The International Council of Nurses (ICN) wants the WHO to enforce a “time-limited moratorium of active recruitment of nurses” after a spike in nurse recruitment from low- and middle-income countries (LMICs) by wealthy countries.
The WHO Health Workforce Support and Safeguard List identifies 55 countries with the worst workforce challenges related to achieving universal health coverage (UHC), shortages being a primary cause, reports Health Policy Watch.
The ICN made the proposal in a recent report to the World Health Organisation on the implementation of the WHO Global Code of Practice on the International Recruitment of Health Personnel.
It linked the the surge in international nurse migration and recruitment to some high-income countries actively recruiting from LMICs and “easing the entry or professional recognition of internationally educated nurses (IENs)”.
The proportion of overseas-trained nurses employed in the Organisation for Economic Co-operation and Development (OECD) – comprising 38 developed countries – jumped from 5% in 2011 to nearly 9% in 2021.
Driving the recruitment are the UK, USA, Canada, Australia, Germany and certain Gulf states.
UK takes nurses from ‘red list’ countries
In the UK, more than 24 000 new international nurses were registered from September 2021 to September 2022, the highest in recorded history.
Around 19% of them, between 2021-2023, came from countries facing “severe health workforce deficits”, according to the WHO list.
Over six months in 2022, more than 20% of new international nurses (more than 2 200) came from just two “red list” countries: Nigeria and Ghana.
The US reported that more than 17 000 nurses applied for visas in 2022, a 44% increase from the previous year.
“Countries that have not been traditionally active in international nurse recruitment are also showing increased demand for overseas-trained nurses, including Finland and Scotland, where the government announced an allocation of £4.5m to support active international recruitment of nurses as part of the overall plan for pandemic recovery and renewal,” notes the ICN.
Huge nurse shortages
More than 1 700 registered nurses in Zimbabwe resigned in 2021, and some 900 left the country in 2022, with many moving to the UK.
The Ghana Registered Nurses and Midwives Association said about 500 nurses leave that country every month, particularly experienced, specialist nurses.
The Philippines has a current shortage of 190 000 healthcare workers and is expected to face a shortage of 250 000 nurses by 2030.
And even though South Africa is not on the list, thousands of nurses have left the country for higher pay and better working conditions overseas. The National Health Department’s human resources strategy for 2030 has projected that by 2025, there will be a shortage of 34 000 registered nurses in primary healthcare alone, while the Hospital Association of SA estimated the nursing gap at between 21 000 and 61 000, according to a report in MedicalBrief in 2022.
The ICN said it “condemns the targeted recruitment of nurses from countries or areas within countries that are experiencing a chronic shortage of nurses and/or a temporary health crisis in which nurses are needed”, and that this jeopardises the global achievement of the UN Sustainable Development Goals, including universal health coverage, by 2030.
Mitigating migration
Some wealthier countries are boosting their own nurse training. In the UK, for example, the NHS Long Term Workforce Plan aims to educate more than 60 000 nurses in England by 2029, a 54% increase from 2022/23.
Australia is developing its National Nursing Workforce Strategy to improve sustainability and self-sufficiency, while Germany’s 2024 Nursing Studies Strengthening Act aims to attract nursing students with monthly salaries to ease the workforce shortage.
The Filipino Department of Health has recently allocated funds to provide nurses with health insurance, housing, and other benefits in an attempt to stem the tide of nurse migration.
However, several LMICs are experiencing nursing shortages and are unable to provide jobs or other measures to retain their nurses because of insufficient funding and other structural factors.
Aside from unemployment, nurses in LMICs often face poor working conditions, low compensation and safety issues.
In Lesotho, for example, almost a third of professional nurses and midwives are unemployed because of a lack of funding.
“LMICs require support to develop and strengthen their health and care workforce and systems so that they can meet their population’s needs,” the ICN said.
WHO health workfoce
See more from MedicalBrief archives:
South African nurses lured to well-paying Canada
Surgery catch-up stymied by South Africa’s shortage of ICU nurses
Massive UK nursing shortage sucks in Kenyan, South African and Zimbabwean nurses