Title : Perceived stigma and bias towards foreign healthcare workers in selected health facilities of South Africa
Abstract:
Background: Foreign healthcare workers (FHCWs) play a crucial role in strengthening healthcare systems in South Africa, helping to fill gaps in critical professional roles. Despite their contributions, they frequently encounter stigma and bias from colleagues, patients, and institutions. These negative experiences can affect workplace integration, morale, and the quality of care. However, there is limited qualitative research examining how FHCWs perceive and navigate these challenges across different sociocultural and policy environments.
Objective: To investigate the lived experiences of stigma and bias among FHCWs in selected healthcare facilities in South Africa, and to understand how these experiences influence their professional integration, coping mechanisms, and perceptions of organizational support.
Methods: A qualitative research approach will be adopted, using semi-structured interviews and focus group discussions with FHCWs, alongside input from local colleagues and managers. Purposive sampling will ensure diversity in profession, facility type, and geographical setting (urban and rural). Interviews will explore workplace interactions, patient relationships, organizational culture, and coping strategies. Data will be analyzed thematically following Braun and Clarke’s six-phase framework, with NVivo software facilitating coding and data management. Trustworthiness will be ensured through member checking, triangulation, peer debriefing, and maintaining an audit trail. Ethical standards, including informed consent, confidentiality, and voluntary participation, will be strictly followed.
Expected Results: The study is expected to uncover themes such as accent and nationality based bias, limited recognition of qualifications, and challenges in patient trust. It is also anticipated that FHCWs will describe resilience strategies, supportive practices, and organizational factors that help reduce stigma. Comparative analysis between countries may reveal both common and context-specific patterns of discrimination and support.
Conclusion: The findings will offer detailed insights into the types and impacts of stigma and bias experienced by FHCWs in South Africa. By highlighting FHCW's perspectives, the study aims to inform recommendations for organizational policies, cultural safety training, and support systems that foster inclusion and equitable healthcare delivery.
