Global nurse growth outpaced by deep inequality in healthcare access

The global nursing workforce has expanded from 27.9 million in 2018 to 29.8 million in 2023, according to the State of the World’s Nursing 2025 report released by WHO, ICN, and partners. However, this growth masks critical inequalities in nurse distribution, with 78% of nurses concentrated in countries that represent just 49% of the global population.

Released on International Nurses Day, the report warns that such disparities threaten the achievement of universal health coverage and sustainable health systems. It highlights the urgency of targeted investments, especially in low- and middle-income countries struggling to train, employ, and retain nurses.

Regional Gaps Endanger Progress Toward UHC
The global shortage of nurses has improved, dropping from 6.2 million in 2020 to 5.8 million in 2023, and is projected to fall to 4.1 million by 2030. Yet low-income countries continue to lag behind due to limited employment opportunities, faster population growth, and emigration of skilled nurses.

Meanwhile, high-income countries face a different crisis as retirement outpaces recruitment in over 20 nations. These trends highlight the need for strategic workforce planning and reduced dependence on foreign-trained professionals.

Graduation Rates Rise, But Jobs Must Follow
Low-income countries are producing more nursing graduates, but this progress is stunted by a lack of job creation and integration into health systems. The WHO urges governments to align graduation growth with employment pathways to retain talent and deliver essential services.

A startling 23% of nurses in high-income nations are foreign-born, compared to only 1%–8% in lower-income regions. This reliance on international migration places additional stress on countries already battling shortages.

Leadership and Gender Equity Remain Core Issues
Women comprise 85% of the global nursing workforce, but structured leadership development is available in just 25% of low-income countries. Although 82% of countries have a senior nursing official in government, only 66% have formal programs to nurture future nurse leaders.

Advanced practice roles are also expanding, with 62% of countries now recognizing these positions—a jump from 53% in 2020. These roles are proven to enhance access and quality of care, especially in underserved communities.

Mental Health Support Severely Lacking
Only 42% of countries have provisions for nurses’ mental health, despite heavy strain since the COVID-19 pandemic. The report emphasizes that well-being support is crucial for retaining skilled professionals and maintaining care standards.

Policy Priorities for 2026–2030
The WHO calls for urgent action in several areas: expanding equitable nursing employment, improving education and regulation, supporting mental health, promoting gender equity, preparing for climate-resilient care, and boosting nursing leadership.

Dr. Tedros Adhanom Ghebreyesus, WHO Director-General, said, “We cannot ignore the inequalities that mark the global nursing landscape. This report is a signpost showing us where we’ve come from, where we are now, and where we need to go—as rapidly as possible.”