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Millions of nurses care for the world’s patients, and millions more will be needed. This is one of the takeaways from “State of the World’s Nursing 2020,” a new report developed by the World Health Organization in partnership with the International Council of Nurses (ICN) and the Nursing Now campaign.

More than ever, the world must have nurses “working to the full extent of their education and training,” states the report’s executive summary. This report “confirms that investment in the nursing profession is a benefit to society, not a cost,” says ICN President Annette Kennedy in a press release.

Some 191 countries provided data for the 144-page report, which provides a detailed look at the profession globally. The report sounds positive notes, while also calling for significant improvements in some areas.

On the plus side:

  • Some 86% of countries have a body responsible for regulating nursing.
  • Of 115 responding countries, 82 (71%) have a national nursing leadership position to provide input into nursing and health policy.
  • From 2013 to 2018, the total number of nurses increased by some 4.7 million. The global nursing workforce is 27.9 million nurses, of which 19.3 million (69%) are classified as “professional nurses” as opposed to “associate professional nurses” or unclassified. As the largest occupational group in the health sector, nursing accounts for about 59% of the health professions.

However, notable needs exist:

  • Despite the growth in the number of nurses, more are needed. The report notes a global shortage of nurses of 5.9 million in 2018, which is a decrease from a shortage of 6.6 million in 2016. The vast majority of that shortage is concentrated in low- and lower middle income countries.
  • To address the shortage by 2030 in all countries, total nurse graduates would need to increase by 8% per year on average, along with an improved capacity to employ and retain these graduates. Without this increase, there will be a shortage of 5.7 million nurses, primarily in Africa, Southeast Asia, and the eastern Mediterranean.
  • In some regions, an aging nursing workforce poses a threat. One out of six of the world’s nurses are expected to retire in the next 10 years, according to a press release. “Substantially older age structures” exist in the American and European regions.
  • Although nursing is 90% female, few leadership positions in health are held by nurses or women.

Other findings:

  • Only 78 countries report having advanced practice roles for nurses.
  • Of 157 responding countries, 97% report that the minimum duration for nursing education is a three-year program.
  • One nurse out of eight practices in a country other than the one where they were born or trained.

Actions to Take

To equip the world with the nursing workforce it needs, WHO and its partners provide a series of recommendations, including the following:

  • increase funding to educate and employ more nurses;
  • monitor nurse mobility and migration and manage it responsibly and ethically;
  • educate and train nurses in the scientific, technological, and sociological skills they need to drive progress in primary health care;
  • establish leadership positions including a government chief nurse;
  • ensure that nurses in primary health care teams work to their full potential;
  • improve working conditions including through safe staffing levels, fair salaries, and respecting rights to occupational health and safety;
  • implement gender-sensitive nursing workforce policies.

“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,” Kennedy is quoted as saying.

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