Global nursing shortage shrinks, but progress isn't equal

What you probably already know: The global nursing workforce has grown from 27.9 million in 2019 to 29.8 million in 2023, but a worldwide shortage of nurses persists. Among the World Health Organization’s 194 member states, the nursing workforce was short 5.8 million people in 2023 — down from 6.2 million in 2020 — and is expected to drop to 4.1 million by the end of the current decade, according to the WHO’s State of the World’s Nursing 2025 report. While these figures indicate progress in resolving the global shortage of nurses, deep inequities persist in the distribution and density of nurses. Low- and middle-income countries are still struggling to graduate, employ, and retain nurses in their respective health care systems, leaving millions of people without access to maternal and child care, disease management, and public health emergency support.

Why? Approximately 78% of the world’s nurses are concentrated in countries representing just 49% of the global population. Statistically, there are 37 nurses for every 10,000 people on the planet, but nurse density is concentrated in higher-income countries; in the United States (home to an estimated 5.4 million nurses, or 1.6% of the national population), nurse density is 10 times higher than in most African and Eastern Mediterranean regions. The WHO’s report also reveals a shift in how nursing personnel are being identified. In 2023, 80% of nurses were classified as “professional nurses” with a greater level of autonomy than “associate professional nurses.” Most nurses also work in the public sector instead of private facilities. Women still make up the vast majority of the workforce (85%) around the world, but they vary in age depending on where they’re located. In many high-income countries, experienced nurses nearing retirement outnumber novices, while the opposite is true in many regions with the greatest need and fewest resources. Additionally, 1 in 7 practicing nurses in 2023 was born in another country. High-income countries are particularly dependent on foreign nurses who make up 23% of their nursing workforce; other countries in lower income brackets have significantly lower reliance on foreign nurses.

What it means: The global density of nurses is expected to rise to 42.5 for every 10,000 people by 2030, but growth and distribution inequities will become more pronounced, the report stated. African and Eastern Mediterranean regions will see no sizable change in their nursing ratio, despite projected population growth in the coming years. “The report clearly exposes the inequalities that are holding back the nursing profession and acting as a barrier to achieving universal health coverage (UHC),” said Pam Cipriano, president of the International Council of Nurses. “Delivering on UHC is dependent on truly recognizing the value of nurses and on harnessing the power and influence of nurses to act as catalysts of positive change in our health systems.”

What happens now? The WHO releases its nursing reports to help inform countries as they work to improve healthcare access at home. Countries can bolster local nursing workforces by offering differentiated nursing roles, scopes of practice, and fair compensation. The report calls on countries to expand and equitably distribute nursing jobs, strengthen domestic education systems, improve working conditions, promote gender equity, and protect nurses working in difficult settings, among other things. “I urge countries and partners to use this report as a signpost, showing us where we’ve come from, where we are now, and where we need to go – as rapidly as possible,” said WHO Director-General Dr. Tedros Adhanom Ghebreyesus.