Working conditions in nursing in Spanish-speaking countries of Central America and the Caribbean

Abstract

Introduction: Nursing personnel are essential to healthcare systems, but they face challenges such as low wages, high workload, and precarious contracts, particularly in Central America and the Caribbean. Previous studies highlight regional disparities in working conditions, professional migration, and social protection, but comprehensive comparative evidence is lacking. This study analyzes these variables to propose strategies to improve talent retention and the quality of services.

Objective: To describe nursing socio-labor indicators in Spanish-speaking countries of Central America and the Caribbean.

Methods: A cross-sectional descriptive study was conducted during 2024 in eight Spanish-speaking Central American and Caribbean countries. A validated questionnaire (Cronbach's alpha >0.84) was administered to nursing association presidents, and 16 socio-labor variables were explored. The data were analyzed using descriptive and comparative statistics and content analysis.

Results: Differences were observed: Cuba guarantees 100% public employment, while Guatemala and Honduras predominantly employ temporary and informal contracts. Workloads were compromised in Guatemala and Honduras (1:20+ patients/nurse), compared to manageable ratios in Costa Rica (1:10-15). Salaries ranged from USD 300-500 (Guatemala/Honduras) to USD 800-1,500 (Costa Rica/Panama). Occupational safety was poor in Guatemala and El Salvador, but regulated in Costa Rica and Panama. Migration was high in Honduras and Guatemala, directed to the US and Spain.

Conclusion: Labor inequalities in nursing require regional policies to guarantee stable contracts, decent wages, and occupational safety. Improving these conditions is key to retaining talent and strengthening health systems.