Inequities in Nursing Workforce May Undermine Global Health Objectives
The global nursing workforce has expanded significantly, according to the World Health Organization (WHO), the International Council of Nurses (ICN), and their partners. The number of nurses worldwide has grown from 27.9 million in 2018 to 29.8 million in 2023. However, large disparities in the availability of nurses across regions and countries still exist. These inequalities in the nursing workforce threaten access to basic health services for many populations, potentially hindering progress towards achieving Universal Health Coverage (UHC), global health security, and related development goals.
The new report, released on International Nurses Day, provides a comprehensive and up-to-date analysis of the status of nurses at global, regional, and national levels. The report, which includes data from 194 WHO member countries, reveals that there has been progress in reducing the nursing shortage. The number of nursing shortages dropped from 6.2 million in 2020 to 5.8 million in 2023, with an anticipated reduction to 4.1 million by 2030. However, overall progress masks significant regional disparities, with approximately 78% of the world’s nurses concentrated in countries that account for only 49% of the global population.
Low- and middle-income countries face challenges in training, hiring, and retaining nurses for their health systems, requiring increased domestic investment to create and maintain jobs. Meanwhile, high-income countries must prepare for a wave of retiring nurses and reassess their reliance on foreign-trained nurses, strengthening bilateral agreements with recruitment source countries.
WHO Director-General Dr. Tedros Adhanom Ghebreyesus said, “This report brings encouraging news, and we congratulate countries that have made progress. However, we cannot overlook the inequalities in the global nursing field. On this International Nurses Day, I urge countries and partners to use this report as a roadmap, highlighting where we have been, our current situation, and the direction we need to move in.”
Key Findings
The “State of the World’s Nursing 2025” (SoWN) report, based on data from 194 countries, shows that the number of countries reporting data has increased by 33% since the 2020 report. The report includes detailed country profiles, which are now publicly accessible online.
The findings highlight the complex differences between countries, regions, and socioeconomic contexts. The data and evidence aim to support country-led dialogues, translating research findings into policy and action.
Pam Cipriano, President of the International Council of Nurses, welcomed the SoWN 2025 report, calling it a critical milestone in monitoring progress and supporting nursing to achieve global health goals. She emphasized that inequalities in the nursing sector hinder the realization of UHC and must be addressed to ensure that nurses are recognized for their value and used as a catalyst for positive transformation in health systems.
Gender and Equality Remain Core Issues
Gender continues to be a central issue in the nursing workforce, with women making up 85% of nurses globally.
The findings show that one in seven nurses worldwide (23% in high-income countries) were born abroad, highlighting the global dependence on international migration. In contrast, the proportion in upper-middle-income countries (8%), lower-middle-income countries (1%), and low-income countries (3%) is significantly lower.
The growth in the number of nursing graduates in low-income countries is outpacing that in high-income countries. However, in many countries, the rapid growth in graduate numbers has not led to better population density or improved job opportunities due to high population growth rates. To address this, countries should create employment opportunities, ensure graduates are integrated into health systems, and improve working conditions.
Age Structure and Retirement Trends
The age structure and retirement trends present a complex situation. The global nursing workforce is relatively young, with 33% of nurses under the age of 35, and 19% of nurses are expected to retire within the next decade. However, in 20 countries, mostly high-income nations, retirements are expected to outnumber new entrants, raising concerns about nursing shortages. Additionally, the number of experienced nurses to guide newcomers is decreasing.
Advancements in Nursing Leadership
Approximately 62% of countries report having advanced practice nursing positions, a notable increase from 53% in 2020. Advanced practice nurses have been shown to expand access to care and improve care quality in many settings.
The report also highlights improvements in nursing leadership: 82% of countries report having senior nursing officials to manage the nursing workforce. However, leadership development opportunities remain uneven, with 66% of countries implementing leadership initiatives but only 25% of low-income countries offering structured leadership development.
Mental Health and Wellbeing Remain Concerns
Despite the increased workload and trauma faced by nurses during and after the COVID-19 pandemic, only 42% of responding countries provide mental health support for nurses. Addressing this issue is crucial for retaining skilled professionals and ensuring the quality of care.
Policy Focus for 2026-2030
The report outlines forward-looking policy priorities, calling for countries to:
Expand and equitably distribute nursing jobs, especially in underserved areas.
Strengthen domestic education systems to align qualifications with clear roles.
Improve working conditions, pay equity, and mental health support.
Further develop nursing regulations and advanced practice roles.
Promote gender equality and protect nurses working in vulnerable, conflict-affected environments.
Leverage digital technology to prepare nurses for climate-responsive care.
Strengthen nursing leadership and ensure equal leadership development opportunities.
These priorities align with the WHO’s 2021-2025 Global Strategic Directions for Nursing and Midwifery, emphasizing the need for accelerated action on health and nursing human resources by 2030.
The “State of the World’s Nursing 2025” report provides the latest evidence on the global nursing workforce, covering education, employment, migration, regulation, working conditions, leadership, and more. The report includes updated indicators and robust estimates on nursing stock, shortages, and forecasts for 2030. Country-level profiles are available for download in PDF format.
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