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Global nurse deficit exposes a growing competition for qualified professionals, as health systems deal with aging populations, retirements, international migration, and inequality in workforce distribution, according to data from the World Health Organization.
The shortage of nurses remains among the main challenges of health systems worldwide, even in an essential, regulated profession with constant demand in hospitals, clinics, public services, and home care.
The global deficit was estimated at 5.8 million professionals in 2023, according to the State of the World’s Nursing 2025 report, released on May 12, 2025, by the World Health Organization, the International Council of Nurses, and partners.
According to the survey, the global nursing workforce increased from 27.9 million people in 2018 to 29.8 million in 2023, but the increase did not eliminate the inequalities in the distribution of these professionals.
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This scenario helps explain the competition for qualified labor in hospitals, emergency units, primary care services, and long-term care institutions, where the need for care also depends on the hiring and retention of these workers.
In many countries, the challenge is not limited to the training of new nurses, as it involves funding, job availability, working conditions, and the capacity of public and private systems to absorb qualified professionals.
Distribution of nurses worldwide
Inequality in the supply of professionals appears directly in the concentration of the workforce, according to the WHO.
About 78% of the world’s nurses are in countries that comprise only 49% of the global population, indicating that the total number of trained workers does not alone represent the actual availability of care.
In practice, populations living in regions with fewer of these professionals may face restrictions in access to consultations, vaccinations, post-operative care, chronic disease management, maternal and child care, and emergency response.
The report also shows that low- and middle-income countries face difficulties in transforming the training of new professionals into effective care, as graduation does not, by itself, guarantee hiring and retention in the health system.
In several nations, the increase in the number of graduates does not automatically translate into more available nurses, because there is a lack of sustainable positions, funding, and institutional capacity to incorporate these workers into services.
In high-income economies, on the other hand, the pressure is associated with the aging workforce, the retirement of experienced professionals, and the reliance on nurses trained abroad.
Nurse Migration and International Competition
International mobility has become a significant factor in addressing the shortage of nurses, especially in countries that rely on foreign workers to keep health services operational.
According to the WHO, 1 in every 7 nurses worldwide was born in a different country from where they work, a proportion that reaches 23% in high-income economies.
This movement helps fill positions in systems capable of attracting foreign professionals, but it also increases international competition for qualified workers in an area already facing a global deficit.
When migration occurs without planning, countries with fewer available nurses may lose part of the workforce needed to serve their own populations, as highlighted in the report.
For this reason, the WHO recommends that high-income countries review their reliance on professionals trained abroad and strengthen bilateral agreements with the countries of origin of these workers.
The guidance aims to balance international hiring with the protection of health systems in countries already facing shortages, preventing the departure of professionals from worsening local deficits.
The age of the workforce adds another element to the pressure on services.
Although 33% of nurses are under 35 years old, about 19% are expected to retire in the next ten years, which could reduce the presence of experienced professionals in care areas.
In 20 countries, most of them high-income, the expected retirements may exceed the entry of new workers, according to the WHO, which increases the need for planning in training, hiring, and retention.
Nursing Education Requires Time and Regulation
Nursing has requirements that make the replacement of professionals slower than in occupations without specific regulation.
The work involves clinical procedures, medication administration, patient monitoring, team coordination, vaccination, intensive care, and direct action in primary care, activities that depend on recognized training and technical responsibility.
In many countries, professional practice also requires active registration, supervised practice, and compliance with legal standards, which limits immediate responses based solely on job openings or the interest of new workers.
This entry barrier brings nursing closer to other regulated health careers, where training takes time and practical experience plays a significant role in the safety of care.
The departure of experienced professionals also affects the training of younger teams, as part of the learning in clinical environments occurs through daily contact with workers who have accumulated care experience.
The WHO states that nurses form the largest occupational group in the health sector and play a significant role in reducing inequalities in access to essential services.
The 2025 report included indicators on education capacity, advanced practice, and remuneration, areas considered by the entity as strategic for guiding public policies and assessing workforce needs.
Women are the majority in global nursing
The presence of women is a structural characteristic of nursing worldwide.
Women represent 85% of the global workforce in the profession, according to the WHO, a figure that links career valuation to debates on employment, income, workplace safety, and equality of opportunities.
This profile makes career, remuneration, and leadership policies relevant for hospitals, governments, and families that depend on the income generated by these jobs, especially in countries where nursing accounts for a large number of formal positions.
When there is precariousness, high turnover, or difficulty in retention, the effects can impact both the organization of health services and the income of workers and families linked to the sector.
The report also highlights progress in advanced practice nursing roles.
About 62% of countries reported the existence of these roles, a percentage higher than the 53% recorded in the previous edition, published in 2020.
These roles allow nurses to take on more complex activities in certain systems, provided there is regulation, adequate training, and a clear definition of professional responsibilities.
In the WHO’s assessment, the expansion of these roles can help increase access to care in contexts of scarcity, especially when integrated with workforce training and planning policies.
Retention of nursing professionals
The shortage of nurses is not solely linked to the number of people trained.
Staying in the profession depends on factors such as working conditions, workload, safety, institutional support, remuneration, and mental health, elements identified by the WHO as related to the retention of these workers.
The entity reports that only 42% of responding countries reported having support measures for the mental health of nurses, despite the increased workload and exposure to stressful situations in health services.
This data helps contextualize why the high demand for professionals does not eliminate difficulties associated with the career, including emotional pressure, technical requirements, and the need for appreciation policies.
Nursing can offer presence in different areas of health and the possibility of international mobility, but the conditions for staying vary according to the country, the type of service, and the support structure for the worker.
There is also an increased demand for nurses outside the traditional inpatient model, due to the expansion of home care, population aging, and continuous monitoring of people with chronic diseases.
With this change, the demand for professionals reaches hospitals, community services, long-term care institutions, basic units, and programs aimed at prevention and continuous care.
For health systems, addressing the deficit involves combining training, hiring, retention, and territorial distribution.
Without coordination between these fronts, the growth in the global number of professionals may continue to be insufficient to reduce access inequalities and relieve pressure on essential services.
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