention (β = 0.346, p < .05), and self-efficacy (β = 0.348, p < .05) at the 95 % confidence level. These variables explained a substantial portion of the variance in emigration intention, underscoring their predictive strength. Human resource standards were found significantly associated with intention to emigrate including key predictors as recruitment fairness (β = –0.354, p < .05), remuneration adequacy (β = –0.335, p < .05), career development opportunities (β = –0.333, p < .05), and organisational transparency (β = –0.326, p < .05) at a confidence level of 95 %. Nurses who perceived deficits in these areas were more likely to consider emigration. Correlation analysis confirmed a significant negative relationship between HR standards and Intention to emigrate (r = –0.326 to –0.354, p < .05), and a positive correlation between socio-cognitive factors and Intention to emigrate (r = 0.315 to 0.353, p < .05). The findings of this study highlighted the urgent need to address both structural and cognitive determinants of nurse intentions to emigrate. Enhancing motivation, building self-efficacy, and fostering supportive work environments to improve a work-life balance are critical to reducing intention to emigrate. To achieve the long-term development health targets outlined in Kenya's Vision 2030, which is embedded in the overarching goal of providing equitable, affordable, and quality healthcare to all citizens, it is imperative to implement comprehensive retention strategies for the Nursing workforce. These should include both financial incentives and career development and advancement opportunities to counteract the strong pull of international job markets. Moreover, interventions aimed at improving the situation with nurses should consider the individual circumstances of nurses at various career stages, notably younger and mid-level nurses, who are most prone to succumb to peer pressure regarding integration and overseas outcome expectations.