The COVID-19 pandemic underscores the urgent need to strengthen the global health workforce. A new report, “The State of the World’s Nursing 2020,” provides an in-depth look at the largest component of the health workforce. Findings identify important gaps in the nursing workforce and priority areas for investment in nursing education, jobs, and leadership to strengthen nursing around the world and improve health for all. Nurses account for more than half of all the world’s health workers, providing vital services throughout the health system. Historically, as well as today, nurses are at the forefront of fighting epidemics and pandemics that threaten health across the globe. Around the world they are demonstrating their compassion, bravery, and courage as they respond to the COVID-19 pandemic: never before has their value been more clearly demonstrated.
“Nurses are the backbone of any health system. Today, many nurses find themselves on the front line in the battle against COVID-19,” said Dr. Tedros Adhanom Ghebreyesus, WHO director-general. “This report is a stark reminder of the unique role they play, and a wakeup call to ensure they get the support they need to keep the world healthy.”
The report, by the World Health Organization (WHO) in partnership with the International Council of Nurses (ICN) and Nursing Now, reveals that today, there are just under 28 million nurses worldwide. Between 2013 and 2018, nursing numbers increased by 4.7 million. But this still leaves a global shortfall of 5.9 million — with the greatest gaps found in countries in Africa, South East Asia, and the WHO Eastern Mediterranean region as well as some parts of Latin America.
Revealingly, more than 80 percent of the world’s nurses work in countries that are home to half of the world’s population. And one in every eight nurses, practices in a country other than the one where they were born or trained. Aging also threatens the nursing workforce: one out of six of the world’s nurses are expected to retire in the next 10 years.
To avert the global shortage, the report estimates that countries experiencing shortages need to increase the total number of nurse graduates by on average 8% per year, along with improved ability to be employed and retained in the health system. This would cost roughly USD 10 per capita (population) per year.
“Politicians understand the cost of educating and maintaining a professional nursing workforce, but only now are many of them recognizing their true value,” said ICN President Annette Kennedy. “Every penny invested in nursing raises the wellbeing of people and families in tangible ways that are clear for everyone to see. This report highlights the nursing contribution and confirms that investment in the nursing profession is a benefit to society, not a cost. The world needs millions more nurses, and we are calling on governments to do the right thing, invest in this wonderful profession and watch their populations benefit from the amazing work that only nurses can do.”
About 90 percent of all nurses are female, yet few nurses are found in senior health leadership positions– the bulk of those positions are held by men. But when countries enable nurses to take a leadership role, for example by having a government chief nursing officer (or equivalent), and nursing leadership programs, conditions for nurses improve.
This report places much-needed data and evidence behind calls to strengthen nursing leadership, advance nursing practice, and educate the nursing workforce for the future,” said Lord Nigel Crisp, co-chair of Nursing Now. “The policy options reflect actions we believe all countries can take over the next 10 years to ensure there are enough nurses in all countries, and that nurses use of the full extent of their education, training, and professional scope to enhance primary health care delivery and respond to health emergencies such as COVID-19. This must start with broad and intersectoral dialogue which positions the nursing evidence in the context of a country’s health system, health workforce, and health priorities.”