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WHO calls on governments to invest in nurses for a healthy Europe

Apr 7, 2020

The COVID-19 pandemic underscores the urgent need to strengthen the global health workforce. A new report, The state of the world’s nursing 2020, released on the occasion of World Health Day, provides an in-depth look at the largest component of the health workforce.

Findings identify important gaps in the nursing workforce and priority areas for targeted investment in nursing education, jobs and leadership to strengthen nursing around the world and improve health for all.

Nurses account for more than half of all the world’s health workers, providing vital services throughout the health system. In the WHO European Region, 57% of the health workforce are nurses.

Historically and today, nurses are at the forefront of fighting epidemics and pandemics that threaten health. Nurses around the Region are responding to the COVID-19 pandemic with courage: never before has their value been more clearly demonstrated.

“Our fight against COVID-19 has once again brought home how fundamental the nursing profession is to society and to all of us. Faced with the most exceptional circumstances and toughest working conditions, nurses across the European Region and the world have met the challenge with bravery, compassion and professionalism. They, together with all frontline health workers, deserve our deepest thanks and respect,” said Dr Hans Henri P. Kluge, WHO Regional Director for Europe.

“It is high time we give the nursing profession the recognition it deserves. Today, as we mark World Health Day, and in the future, countries must invest in nurses and support them to work to the full extent of their training and scope of practice. In so doing, our skilled and dedicated nursing workforce will have the strength and resources to build a healthier Europe,” he concluded.

A global shortage of nurses

The state of the world’s nursing 2020, developed by WHO in partnership with the International Council of Nurses (ICN) and Nursing Now, reveals that today there are just under 28 million nurses worldwide.

In the European Region, there are 7.3 million nurses, or about 79 nurses per 10 000 people. Although this is about double the global average, experts say that because of the age structure of the nursing workforce in the Region and a reliance on international recruitment of nurses in some high-income countries, there is no room for complacency.

About 90% of all nurses are female, yet only 25% of leadership positions are held by them. This emphasizes the need for policies that increase and enhance nursing leadership and encourage female participation at leadership levels.

When countries enable nurses to take a leadership role, for example, by having a government chief nursing officer (or equivalent) and nursing leadership programmes, the regulation of nursing education and of working conditions improves.

“Nurses are key to answering many of our health problems. If we are to have strong health services, we must invest in nurses, educate and train them to international standards and to degree level, and provide them with appropriate equipment and resources. Nurses should receive fair pay for their work and be able to continue to develop professionally. This will help enhance health outcomes, improve quality of care and advance universal health coverage,” said Dr Sergy Koryak, Head of WHO Pristina Office.  

Ten recommendations for a strengthened nursing workforce

To equip the world with the nursing workforce it needs, WHO and its partners recommend that all countries:

  1. increase funding to educate and employ more nurses;
  2. strengthen capacity to collect, analyse and act on data about the health workforce;
  3. monitor nurse mobility and migration and manage it responsibly and ethically;
  4. educate and train nurses in the scientific, technological and sociological skills they need to drive progress in primary health care;
  5. establish leadership positions, including a government chief nursing officer, and support leadership development among young nurses;
  6. ensure that nurses in primary health-care teams work to their full potential, for example, in preventing and managing noncommunicable diseases;
  7. improve working conditions, including through safe staffing levels, fair salaries, and respect for rights to occupational health and safety; 
  8. implement gender-sensitive nursing workforce policies;
  9. modernize professional nursing regulation by harmonizing education and practice standards and using systems that can recognize and process nurses’ credentials globally; and
  10. strengthen the role of nurses in care teams by bringing different sectors (health, education, immigration, finance and labour) together with nursing stakeholders for policy dialogue and workforce planning.

The report’s message is clear: governments should invest to accelerate nursing education and training, create nursing jobs, and empower nurse leadership. Without nurses, midwives and other health workers, countries cannot win the battle against outbreaks, or achieve universal health coverage and the Sustainable Development Goals.

“Nurses are the backbone of any health system. Today, many nurses find themselves on the frontline in the battle against COVID-19,” said Dr Tedros Adhanom Ghebreyesus, WHO Director-General. “This report is a stark reminder of the unique role they play, and a wake-up call to ensure they get the support they need to keep the world healthy.”

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