Escalating pharmacist emigration amid workforce shortages intensifies system strain, reinforcing a poorly understood retention crisis in Nigeria. This study examined the influence of work-life balance (WLB), personal fulfillment (PF), and job satisfaction (JS) on emigration intent (EI) among pharmacists. A mixed-method cross-sectional survey of 407 pharmacists from all six geopolitical zones and practice settings (community, industry, hospital, regulatory, and academia) was conducted. Data were analyzed using Partial Least Squares Structural Equation Modeling (PLS-SEM) complemented by thematic analysis of two focus groups ( n = 16). WLB significantly predicted PF (β = 0.773, p < 0.001) and JS (β = 0.294, p < 0.001) but negatively influenced EI (β = −0.225, p < 0.05). PF significantly influenced JS (β = 0.521, p < 0.001) but had no effect on EI. JS negatively predicted EI (β = −0.280, p < 0.001). Mediation analysis showed that PF partially mediated the WLB-JS relationship and, together with JS, partially mediated the WLB-EI relationship. JS fully mediated the PF-EI relationship. The model explained 59.8% of PF, 59.4% of JS, and 23.5% of EI variance. These findings underscore work-life balance and job satisfaction as critical drivers of pharmacists' emigration intents, and highlight their strategic importance in workforce retention interventions. • This study explores the psychosocial drivers of high healthcare workforce emigration from poorly resourced settings to developed health systems, using Nigeria pharmacists as a case. • Work-life balance was significantly associated with personal fulfillment and job satisfaction, but negatively predicted emigration intent of pharmacists. • Personal fulfillment predicted job satisfaction but a fulfilled pharmacist may still emigrate. • Job satisfaction was significantly associated with reduced emigration intent. • Interventions for skills retention should aim to reduce pharmacists' workload and improve their job satisfaction for improved patient and health system outcomes.
Ihekoronye et al. (2026) studied this question.