Policymakers Forewarned in State of the World’s Nursing 2020


The State of the World’s Nursing 2020 Report was released by the World Health Organization on World Health Day, April 7. Countries across the world contributed information for this first of its kind report on the global status of the nursing workforce. The report provides clear guidelines for policymakers if they want to meet their commitment towards achieving universal health coverage. 

“This is the Year of the Nurse and Midwife – not the one that any of us had envisaged – but the COVID-19 outbreak is the most powerful demonstration of why we need to support and invest in our nursing workforce,” said Nigel Crisp, Co-Chair of Nursing Now. “It will be the greatest tragedy if we do not learn the lessons from this pandemic. We call on politicians to be as brave and courageous as those nurses currently fighting COVID-19. Be as brave and courageous in your political leadership and say ‘yes’ to implementing all recommendations.”

Data collection for the State of the World’s Nursing Report

The State of the World’s Nursing Report 2020 was published by the World Health Organization, in partnership with the International Council of Nurses (ICN) and Nursing Now This was part of its planned actions for 2020 International Year of the Nurse and Midwife.

Information on 15 indicators was provided by 191 WHO member states to create the most comprehensive overview to date of nursing across the globe. Data was mostly supplied by national government departments, although many were unable to supply all the required information on each indicator. In every country, other organizations, including educational institutions and local nursing associations in membership with the ICN, also played a collaborative and advocacy role.

The global nursing workforce in 2020

At about 59% of all health care professionals, nurses comprise the largest occupational group within health care. There are nearly 28 million nurses worldwide, but their distribution is unequal. More than 80% of the world’s nurses work in countries that make up half of the world’s population. 

Country profile for the United States from the State of the World’s Nursing. Check more via: NHWAportal

Nursing numbers grew by 4.7 million between 2013 and 2018, but there is still a global shortage of 5.9 million. The most significant shortages are in the lower and middle-income countries, particularly in Africa, South East Asia, the WHO Eastern Mediterranean region, and some parts of Latin America.

One-in-eight nurses practice in countries other than those where they were born or trained. The international mobility of nurses is growing, but this is aggravating the nursing shortages in some of the source countries. Many high-income countries tend to rely too heavily on recruiting nurses from other countries, rather than increasing nursing education opportunities in their own countries.

Furthermore, around 10% of the current nursing workforce is due to retire in the next ten years – mostly in the European and American regions.


According to the report, 36 million nurses will be needed by 2030. To meet this target, the number of nursing graduates needs to increase by 8% per year. Policymakers also need to improve the retention of qualified nurses and increase employment opportunities.

Also of significance is that 90 percent of nurses are female and that they continue to face gender discrimination and inequality. For example, although they make up 59% of the health workforce, few of them are found in senior leadership positions in health care.


From the report, it is clear that governments need to increase investment in nursing urgently. Without a strong nursing profession, it will be impossible to achieve universal health coverage or be adequately prepared for health disasters.

The recommendations in the State of The World’s Nursing Report for all countries are summarized as follows by the ICN:

  • “Increase funding to educate and employ more nurses
  • Strengthen capacity to collect, analyze and act on data about the health workforce
  • Monitor nurse mobility and migration and manage it responsibly and ethically
  • Educate and train nurses in the scientific, technological and sociological skills they need to drive progress in primary health care
  • Establish leadership positions including a government chief nurse and support leadership development among young nurses
  • Ensure that nurses in primary health care teams work to their full potential, for example in preventing and managing non-communicable diseases
  • Improve working conditions including through safe staffing levels, fair salaries, and respecting rights to occupational health and safety
  • Implement gender-sensitive nursing workforce policies
  • Modernize professional nursing regulation by harmonizing education and practice standards and using systems that can recognize and process nurses’ credentials globally
  • Strengthen the role of nurses in care teams by bringing different sectors (health, education, immigration, finance, and labor) together with nursing stakeholders for policy dialogue and workforce planning.”


The strengths and weaknesses in the nursing workforce are highlighted in the State of the World’s Nursing report and clearly shows where policymakers need to put their money to improve nursing education, the workplace environment, and leadership in the profession.

“Politicians understand the cost of educating and maintaining a professional nursing workforce, but only now are many of them recognizing their true value,” said Annette Kennedy, President of the ICN. “This report highlights the nursing contribution and confirms that investment in the nursing profession is a benefit to society, not a cost.”

Use this link to read the executive summary of the State of The World’s Nursing 2020. 


Frieda Paton is a registered nurse with a Master’s degree in nursing education. Her passion for nursing education, nursing issues and advocacy for the profession were ignited while she worked as an education officer, and later editor, at a national nurses’ association. This passion, together with interest in health and wellness education since her student days, stayed with her throughout her further career as a nurse educator and occupational health nurse. Having reached retirement age, she continues to contribute to the profession as a full-time freelance writer. In the news and feature articles she writes for Nurseslabs, she hopes to inspire nursing students and nurses on the job to reflect on the trends and issues that affect their profession and communities - and play their part in advocacy wherever they find themselves.