Even though many scholars and educators argue that living wage guarantees meeting the basic needs of the employees, it is also evident that they continue seeking for other jobs due to the push and pull factors. Push factors include dangerous working conditions and crime. For example, many employees in the Arab countries have experienced crime (Nadeem, 2008). Furthermore, this is the reason why employees often choose to leave their country for fear of experiencing violent actions in the future. Therefore, they opt to move and work in more secure places (Connell, 2009).

Low salaries of the workers on living wage are another cause of moving abroad. The developed countries provide the foreign workers with much higher salaries (Gertner, 2006). Thus, it becomes clear, why the counties like Nigeria and India have become very popular among the doctors who are trained there and then exported to the international market. The low wages and unguaranteed employment cause insecurity among the employees on living wage. Because of the fact that the cost of living is constantly increasing, the workers are often unable to gain financial independency (Adams & Neumark, 2005). It often forces them to move to the countries, where they would be able to gain financial independence and even start a family.   

There is also a number of other job related dissatisfaction issues. For example, home countries offer a very high workload for a less pay. The health systems are dysfunctional and there are a lot of problems concerning the deprived professional standards, for instance, interacting with workmates or handling the patients. Make the matters worse, the rules that govern educational and professional advancement are unfair (Connell, 2009). As a result, there are many cases of nepotism in the recruitment programs, and the employees on living wage lack motivation. The home countries have very limited career options because of the underdeveloped systems and limited specialization (Adams & Neumark, 2005).

On the other hand, most of the pull factors oppose the push factors. For instance, employees on living wage would migrate because of higher salaries and in search of better social and economic structures in the foreign countries. It is exactly what they lack in their home countries (Gertner, 2006). Health professionals are also attracted to the top foreign countries because there are able to access a wider range of career options and professional development in order to advance their careers. Furthermore, it gives them satisfaction and hope for better lives. The foreign countries offer enough exposure to the skills, and training focuses more on the procedural skills. The trainees are able to access more responsibilities and get trained on a stick adherence to the set standards of care (Gertner, 2006).

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Developed countries have well defined job responsibilities, especially in the healthcare system, which presents better working conditions. They also have a regulated healthcare workload, and employees on living wage do not have to work under pressure. Workplace relationships are well managed and employees on living wage enjoy collegial relationships with each other.  There are also better reward systems that are set in place for dedicated and professional work of the employees. Regarding the working conditions, the foreign countries offer lighter workload and the employees on living wage work in the functional health systems with a better professional standard. In the institutions of higher learning, career advancements programs are based on the educational and research as well as teaching levels. The foreign nations, especially the developed ones, present a chance for a continuous medical education and a guaranteed job security (Nadeem, 2008). Other pull factors include good living standards, easy access and availability of information, better communication technology, security, and promise of better education for the children.

It should be noted that public sector depends on the private recruiting agents. However, the past research has found out that the private practice did not depend too much on those agencies. The studies showed that for the recruitment agencies do not actively carry out the processes of recruitment in the African countries, since they were at the lower end of development (Buchan, 2007).

Moreover, living wage can make employees migrate in search of good salaries, employment benefits, better work conditions, and wider career prospects (Aiken & Cheung, 2008). It can also make employees search for a system that meets international work standards and for a secure and stable job. In addition, people would aim at having a modern lifestyle with a better infrastructure or social amenities and a multi-cultural environment (Gertner, 2006).

In conclusion, the reasons for migration among the workers on living wage are mainly caused by the push factors, which involve issues of deficient career development opportunities, meager salaries, inequality with other workers and their imperceptions. The reasons for moving abroad vary according to the sector of employment. For instance, financial issues were the major factors causing the workers on living wage to leave the Middle East. While in the region of the European Union, continuing education and career prospects were the major factors influencing migration. Even though most of the workers on living wage, who had already left their countries, did not have the intents to return home, others indicated that both financial and non-financial enticements could encourage them to come back and practice at home. For example, many health practitioners reported that there are some factors that can encourage their stay in Oman or make them return home. As a result, the salaries would become higher, the work benefits would be improved, and the work and accomplishments would be appreciated by the management. Moreover, the workplace polices and environment as well as better social infrastructure and technology would be improved in order to gain better performance of the employees on living wage.  

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