`This is our country and somehow, we have to make it work’: a sequential explanatory mixed-methods study of the enablers of non-migration and return migration in a cohort of Nigerian medical doctors and dentists
University of Medical Sciences, Ondo, and the MRC Unit The Gambia at the London School of Hygiene & Tropical Medicine
How they used Delve
A 21-author team led from Nigerian medical schools with the London School of Hygiene & Tropical Medicine and Dartmouth used Delve to thematically code 50 key informant interviews with Nigerian doctors and dentists, applying a hybrid inductive-deductive coding framework to identify what enables non-migration and return migration.
“Qualitative data from the KIIs were analyzed thematically using the approach outlined by Braun and Clarke [22]. Transcripts were imported into Delve®, an online qualitative analysis platform [23]. We applied a hybrid coding approach that combined inductive and deductive techniques.”
- Field
- Health workforce migration / global health policy
- Data
- 50 one-on-one key informant interviews in English with Nigerian medical doctors and dentists — those already abroad and those who stayed — audio-recorded and transcribed by the research team, alongside a 274-respondent survey built from a systematic review of healthcare worker migration in LMICs
- Approach
- Sequential explanatory mixed methods: a survey of 274 respondents in KoboToolbox analysed in R, followed by Braun and Clarke thematic analysis of key informant interviews using a hybrid coding approach — inductive themes from the narratives plus deductive codes pre-identified from the quantitative findings and the literature; multiple authors read transcripts independently, the coding framework was iteratively refined against the data, and coding continued to thematic saturation
- Data types
- Interviews, Open-ended survey responses
Abstract
BACKGROUND: While many studies have explored the drivers of health-worker emigration, there is limited understanding of the factors that potentially encourage them to remain or return after migration. OBJECTIVES: We explored three interrelated questions: what factors encouraged some members of the study population to remain in Nigeria?; what circumstances might encourage those intending to migrate to reconsider their plans?; and what conditions could encourage those who have already emigrated to consider returning? METHODS: We conducted a sequential explanatory mixed-methods study among a cohort of Nigerian-trained doctors and dentists. In the quantitative phase, 274 cohort members completed a structured survey assessing drivers of migration. In the qualitative phase, 50 participants across three migration status groups (emigrated, intending to migrate, and not intending to migrate) were interviewed. Thematic analysis was conducted. RESULTS: Overall, 49.3% (135/274) of the cohort had already migrated within 15 years of qualifying, while 63.6% (82/139) of those still in Nigeria expressed an intention to migrate. Qualitative findings reinforced the quantitative results, highlighting shared potential enablers of staying (among those intending to migrate) or returning (among already migrated), including improved security, economic stability, better remuneration, stronger healthcare infrastructure, and enhanced training opportunities. Most of those who had already migrated expressed a willingness to return, though often as a long-term plan. Those with no intention to migrate cited a sense of duty and patriotism, family responsibilities, thriving businesses, and professional or age-related factors as reasons for staying back. CONCLUSION: This study offers actionable insights to inform policies on health-worker migration.
Citation
Paul Ikhurionan, Patience Toyin-Thomas, Efetobo Victor Orikpete, Philippa Odika, Oti N. Aria, Avwebo Ukueku, Yasangra R. Adeniji, Chinelo Iwegim, Uwaila Otakhoigbogie, Itua C. G. Akhirevbulu, Sunday C. Madubueze, Ekhosuehi Theophilus Agho, Chukwunwike W. Ozegbe, Josephine Atat, Oluchi Omogbai, Ekpereka S Nawfal, Uyoyo Odogu, Oladapo Babatunde Oladeinde, Efe E. Omoyibo, Ukachi C. Nnawuihe, Oghenebrume Wariri (2026). `This is our country and somehow, we have to make it work’: a sequential explanatory mixed-methods study of the enablers of non-migration and return migration in a cohort of Nigerian medical doctors and dentists. Global Health Action. https://doi.org/10.1080/16549716.2026.2623345