Learning Objective 1: Describe how trade agreements can influence the development of nursing human resources.
Learning Objective 2: Identify the confluence of actors and variables that trade agreements affect and subsequently influence nursing human resources policy.
Methods: An equally weighted, mixed-methods case study was used to examine the effects of NAFTA on Mexican nursing. Qualitative data consisted of semi-structured interviews with 48 purposively selected Mexican nurses residing in four regions of the country. Directed content analysis structured the qualitative data analysis process. Quantitative data consisted of state-level, longitudinal nursing workforce data from the Mexican Secretary of Health, socioeconomic data, and National Council of State Boards of Nursing data between 1983 and 2008. Longitudinal regression modeling structured the quantitative data analysis.
Results: The analysis demonstrates that NAFTA served as a key turning point in the development of Mexican nursing primarily because the creation of the agreement changed the nature of the relationship between the profession and the State. Consequently, this lead to policy changes that invested in infrastructure development supportive of nursing human resources production. Economic instability shortly after NAFTA also slowed the rate at which these changes could occur for about five years. The quantitative analysis confirmed this finding as the longitudinal regression model showed a link between key socioeconomic development indicators and the numbers and types of nursing personnel (r2=.7; p=.0001). NAFTA did not provoke a mass migration of Mexican nurses, even fifteen years after implementation.
Conclusion: This study suggests that trade agreements do not always provoke a mass migration and may help countries target investments in infrastructure supportive of developing and improving the quality of nursing human resources. The findings challenge the current thinking about trade agreements and offers new information that can help structure future agreements.