The factors associated with workforce attrition and intention-to-leave among healthcare workers in New Zealand: a systematic literature review and meta-synthesis of qualitative research

Despite growing concern about the stability of New Zealand's (NZ) health workforce, no prior synthesis has examined qualitative evidence on factors associated with attrition or intention-to-leave. This systematic review and meta-synthesis included 20 studies and followed the ENTREQ checklist to guide a content analysis of the literature. Seven themes were generated spanning organizational, professional, and personal levels: high workloads, unsupportive organizational culture, limited opportunities for career advancement, inadequate remuneration, a decline in professional identity, negative impacts on wellbeing, and work-life imbalance. The findings demonstrate that attrition and intention-to-leave arise from cumulative pressures across these levels, highlighting the need for coordinated retention strategies that address all domains of work experience.