By Haruna Gimba
The global nursing workforce has grown from 27.9 million in 2018 to 29.8 million in 2023, but wide disparities in the availability of nurses remain across regions and countries, according to the State of the World’s Nursing 2025 report, published by the World Health Organization (WHO), International Council of Nurses (ICN) and partners.
Inequities in the global nursing workforce leave many of the world’s population without access to essential health services, which could threaten progress towards universal health coverage (UHC), global health security and the health-related development goals.
The new report released on International Nurses Day provides a comprehensive and up-to-date analysis of the nursing workforce at global, regional and country levels.
Consolidating information from WHO’s 194 Member States, the evidence indicates global progress in reducing the nursing workforce shortage from 6.2 million in 2020 to 5.8 million in 2023, with a projection to decline to 4.1 million by 2030.
But the overall progress still masks deep regional disparities: approximately 78% of the world’s nurses are concentrated in countries representing just 49% of the global population.
Low- and middle-income countries are facing challenges in graduating, employing and retaining nurses in the health system and will need to raise domestic investments to create and sustain jobs.
In parallel, high-income countries need to be prepared to manage high levels of retiring nurses and review their reliance on foreign-trained nurses, strengthening bilateral agreements with the countries they recruit from.
“This report contains encouraging news, for which we congratulate the countries that are making progress,” said WHO Director-General Dr Tedros Adhanom Ghebreyesus.
“However, we cannot ignore the inequalities that mark the global nursing landscape. On International Nurses Day, I urge countries and partners to use this report as a signpost, showing us where we’ve come from, where we are now, and where we need to go – as rapidly as possible.”
The State of the World’s Nursing 2025 (SoWN) report, based on data reported by 194 countries through the National Health Workforce Accounts, shows a 33% increase in the number of countries reporting data since the last edition in 2020. It includes detailed country profiles now available for public access online.
The report reveals complex disparities between and among countries, regions and socio-economic contexts. The data and evidence are intended to support country-led dialogue to contextualize the findings into policies and actions.
“We welcome the SoWN 2025 report as an important milestone for monitoring progress on strengthening and supporting the nursing workforce towards global health goals,” said Pam Cipriano, President, International Council of Nurses.
“The report clearly exposes the inequalities that are holding back the nursing profession and acting as a barrier to achieving universal health coverage (UHC).
“Delivering on UHC is dependent on truly recognizing the value of nurses and on harnessing the power and influence of nurses to act as catalysts of positive change in our health systems.”
Gender and equity remain central concerns in the nursing workforce. Women continue to dominate the profession, making up 85% of the global nursing workforce.
Findings suggest that 1 in 7 nurses worldwide – and 23% in high-income countries – are foreign-born, highlighting reliance on international migration. In contrast, the proportion is significantly lower in upper middle-income countries (8%), lower middle-income countries (1%), and low-income countries (3%).
Low-income countries are increasing nurse graduate numbers at a faster pace than high-income countries. In many countries, hard-earned gains in the graduation rate of nurses are not resulting in improved densities due to the faster pace of population growth and lower employment opportunities.
To address this, countries should create jobs to ensure graduates are hired and integrated into the health system and improve working conditions.
Age demographics and retirement trends reveal a mixed picture. The global nursing workforce is relatively young: 33% of nurses are aged under 35 years, compared with 19% who are expected to retire in the next 10 years.
However, in 20 countries, mostly high-income, retirements are expected to outpace new entrants, raising concerns about nurse shortfalls, and having fewer experienced nurses to mentor early career nurses.
Around two thirds (62%) of countries reported the existence of advanced practice nursing roles, marking significant progress since 2020 (where only 53% reported advanced practice nursing roles). These types of nurses have been shown to expand access to and quality of care in many different settings.
The report also highlights improvements in nursing leadership: 82% of countries reported having a senior government nursing official to manage the nursing workforce.
However, leadership development opportunities remain uneven. While 66% of countries report having such initiatives in place, only 25% of low-income countries offer structured leadership development.
Mental health and workforce well-being remain areas of concern. Only 42% of responding countries have provisions for nurses’ mental health support, despite increased workloads and trauma experienced during and since the COVID-19 pandemic. Addressing this is essential to retain skilled professionals and ensure quality of care.
