Nurses provide most of the hands-on care in a health system, making up almost half of the world's healthcare workforce and delivering nearly 80% of care. With the ongoing escalation of health challenges across Asia and the Pacific, the nursing profession assumes an increasingly pivotal role in meeting the evolving healthcare needs.

However, chronic underinvestment in the education and training of nurses in many countries, coupled with mismatches between education planning and population needs, has resulted in persistent shortages and an overall decline in the dignity of the profession. 

These challenges are further compounded by difficulties in deploying health workers to rural, remote, and underserved areas, exacerbating disparities in access to healthcare.

 By 2030, the global health workforce will likely face a potential deficit of approximately 18 million health workers compared to the requirements needed to achieve the Sustainable Development Goals (SDGs), according to the World Health Organization.

In a world with increasing global mobility this deficit drives the international recruitment of health workers, leading to large numbers of out-migrations of nurses and other health care workers from lower-resourced countries to richer countries, further compounding over-burdened and underinvested health systems.

The Asia and Pacific region - with its large population, changing demographics, aging populations, changing disease profiles, and increasing climate vulnerability - has a growing demand for nurses and other skilled health workers.

However, the region is also a significant supplier of the global nursing workforce. The Philippines, for example, is the leading country for supplying nurses abroad, supplying close to a quarter of the world's overseas nurses and more than 80% of foreign nurses to the United States.

In some countries, poor health workforce planning delinked from education and supply planning leads to an imbalance between supply capacity and health system capacity. This results in a paradox of health worker unemployment in the context of significant unmet health needs.

For example,  despite the Philippines being a major provider of nurses abroad, it faces chronic understaffing in its own hospitals due to low pay, lack of tenure, and burnout. In another example, Pakistan has a severe shortage of health workers across all cadres, and is listed by the World Health Organization as one of the countries with a “human resources for health crisis”. However, with limited public and private sector jobs available, many healthcare workers remain unemployed and eventually either leave the country or the field.

To address the pressing issues surrounding nursing shortages and workforce challenges in the Asia and the Pacific region, countries can take several proactive steps. Increasing nursing sector challenges in the context of the broader macro-trends require health systems to review the effectiveness of past policies and strategies and adopt new, fit-for-purpose approaches to transform their health workforce from planning, education, deployment, managing, and rewarding workers. 

Ultimately, investing in the nursing sector not only addresses immediate healthcare needs but also has the potential to create millions of new jobs, spur economic growth, and foster broader socioeconomic development across the region.

There needs to be a concerted effort to invest in the education and training of nurses. This involves not only increasing funding for nursing programs but also ensuring that these programs are aligned with the current and future healthcare needs of the population.

Additionally, measures should be put in place to incentivize nurses to work in rural, remote, and underserved areas, such as offering financial incentives, career advancement opportunities, and improved working conditions. Digital innovations and private sector partnerships can help increase the efficiency and quality of existing resources while building new ones.

 Countries must focus on improving health workforce planning to ensure a balance between supply capacity and health system capacity. This includes strengthening coordination between education and supply planning to avoid the paradox of health worker unemployment coexisting with unmet health needs. Countries also need to assess their education and health care planning systems based on global market dynamics.

For many countries, nurses and health care workers migrating to other countries offer the home country foreign remittances, contributing to the economy, while also helping with long-term poverty alleviation of the individual health care worker and their families. However, supporting – or indeed promoting – out migration needs to be balanced with strategies that help address the national need as well.

Nursing is a female-oriented profession in a region where many countries face gender inequality issues. In many countries, social prejudices, few career advancement pathways, lower pay, and low quality of life result in very few people opting for a nursing career.

By creating inclusive and supportive work environments and removing barriers to advancement, countries can empower female nurses and contribute to broader gender equality initiatives.

Ultimately, investing in the nursing sector not only addresses immediate healthcare needs but also has the potential to create millions of new jobs, spur economic growth, and foster broader socioeconomic development across the region.

Today, the nursing profession stands at a compelling intersection: amidst rising health demands, shrinking fiscal capacities, persistent gender disparities, and a growing need for livelihoods and skills, nursing presents a unique opportunity to address these multifaceted challenges.

 Investment in the nursing sector has the potential to create millions of new jobs and spur economic growth and broader socioeconomic development. By supporting reforms in the nursing field, we can empower nurses and address gender imbalance, maximize labor markets, increase female labor market participation, and contribute to positive health outcomes across the Asia and Pacific region.