he COVID-19 pandemic has put a significant strain on healthcare systems globally, exacerbating an already-existing problem of labour shortages in the healthcare workforce. This has led to a higher turnover rate among healthcare workers, which can further worsen the current situation. To address this issue, proactive measures should be taken to retain healthcare workers. This review aims to identify the factors that affect turnover intention among healthcare workers during the COVID-19 pandemic.

A mixed studies systematic review was conducted by searching the PubMed, Embase, Scopus, CINAHL, Web of Science, and PsycINFO databases from January 2020 to March 2022. Forty-three studies were included in this review, comprising 39 quantitative, two qualitative, and two mixed methods studies. The studies were conducted in various regions worldwide, with the Middle East having the highest number of studies (18), followed by the Americas (10), the Asia-Pacific region (9), and Europe (6). Nurses (35) were the most frequently studied healthcare workers, followed by physicians (13), allied health workers (11), and healthcare administrative or management staff (7).

The data synthesis resulted in five themes: (1) fear of COVID-19 exposure, (2) psychological responses to stress, (3) socio-demographic characteristics, (4) adverse working conditions, and (5) organisational support. Fear of COVID-19 exposure was a significant factor affecting healthcare workers' turnover intention, with concerns about contracting the virus at work being a significant source of stress. Healthcare workers experienced psychological responses to stress, such as anxiety, depression, and burnout. Socio-demographic factors, such as age, gender, marital status, and education level, were also found to influence turnover intention. Adverse working conditions, such as heavy workload, lack of personal protective equipment, and inadequate training, were identified as significant factors. Finally, organisational support, such as employee recognition, adequate compensation, and job security, was found to be a critical factor in retaining healthcare workers.

The findings suggest that a wide range of factors influence healthcare workers' turnover intention during the COVID-19 pandemic. Policymakers should focus on specific factors, such as working conditions, burnout, and job security, and specific vulnerable groups, such as migrant healthcare workers and healthcare profession minorities, to develop strategies that support and incentivise healthcare workers to stay in their jobs.