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

Abstract

BackgroundPrecarization 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.MethodsA 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.ResultsFour 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.ConclusionsThroughout 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.

Regulación de la enfermería en México: actores, procesos y resultados

“…However, in 2018, nursing technicians accounted for 47.6% of the market and were still a majority 21 . The increasing trend of university nurses is also confirmed with data from the ENOE 22 . On the other hand, the type of contract varies across institutions.…”

Violence against female health workers is tip of iceberg of gender power imbalances

“…22 In contrast, in Mexico the increasing numbers of trained health workers and a restrictive policy of permanent positions in the public sector make it more difficult for nurses to get and maintain jobs. 23 Female nurses may therefore fear the ramifications of reporting workplace violence.…”

“…In countries with low ratios of health workers to patients, such as Pakistan, the high demand for their skills means women find it easier to switch jobs than report victimisation 22. In contrast, in Mexico the increasing numbers of trained health workers and a restrictive policy of permanent positions in the public sector make it more difficult for nurses to get and maintain jobs 23. Female nurses may therefore fear the ramifications of reporting workplace violence.…”

De autonomia roubada ao fortalecimento da profissão: conexões entre Enfermagem Brasileira e Africana

“…In that country, there was an increase of 8.6% in admissions of nurses without a contract, 53.4% with low salaries and another part of this population is working underemployed. 18 On the other hand, interprofessional integration in health teams occurs in some countries. A study carried out with nurses from England revealed that some nurses are able to exercise their autonomy through teamwork, in their daily practices sharing their knowledge and skills.…”