WHO: State of the World’s Nursing Report – 2020

The State of the world’s nursing 2020 report provides the latest, most up-to-date evidence on and policy options for the global nursing workforce. It also presents a compelling case for considerable – yet feasible – investment in nursing education, jobs, and leadership.

The primary chapters of the report outline the role and contributions of nurses with respect to the WHO “triple billion” targets; the health labour market and workforce policy levers to address the challenges to nurses working to their full potential; the findings from analysis of National Health Workforce Account (NHWA) data from 191 Member States and progress in relation to the projected shortfall of nurses by 2030; and forward-looking policy options for an agenda to strengthen the nursing workforce to deliver the Sustainable Development Goals, improve health for all, and strengthen the primary health care workforce on our journey towards universal health coverage.

The report concludes with a call to Member States and other stakeholders to commit to this agenda.  The investments called for will drive progress toward Universal Health Coverage and across the Sustainable Development Goals including health but also education, gender, decent work and economic growth.

Highlights 

• Investment in nurses will contribute not only to health-related SDG targets, but also to education (SDG 4), gender (SDG 5), decent work and economic growth (SDG 8).
• Nursing is the largest occupational group in the health sector, accounting for approximately 59% of the health professions. 
• The global nursing workforce is 27.9 million, of which 19.3 million are professional nurses.
• The world does not have a global nursing workforce commensurate with the universal health coverage and SDG targets.
• To address the shortage by 2030 in all countries, the total number of nurse graduates would need to increase by 8% per year on average, alongside an improved capacity to employ and retain these graduates.
• The majority of countries (152 out of 157 responding; 97%) reported that the minimum duration for nurse education is a three-year programme.
• Nursing remains a highly gendered profession with associated biases in the workplace. Approximately 90% of the nursing workforce is female, but few leadership positions in health are held by nurses or women.
• A total of 82 out of 115 responding countries (71%) reported having a national nursing leadership position with responsibility for providing input into nursing and health policy.

Future directions for nursing workforce policy

1. Countries affected by shortages will need to increase funding to educate and employ at least 5.9 million additional nurses.
2. Countries should strengthen capacity for health workforce data collection, analysis and use.
3. Nurse mobility and migration must be effectively monitored and responsibly and ethically managed.
4. Nurse education and training programmes must graduate nurses who drive progress in primary health care and universal health coverage.
5. Nursing leadership and governance is critical to nursing workforce strengthening.
6. Planners and regulators should optimize the contributions of nursing practice.
7. Policy-makers, employers and regulators should coordinate actions in support of decent work. C
8. Countries should deliberately plan for gender-sensitive nursing workforce policies
9. Professional nursing regulation must be modernized.
10. Collaboration is key.

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