The goal of this project was to remedy the lack of data on internal mobility patterns in LMICs by prospectively following a cohort of nurses in South Africa and gathering detailed information of their mobility patterns. The study sought to find out where they work, where they move to, when they move and the reasons for their mobility in order to generate insights towards effective policies and interventions.

The paper makes the following recommendations:

Implications for nursing policy and practice

• Effective supportive systems need to be introduced for newly qualified nurses to ensure that they are prepared for and supported in their professional role.
• Innovative strategies are needed to keep nurses in clinical nursing.
• The job satisfaction of rural and public sector nurses needs to be improved.
• Creating a more positive nursing practice environment should be an important priority.
• A combination of financial and non-financial HRH interventions is required to increase job satisfaction and retention of nurses.
• Strategies for promoting nurses’ resilience in the workplace are required.

Implications for nursing education

• Preferential selection of students from rural areas could increase rural retention.
• New training institutions may be better located in rural areas.
• Strategies to attract more dedicated nursing students are required.
• There is a need to find ways to promote and strengthen altruistic values during training.

Implications for information and research

• Better national HR information systems are required to monitor the distribution of health workers.
• Longitudinal HR data is more useful for tracking and understanding health worker movements over time; investment in studies of this nature is needed.