A case study of the professionalization of Mexican nursing: 1980 to 2005

Abstract

The study of the evolution of a healthcare profession in a developing country context has many implications not only for healthcare human resources policy structuring, but also fur health and development outcomes. With the global shortage of nursing personnel, understanding the country-specific factors involved in the recruitment and retention of nurses into the profession becomes critical for ensurin ongoing, quality health care services delivery. Using theories about professions, an examination of the process of the professionalization of nurses is one way to improve understanding about nursing human resources. Professionalization is a developmental process that structures how a group organizes to advance itself socially, politically, and economically in a country. Mexico is an economically high-middle income country with an established but underdeveloped nursing profession. This exploratory case study examined the professionalization of nursing in Mexico between 1980 and 2005 with the aim of improving understanding about Mexican nursing human resources. The twenty-five year period was selected because it represented a period of significant economic and political change in Mexico that would have impacted Mexican nurses both personally and professionally. Methods included semi-structured interviews with 32 Mexican nurses from both rural and urban healthcare settings, an extensive interdisciplinary literature review from the designated period, and a contextual analysis of Mexican federal government and Ministry of Health documents related to nursing human resources. Study findings indicate that eight variables strongly affect the development of the nursing profession: professionalization processes, the workplace, unions, history, economic, political, sociocultural factors, and international influences. The relationships among the variables suggest the presence of a country-level "nursing system" that produces nursing personnel and affects health-system outcomes. To illustrate the relationships and potential effects on these outcomes, a theoretical model was developed. The findings of this study have implications for the production, development, and management of nursing human resources in other developing countries and may also apply to nursing in developed countries.