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Worsening Global Health Workforce Shortage: What’s Being Done?

December 9, 2013
JM: photo emailed to you. Photo is of Frances Day-Stirk, president of the International Confederation of Midwives, and David Benton, CEO of the International Council of Nurses. Photo courtesy of Marilyn DeLuca, consultant, Global Health - Health Systems  and adjunct associate professor, College of Nursing, New York University.

Frances Day-Stirk, president, International Confederation of Midwives, and David Benton, CEO of International Council of Nurses. Photo courtesy of Marilyn DeLuca.

By Shawn Kennedy, MA, RN, AJN editor-in-chief

While it might seem—based on what we see in our own country—that there is no shortage of health care workers, there is indeed a global shortage and it’s only going to get worse. We reported on the global health workforce last year; new reports are revealing just how much worse things may get. According to the World Health Organization (WHO), by 2035 there will be a shortage of 12.9 million health care workers; currently, there is a shortage of 7.2 million.*

The shortage is being exacerbated by a confluence of occurrences:

  • the aging population is living longer and with more illness
  • noncommunicable chronic illnesses like cancer, cardiovascular disease, and diabetes are increasing worldwide
  • many undeveloped countries lack educational facilities for training new professionals
  • experienced health care workers migrate to developed countries for better working conditions and pay

Discussions focused on how nations individually and together can develop and strengthen the workforce to meet Millenium Development Goals and attain the goal of universal health coverage. The result was the Recife Declaration, a call to action detailing what needed to be done to address the problem, asking nations and organizations to commit to a goal of universal health coverage for all, and committing resources to develop the workforce to provide it.

The International Council of Nurses (ICN) and the International Confederation of Midwives (ICM) were among those making a commitment to work towards universal health coverage and to “support policies that advance equity and the provision of high quality care and services that are available, accessible, and acceptable.”

A glaring irony at WHO. I can’t help wondering, though, with nurses and midwives the key providers in many underdeveloped countries—and often the only educated providers of any health care—why the WHO has yet to fill the nursing and midwifery leadership position at headquarters. (See my editorial from 2011.) The Office of Nursing and Midwifery, which coordinated the work of the Global Advisory Group on Nursing and Midwifery, has been without a director since 2009. This is the group that develops and supports nursing and midwifery training programs in WHO member countries. Seems to me it would be a good idea to fill this position if the WHO is serious about universal health care.

* The figures cited above come from a new report, A Universal Truth: No Health Without a Workforce, released at last month’s Third Global Forum on Human Resources for Health conference in Recife, Brazil. Organized by the Global Health Workforce Alliance in conjunction with the WHO, the Brazilian government, and the Pan American Health Organization, the meeting drew representatives from 85 countries—over 1,300 participants in total—to address the workforce shortage.

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6 comments

  1. As it is stated here global nursing shortage is a big issue, here in America of course is not so much as a big issue since, nurses and doctors from around the world migrate to work here. Take for example the incentives that the people of India have; they have in place training schools which the United States recruits from. For many Indians it is a dream to come to America due to the poverty and salaries they earn in such a demanding profession, In an article I read recently an Indian migrant states, “We will be paid $30 an hour in the US. Here the average salary for nurses is about 6,000 rupees ($120) a month.” Indian nurses working in the US are paid on par with their American counterparts, meaning they take home around $3,000 plus a month. To my knowledge the global nursing shortage will continue to grow in countries where there are no or little incentives for nurses, nursing is a demanding profession mentally and physically and it deserves to be rewarded with a compensation that one can actually support themselves and their family.

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  2. Even developed countries like Canada, Australia, and United Kingdom are facing health care professionals shortage. These countries, like United States, have aging health professionals caring for a rising number of elderly people. In the case of nursing, the challenge is how to substitute the number of nurses that are expected to retire during next decades. As we all have seen through the last decades, developed countries rely in more nurses than they are capable to produce. This is been achieved by recruiting them from developing countries. Since these nurses have lower payment, worst work’s conditions, less opportunities to advance education and even the thread of violence; they leave their countries where their centrally to deliver care. While this fix the shortage in developed countries temporarily, worsens the global situation. This is a big issue that needs to be address before is too late for all countries.

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  3. Nursing shortage continues to be a big treat to the world of medicine. Despite the amount of new nursing schools that we see opening their doors all over the United States, the thousands of nurse graduates that have entered the field of nursing or getting reading for the challenge, it we are still unable to meet the demand of our population. At this point of time, the “Baby Boomers”, which we can say are a great part of our population, are aging, requiring medical assistance and nursing care, but yet staffing in nurses continues to be poor. The lack of nurses is not only caused by a greater number of people needing care, but also by a lot of nurses quitting the profession and redirecting their career toward something else then nursing. Many nurses quit because of different factors, including the pay, workload, working circumstances, long hours, lack of support and appreciation, burnouts and many more. For these reasons, some countries like ours recruit nurses from other country offering them a brighter future, creating a shortage in these countries as well. Finally, we have a lot of work to do in order to not only encourage people to become nursing professionals but also to keep the vast numbers of nurses that we already have from quitting. “Others do not produce enough nurses, and they tend to make up these shortages through the recruitment of healthcare personnel from other countries, particularly low- and middle-income countries.” (Holtz, 2008, pp. 99)
    Holtz, C. (2008). Global Health Care: Issues and Policies. Sudbury, MA: Bartlett and Jones Publishers

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  4. Regarding the noncommunicable chronic illnesses that have the possibility of been preventable, it is crucial for nurses to implement education to all patients that are at risk or already have such conditions. Education has to become part of the daily routine of nurses to make the patients feel as if each part of the nurses education is the same as taking a pill of prevention.
    Another interesting topic dealt with here is how the World Health Organization has not had a leadership position filled since 2009. If the shortage of nursing is at such risk to be exacerbated, then this position should be filled to promote and facilitate the fulfillment of nursing and midwifery positions in underdeveloped countries. If this position is to be filled, then the training programs could aid in the growth of nursing and prevent the shortage.

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  5. As most of us have heard before, the shortage in health care workers around the world is a very big issue. Just as us Americans have health problems, so do people from low income and underdeveloped countries. Every person has the right to be treated for his or her health care issues. With the increasing shortage of health care workers, something drastic needs to be done. As the years pass, the increasing aging population and chronic illnesses are making it more difficult to get assistance in health care around the world. Although many people in the United States are attending medical and nursing school, we retain most of the health care workers. Globally, we all need to find a way to increase the amount of health care workers, especially in underdeveloped countries.

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  6. As stated above the health care shortage is world wide, even if in our native country it isn’t evident. According to the WHO, the shortage is going to get more profound than it already is, almost doubling in numbers by 2035. The WHO can and should create a strategy to effectively address in detail the overwhelming impending shortage. As seen in recent decades, developed countries stuggle to produce an adequate amount of health care professionals. With that thought in mind, expecting these countries to effectively produce enough qualified nurses for the under developed countries as well as incentives urging them to take the positions rather than take opportunities provided in their own countries is going to be no small task.

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