Top

Human Resources for Health

Published in:

Open Access 01-12-2019 | Care | Research

The precarization of the Mexican nursing labor market: a repeated cross-sectional analysis for the period 2005–2018

Authors: Patricia Aristizabal, Gustavo Nigenda, Edson Serván-Mori

Published in: Human Resources for Health | Issue 1/2019

Abstract

Background

Precarization of labor conditions has been expanding over the last three decades as a consequence of global economic transformations. The health workforce labor market is exposed to these transformations as well. In Mexico, analyses of the nursing labor market have documented high levels of unemployment and underemployment; however, precarization has been not considered as a relevant indicator in these analyses. In this study, precarization is analyzed using a quantitative approach to show its prevalence and geographic distribution between 2005 and 2018.

Methods

A repeated cross-sectional study was carried out with data from the population-based National Occupation and Employment Survey (ENOE in Spanish) which is administered quarterly to people 15 years or older in over 120 000 households. All individuals who reported having nursing training (technical or university level) were selected for this study. Our main variable was labor precariousness, which included three dimensions: (i) economic, (ii) regulatory, and (iii) occupational safety. We show the evolution of the relative weight of nursing activity between the years 2005 and 2018, the main socio-demographic characteristics of nurses as well as their main labor conditions, and the geographic distribution of precariousness for the 32 federal states in México.

Results

Four of the five indicators of labor precariousness increased among the group of nurses analyzed: (a) the percentage of people with no written contract, (b) the percentage of people with incomes lower than two times the minimum wage, (c) the percentage of nurses without social security, and (d) the percentage of nurses without social benefits. The percentage of nurses that work under some condition of work precariousness increased from 46% in 2005–2006 to 54% in 2018. Finally, the number of states with high precariousness level increased from seven in 2005–2006 to 17 in 2018.

Conclusions

Throughout Mexico, nursing precariousness has expanded reaching 53% by 2018. The advancement of precarization of nursing jobs implies a reduction in the capacity of the Mexican health system to reach its coverage and care goals as nurses represent 52% of all available workers that provide direct services to the population.

Anaya R, et al. Cobertura Universal en Salud: lecciones internacionales aprendidas y elementos para su consolidación en México. México: OPS/OMS; 2013. p. 16–336. Available at: http://bit.ly/2DnlaAH

WHO. World Health Report 2010. Health systems financing. Path to universal coverage. Geneva: WHO; 2010. [Consultado 11 enero 2018]. Available at: http://bit.ly/1jt45Xr

The Lancet Editorial. Mexico: celebrating universal health coverage. 2012. http:/dx.doi.org/10.1016/S0140-6736(12)61342-7.

Nigenda G, Ruiz JA, Martínez-Aguilar EM, Bejarano-Arias RM. Regularización laboral de trabajadores de la salud pagados con recursos del Seguro Popular de Salud. Salud Publica Mex. 2012a;54:616–23 Available at: saludpublica.mx/index.php/spm/article/view/7177.CrossRef

Nigenda G, Ruiz-Larios JA. Editores. Formación, empleo y regularización de los recursos humanos para la salud. Bases para su planeación estratégica. México; 2010 [consulted on 2018 Nov 13]. Available at: https://bit.ly/2WCyk78.

OCDE (2015), Estudios económicos de la OCDE: México 2015, OECD Publishing. [consulted on 2018 Jul 12]. Available at: https://bit.ly/1BPzeQv.CrossRef

Instituto Nacional de Salud Pública (INSP). Brechas en la disponibilidad de recursos humanos para la salud en el primer nivel de atención. [Gaps in the availability of human resources for health in the first level of care]. Cuernavaca; 2015. p. 157. [consulted on Feb 15, 2019]. Available at: https://bit.ly/2QQ1FbC

Nigenda G, Ruiz JA, Rosales Y, Bejarano R. Enfermeras con licenciatura en México: estimación de los niveles de deserción escolar y desperdicio laboral. Salud Publica Mex. 2006;48(1):22–9 [consulted on 2018 Jul 1]. Available at: https://bit.ly/2ZtNkpc.CrossRef

Bimbaum S. Equality of opportunity and the precarization of labour markets. Eur J Pol Theory. 2017. https://doi.org/10.1177/1474885117738116.

10.

Kalleberg AL. Flexible firms and labor market segmentation: effects of workplace restructuring on jobs and workers. Work Occup. 2003;30:154 [consulted on 2018 Jul 3]. Available at: https://bit.ly/2ID4PNM.CrossRef

11.

García B. Los mercados de trabajo urbanos en México a principios del Siglo XXI. Rev Mex Sociol. 2009;71(1):05–46 [citado 2018 Jul 17] [consulted on 2018 Jul 1]. Available at: https://bit.ly/2GjzjRZ.

12.

De Oliveira O. Jóvenes y precariedad laboral en México. Papeles Población. 2006;12(49):37–73 [consulted on 2019 Jul 23]. Available at: https://bit.ly/2AnT5ZO.

13.

Martínez K, Marroquín J, Ríos H. Precarización laboral y pobreza en México. Análisis Económico. 2019;34(86):113–31.CrossRef

14.

Martinez J. El sector informal en México. El cotidiano. 2005;(130):31–45 [consulted on 2019 Jul 21]. Available at: https://bit.ly/32WHePS.

15.

Román Y, Ovando W. Flexibilidad laboral de la población ocupada: un análisis espacial en México, 2005 y 2014. Soc Econ. 2016;(31):193–213 [consulted on 2019 Jul 23]. Available at: https://bit.ly/2Yf0n0z.

16.

Buerhaus P, Skinner L, Auerbach D, Staiger D. Four challenges facing the nursing workforce in the United States. J Nurs Regul. 2017;8(2):40–6 [consulted on 2018 May 01]. Available at: https://bit.ly/2HoYOTK.CrossRef

17.

Román-Sanchez Y. Impactos sociodemográficos y económicos en la precariedad laboral de los jóvenes en México. Región Sociedad. 2013;25(58):165–202 [consulted on 2019 Jan 22]. Available at: https://bit.ly/2D9aPNg.

18.

Torres BS, Zambrano L, et al. Rev Enferm Inst Méx Seguro Soc. 2010;18(2):105–10 [consulted on 2018 Oct 12]. Available at: https://bit.ly/2Ph6iKQ.

19.

Pavlin S. Should higher education institutions worry about the precarisation of professional work? ANNALES Ser Hist Soc. 2018;28(4):853–61 [consulted on 2019 Jan 22]. Available at: https://bit.ly/2UKmASz.

20.

Diana-Menéndez N. La múltiple dimensión de la precariedad laboral: el caso de la administración pública en Argentina. Rev Cienc Soc. 2010;128(129):119–36 [consulted on 2019 Jan 22]. Available at: https://bit.ly/2UI2wAa.

21.

Escamilla CSN, Córdoba AMA. Los hombres en la Enfermería. Análisis de sus circunstancias actuales. Rev CONAMED. 2011;16(Supl 1):S28–33 [consulted on 2018 Nov 12]. Available at: https://bit.ly/2EDvPXX.

22.

Osses PC, Valenzuela SS, Sanhueza AO. Hombres en la enfermería profesional. Enferm Glob. 2010;(18) [consulted on 2019 Feb 20]. Available at: https://bit.ly/2Zl2IE0.

23.

Aspiazu E. Las condiciones laborales de las y los enfermeros en Argentina: entre la profesionalización y la precariedad del cuidado en la salud. Trab Soc. 2017;(28):11–35 [consulted on 2018 Nov 10]. Available at: https://bit.ly/2XlkGEM.

24.

Wilson B, Butler M, Butler R, Johnson W. Nursing gender pay differencials in the new millennium. J Nurs Scholarsh. 2018;50(1):102–8. https://doi.org/10.1111/jnu.12356.CrossRefPubMed

25.

Muench U, Dietrich H. The male-female earnings gap for nurses in Germany: a pooled cross-sectional study of the years 2006 and 2012. Int J Nurs Stud. 2019;89:125–31. https://doi.org/10.1016/j.ijnurstu.2017.07.006 Epub 2017 Jul 14.CrossRefPubMed

26.

Ugalde A and Homedes N. Las reformas neoliberales del sector de la salud: deficit gerencial y alienación del recurso humano en América Latina. Rev Panam Salud Publica / Pan Am J Public Health. 2005:17(3);202.

27.

Bloomrosen M, Starren J, Lorenzi N, Ash JS, Patel VL, Shortliffe EH. Anticipating and addressing the unintended consequences of health IT and policy: a report from the AMIA 2009 Health Policy Meeting. J Am Med Inform Assoc. 2011;18:82–90 [consulted on 2018 Nov 13]. Available at: https://bit.ly/2UvNI2t.CrossRef

28.

Chace, Meredith Joy. 2012. Evaluating intended and unintended consequences of health policy and regulation in vulnerable populations. Doctoral dissertation, Harvard University. [consulted on 2019 Jan 30]. Available at: https://bit.ly/2IuLa3h.

29.

Progianti JM, de Melo PMN, Amaral Plata J, Cardoso VML, Andrade AT, da Muniz CVO. Precarizacao do trabalho da enfermeira obstétrica. Rev Enferm UERJ. 2018;26:e33846 [consulted on 2019 Jan 30]. Available at: https://bit.ly/2Va5SLD.CrossRef

30.

Van Wezel SK. Flexibilization, globalization and privatization: three challenges to labor rights in our time. Osgood Hall Law J Fall. 2005; UCLA school of law research paper no. 05-19. Available at SSRN: https://ssm.com/abstract=781249.

31.

Martins MIC, Molinaro A. Reestruturação produtiva e seu impacto nas relações de trabalho nos serviços públicos de saúde no Brasil. Cien Saude Colet. 2013;18(6):1667–76 [consulted on 2018 Jul 1]. Available from: https://bit.ly/2XjTfez.CrossRef

32.

Gómez-Frode C. The health system in Mexico. Revista CONAMED. 2017;22(3) [Consulted on July 31, 2019] Available at: https://dialnet.unirioja.es/descarga/articulo/6434801.pdf.

33.

Díaz-Portillo SP, Reyes-Morales S, Cuadra-Hernández SM, Idrovo AJ, Nigenda G, Dreser A. Working conditions in outpatients clinics adjacent to private pharmacies in Mexico City: perspective of physicians. Gac Sanit. 2017;31(6):459–65.CrossRef

34.

Polo CFH, Zeitoune GR, Luz LMT, Vásquez CN. EL fenómeno de la tercerización del trabajo y su repercusión en la salud del trabajador de salud. In Crescendo. 2017;8(1):149–64 [consulted on 2018 Jul 1]. Available from: https://bit.ly/2UsoDpj.

35.

Benach J, Vives A, Tarafa G, Delclos C, Muntaner C. What should we know about precarious employment and health in 2025? Framing the agenda for the next decade of research. Int J Epidemiol. 2016:232–8 [consulted on 2019 Feb 10]. Available at: https://bit.ly/2UFC2PI.CrossRef

36.

OPS/OMS. Cobertura Universal en Salud: Lecciones Internacionales Aprendidas y Elementos para su Consolidación en México. México: OPS; 2013. [consulted on 2019 Jan 02]. Available from: https://bit.ly/2HsSxGV

Title: The precarization of the Mexican nursing labor market: a repeated cross-sectional analysis for the period 2005–2018
Authors: Patricia Aristizabal
Gustavo Nigenda
Edson Serván-Mori
Publication date: 01-12-2019
Publisher: BioMed Central
Keyword: Care
Published in: Human Resources for Health / Issue 1/2019
Electronic ISSN: 1478-4491
DOI: https://doi.org/10.1186/s12960-019-0417-x

Keynote webinar | Spotlight on medication adherence

Springer Medicine

The precarization of the Mexican nursing labor market: a repeated cross-sectional analysis for the period 2005–2018

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 1/2019

Medical diaspora: an underused entity in low- and middle-income countries’ health system development

The impacts of training pathways and experiences during intern year on doctor emigration from Ireland

Setting the global research agenda for community health systems: literature and consultative review

Nurse prescribing of medicines in 13 European countries

Pre- and in-service training of health care workers on immunization data management in LMICs: a scoping review

Does the Diabetes Specialist Nursing workforce impact the experiences and outcomes of people with diabetes? A hermeneutic review of the evidence