The courage and compassion displayed by frontline nurses across the globe in the current battle against the COVID-19 pandemic underlines the need for urgent investment in the profession so that universal health coverage can be achieved, according to a landmark report on the State of the world’s nursing, released on today’s World Health Day by the World Health Organization (WHO).

Published in partnership with the International Council of Nurses (ICN) and global Nursing Now campaign, the State of the world’s nursing 2020: Investing in education, jobs and leadership report found significant gaps in the nursing workforce, leading it call for a ‘massive acceleration’ of nursing education, the creation of at least six million new nursing jobs by 2030, and the strengthening of nurse leadership to ensure current and future leaders play an influential role in developing health policy and decision-making.

“Nurses are the backbone of any health system,” said WHO Director General, Dr Tedros Adhanom Ghebreyesus.

“This report is a stark reminder of the unique role they play, and a wakeup call to ensure they get the support they need to keep the world healthy.”

To equip the world with the nursing workforce it requires and maximise the contributions of the profession, the report recommends all countries:
• Increase funding to educate and employ more nurses
• Strengthen capacity to collect, analyse and act on data about the health workforce
• Educate and train nurses in the scientific, technological and sociological skills they need to drive progress in primary healthcare
• Establish leadership positions, including a government chief nurse, and support leadership development among nurses
• Ensure primary healthcare nurses work to their full scope
• Improve working conditions, including safe staffing levels, fair salaries, and rights to occupational health and safety
• Strengthen the role of nurses in care teams by bringing different sectors (health, education, immigration, finance, health) together with nursing stakeholders for policy dialogue and workforce planning

Released to coincide with this year’s International Year of the Nurse and Midwife, the report states the world has just under 28 million nurses and suggests that despite an increase of 4.7 million nurses between 2013 and 2018, a 5.9 million shortfall remains, with the greatest gaps found in places including Africa, South East Asia, Latin America and the WHO Eastern Mediterranean region.

The report  revealed more than 80% of the world’s nurses work in countries that are home to half of the world’s population, one in eight nurses practise in a country other than the one they were born in or trained, and that ageing continues to threaten the nursing workforce, with one out of six of the world’s nurses expected to retire in the next decade.

To prevent a global shortage, the report estimates countries facing shortages would need to increase their total number of nurse graduates by an average of 8% per year, along with taking steps to improve employment opportunities and retention.

Key chapters within the report cover nursing roles in 21st century health systems, policy levers to enable the nursing workforce, the current status of evidence and data on the nursing workforce, and future directions for nursing workforce policy.

The report argues boosting nursing leadership is critical to strengthening the nursing workforce, explaining that while 90% of all nurses are female, few are found in senior health leadership positions.

However, when countries enable nurses to take on leadership roles, conditions for nurses improve, the report says.

The collaborative report drew on data and evidence provided by 191 countries and key nursing stakeholders across the world, including national nursing associations such as the Australian Nursing and Midwifery Federation (ANMF).

“Politicians understand the cost of educating and maintaining a professional nursing workforce, but only now are many of them recognising their true value,” ICN President Annette Kennedy said.

“Every penny invested in nursing raises the wellbeing of people and families in tangible ways that are clear for everyone to see.

“This report highlights the nursing contribution and confirms that investment in the nursing profession is a benefit to society, not a cost. 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 only nurses can do.”

The report concludes with a call to global governments to invest in nursing education, jobs and leadership so that primary healthcare can be strengthened and universal health coverage and Sustainable Development Goals targets achieved.

“The investments required will necessitate additional financial resources,” the report concludes.

“If these are made available, the returns for societies and economies can be measured in terms of improved health outcomes for billions of people, creations of millions of qualified employment opportunities, particularly for women and young people, and enhanced global health security. The case for investing in nursing education, jobs and leadership is clear: relevant stakeholders must commit to action.”

To view the report click here