Nursing targets 'off track' as global shortfall worsens

Africa and Eastern Mediterranean worst exposed to staffing crisis in frontline care, as WHO calls for action

Emirati nurse Jood Hamad said she found the challenge of nursing enjoyable. Victor Besa / The National

A global nursing crisis has been highlighted in a detailed report that says a 5.8 million shortfall in frontline professionals could destroy the ability to deliver appropriate care.

The second State of the World’s Nursing report by the World Health Organisation found 78 per cent of nurses treated fewer than half the global population (49 per cent) with Africa and the Eastern Mediterranean regions most exposed to poor access.

While the number of available nurses has increased from 27.9 million in 2018 to 29.8 million in 2023, the world’s population has grown alongside a demand for care.

Analysts forecast nursing access will continue to deteriorate and increased the predicted shortage by 2030 from 10 million to 11 million from previous estimates.

A gender bias was also highlighted, with more than 70 per cent of nurses women, and 19 per cent over the age of 55, placing further focus on the need for better recruitment to replace retiring staff.

Facing 'tough realities'

Speaking at a Dubai nursing summit hosted by the Ministry of Health and Prevention and Emirates Health Services, Dr Hanan Balkhy, the WHO’s Eastern Mediterranean director, said the region was braced to take on a quarter of the global shortfall by 2030.

“Progress is off track and, without targeted action, nursing workforce gaps will persist beyond 2030, especially in the most vulnerable regions,” she said.

“We face tough realities: deteriorating working conditions, gaps in education and training, weak regulation, deep inequities and the immigration of nurses.

“To make matters worse, more than 60 per cent of global attacks on health care occur in our region. We urgently need targeted, high-impact and sustainable investments in jobs, education, leadership and service delivery.”

Recruitment drive

The WHO's regional flagship initiative on investing in a resilient health workforce aims to accelerate these efforts.

The drive promotes increased investment in the health workforce, with a strong focus on primary health care and essential public health functions.

It aims to expand access to care and strengthen emergency response, with midwives and nurses prioritised.

And with 56 per cent of nurses in the region below the age of 35, the potential for transformation is immense, Dr Balkhy said.

One of those is Jood Hamad, 24, an Emirati paediatric nurse at Al Qassimi Women and Children’s Hospital in Sharjah.

Her generation is viewed as pivotal in inspiring other young people to consider a career in nursing.

"In 2018 I wanted to study something that nobody I knew had entered into, so it was completely new to me,” she said.

“When I'm telling somebody that I'm a nurse, they are surprised, but it is important to show that we, as locals, can also do this work.

“I was still a student during the pandemic so it was difficult, but over time I found the challenge and the experience enjoyable.”

Her colleague at the hospital, Bincy Bindu Raj, 33, a nurse from India, is mother to a 10-year-old daughter and has been in the profession since 2014.

“As nurses, we are dedicated and work hard, but are facing some challenges,” she said.

Indian nurse Bincy Bindu Raj. Victor Besa / The National

“Without dedication to this job, we cannot possibly do what is required as we must firstly focus on the patient care and their satisfaction.

“But it is a rewarding career – you see people get better, get well and move on with their lives.”

Density of nurses in Europe is five times that of Africa and the Eastern Mediterranean, a region that includes the Gulf.

UAE graduates filling the gap

There has also been a huge increase in the number of nurses choosing to work in high-income countries rather than in the Global South, leaving much of the world’s population with limited access to vital nursing services in maternity, childcare and chronic disease management.

Dr Sumaya Al Balooshi, director of the nursing department at Emirates Health Services, said significant steps had been taken in the UAE to increase nursing recruitment and retention of staff.

“Worldwide we need more investment in jobs, education and leadership in nursing,” she said. “In the UAE, we do not face these shortages because we work intensively to strengthen our national workforce and our graduate rates are increasing year by year.”

Dr Sumaya Al Balooshi said significant steps had been taken in the UAE to increase nursing recruitment and retention of staff. Victor Besa / The National

A national strategy launched in 2020 to increase nursing recruitment aimed to safeguard UAE hospitals against recruitment challenges.

Dr Al Balooshi said nurses are the backbone of the UAE’s health system, making up more than 50 per cent of the care workforce.

There was particular demand for nurses in critical care and mental health, as well as more male nurses, she added.

“We are proud that females are the dominant force, yet we are calling for gender equity, as both are required for the profession,” she said.

“Strategies must be invested towards attracting more male nurses and that's what we are doing. It can be very difficult to convince people to join a health profession in general, not only nursing, but once they join us, they love it.”