Transformation Partnership in the Healthcare Sector (TAPIG)

  • Country of destination: Germany
  • Country of origin: Tunisia
  • Sectors: Healthcare
  • Skill level: Mid-level
  • Timeline: August 2012 - August 2013
  • Number of beneficiaries: 50


This program aimed to offer 150 Tunisian young school-leavers six months pre-departure training (in the German language and in cultural orientation) and a three-year apprenticeship as trained nurses at a private hospital in Hamburg. Participants committed to sign a five-year work contract afterward, at a gross salary of €2,000 a month.

Why was it started?

Like many high-income countries, Germany is suffering from a nursing shortage. The sector is programed to need 150,000 new nurses by 2025, and the need is expected to grow, given Germany’s aging population. To care for the elderly alone Germany is programed need more than 200,000 additional nursing staff by 2030, including almost 100,000 geriatric nurses.

The World Health Organization (WHO) largely prohibits the active recruitment of nurses from low- and middle-income countries. To meet its need without violating WHO rules, Germany sought countries with large pools of trained nurses who were unable to be hired at home and brought them to Germany under a new multilateral framework.

The program was initiated within the framework of Germany’s transition partnership with the Arab World and partly funded by the Ministry of Foreign Office.

How does it work?

Groups of 25 nurses were to arrive in Germany every six months. Their apprenticeship was to have consisted of a six-month “welcome” stage, three years of training, and an employment stage lasting at least five years. The German Ministry of Foreign Affairs funded the initial stage (six-months of training in German and soft skills). The employer (Asklepios) funded the three years of apprenticeship training. Student loans were provided to help the apprentice nurses cover expenses.

What impact has it had?

The program failed, leaving all parties dissatisfied. It ended before expected after the employer withdrew. Participants believed they were overqualified for the work and underpaid. The financing structure of the program was complex. Participants needed loans to cover their expenses. The evaluator of the program claimed that the Tunisian authorities insisted on selecting and placing already trained nurses instead of school leavers, which created a gap between expectations about the job and its actual content and status.