From the CEO: What you need to know about the first-ever State of the World’s Nursing Report

By Elizabeth A. Madigan |

In May 2019 when the 72nd World Health Assembly declared 2020 as the International Year of the Nurse and the Midwife, they couldn’t have possibly known the true depths of heroism nurses around the world would display during the COVID-19 pandemic.  

What they did know though is how critical the nursing workforce is to achieving Universal Elizabeth MadiganHealth Coverage (UHC), improving primary healthcare (PHC), and the United Nations’ Sustainable Development Goals (SDGs). But as heroic as nurses are, we are still only human. We can’t meet these world-changing goals without first addressing and making a plan for the shortage of nurses and the need for additional investments and policy development in the health workforce.  

Enter the World Health Organization’s (WHO) decision to develop the first-ever State of the World’s Nursing Report in conjunction with the International Council of Nurses and Nursing Now. Despite the mounting turmoil in the world, I’m so proud that this report has been completed as intended because it is truly a necessary foundation for launching our efforts to deliver UHC and meet the SDGs by 2030. 

So how did they do it? They spent months collecting data from countries around the world about their number and types of nurses, education, regulation, practice, leadership, and gender issues. Here’s where Sigma comes in. Because this data was self-reported by these countries, they needed a way to validate the information they received. For a few years prior, Sigma had been developing a database to track and record a variety of nursing indicators, including nursing educational programs by level of program and duration. And we were pleased to offer this information to the group working on the report.  

If you’re thinking, “Sure, this is great, but now what?” let me share a few of my observations from the report.  

  1. There are not enough nurses, particularly in low and middle-income countries but also in North America and Europe. The report indicates that we need at least 6 million more nursing jobs by 2030. In the Americas and Europe, the predicted nursing shortages are driven by the aging nursing workforce.

  2. There needs to be a deep, sustained, and rapid acceleration of nursing education to meet this demand for nurses. There are wide variations in the length and depth of nursing education, and to meet the world’s needs, it is going to take a substantial change in how nursing education is provided. There are not sufficient numbers of nurse faculty.  

  3. Nursing leadership needs to be strengthened. Nurses represent, according to the report, 59% of the world’s health workforce. But nursing leaders need support—both current leaders and emerging or young nurse leaders. And of course, this is where Sigma shines with our support of nursing leadership development across one’s career, whether in a clinical or academic setting.

  4. Finally, nursing remains, in many places, a highly gendered profession, with no region exceeding 24% of males. This is critical because of the cultural and historical issues relative to career progression, pay, and women’s multiple roles in addition to work.
There is good news, too: the number of advanced practice nurses is growing with 53% of the reporting countries (n = 78) having advanced practice roles. These nurses are particularly important in addressing the social determinants of health and providing care to the under-served.  

Please spread the word about this report—especially now, we need to recognize nursing’s contributions to healing the world. Now, more than ever, we need nurse leaders.  

All my best,

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Elizabeth “Liz” Madigan, PhD, RN, FAAN
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