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South Africa is unique in the region as it is both a source and destination country of migrant workers. The country faces a healthcare crisis arising from a significant burden of disease, underfunding and understaffing of health facilities and the continuing out-migration of health and social care workers. The research shows that understaffing, low pay and poor working conditions are strong underlying factors that push health and social care workers to migrate. This is exacerbated by the absence of a coherent approach to human resources for health planning and difficulties in implementing the country’s strategic health priorities.