A majority of Tunisia’s nursing workforce is leaving the country, driven primarily by low salaries and the pursuit of better living conditions, according to a recent survey by the Institute of Health and Occupational Safety.
The January 2026 study found that 84.6 percent of nurses cited insufficient pay as the main reason for emigrating, while 76.9 percent said they were seeking improved living and working conditions abroad. The survey highlights a growing crisis in Tunisia’s healthcare sector, where staff shortages threaten service delivery and patient care.
Conducted by occupational health doctors from Habib Thameur Hospital and the Regional Hospital of Zaghouan, the research surveyed 52 nurses and included paramedical staff who had spent at least six months working outside the country. Data collection ran from March 15 to April 15, 2024, and sought to uncover the factors influencing healthcare professionals to leave Tunisia despite the country’s long-standing reputation for medical training and professional standards.
“The findings confirm what many healthcare administrators have observed over the past decade,” said a spokesperson for the Institute of Health and Occupational Safety. “Nurses are increasingly seeking opportunities abroad where compensation reflects their skills, and working conditions support both professional growth and quality of life.”
Tunisia has long faced challenges in retaining skilled healthcare workers. According to the Ministry of Health, the country trains thousands of nurses annually, yet a significant portion migrates to Europe, the Gulf, and North America soon after graduation. Countries such as France, Germany, and Canada have become primary destinations for Tunisian nurses, drawn by higher salaries, benefits, and structured career pathways.
Low wages are exacerbated by heavy workloads, limited professional development, and inadequate healthcare infrastructure. Nurses in public hospitals often report long shifts, outdated equipment, and insufficient support, factors that intensify job dissatisfaction. “Even with dedication to patient care, the conditions here make it unsustainable for many,” said one nurse, who requested anonymity.
The financial incentive abroad is substantial. Tunisian nurses can earn three to five times their domestic salary in Europe, a gap that continues to fuel the brain drain. Beyond remuneration, migrants cite better work-life balance, safer environments, and access to advanced medical technologies as key motivations.
The exodus poses risks not only to hospital operations but also to public health outcomes, particularly in rural regions where staffing is already limited. Experts warn that continued departures could strain emergency services, intensive care units, and primary care facilities, ultimately affecting patient mortality and morbidity rates.
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In response, healthcare policymakers have begun exploring strategies to stem the outflow. Proposed measures include salary adjustments, targeted retention bonuses, improved working conditions, and professional development programs. The government is also considering bilateral agreements with destination countries to regulate migration flows while maintaining domestic healthcare capacity.
“Retaining our nursing workforce requires addressing both economic and professional concerns,” said a senior health official. “We must make careers in Tunisia financially viable and professionally rewarding if we hope to reverse this trend.”
The survey also underscores a broader challenge in Tunisia’s labor market, where skilled professionals often migrate due to a combination of financial and lifestyle factors. For the healthcare sector, which relies on highly trained personnel, the stakes are particularly high. Analysts warn that without decisive reforms, Tunisia could face prolonged shortages that undermine public confidence in the health system.
As global demand for healthcare workers rises, the Tunisian government faces pressure to implement policies that retain talent while ensuring that the country’s hospitals continue to meet national and international standards. The survey paints a stark picture of the urgent need for action: a skilled workforce slipping away due to inadequate compensation and living conditions, threatening both the sustainability and quality of Tunisia’s healthcare services.
