Abstract
In the context of persistent health workforce shortages, this study investigates the psychosocial determinants influencing the emigration intentions of nurses and midwives in Morocco. This study offers a novel contribution by being the first to quantitatively examine the interplay between Perceived Organizational Support (POS), Organizational Trust (OT), and Intention to Leave (IL) within the Moroccan healthcare context. By filling this critical empirical gap, the research provides context-specific evidence that can guide policymakers in designing targeted and culturally adapted retention strategies.
Grounded in Social Exchange Theory, a quantitative approach was used, collecting data from 337 healthcare professionals who had formally initiated emigration procedures to Canada. Partial Least Squares Structural Equation Modeling (PLS-SEM) assessed the measurement and structural models, ensuring construct validity and robustness. Results reveal that POS significantly predicts OT (β = 0.342, p < 0.001), OT significantly predicts IL (β = 0.561, p = 0.001), and POS directly influences IL (β = 0.413, p < 0.001). The model accounts for 69.2% of the variance in IL (R2 = 0.692).
These findings indicate that diminished perceived organizational support undermines organizational trust, which in turn elevates intentions to emigrate. The dual influence of POS underscores its critical role in retention. The study highlights the necessity for public health institutions to enhance organizational support and rebuild trust to mitigate brain drain. Policy recommendations include improving transparency in career advancement and fostering supportive work environments, both essential for retaining skilled healthcare workers and ensuring the sustainability and resilience of Morocco’s health system.