The Global Nurse Shortage in Numbers: Where the World Needs Nurses Most
Summary
Nurses represent the largest occupational group in most healthcare systems and are fundamental to the delivery of hospital care, primary care, community health, long-term care, emergency medicine and public health.
Yet the world does not have enough nurses in the places where they are needed most.
According to the World Health Organization's State of the World's Nursing 2025, the global nursing workforce increased from 27.9 million nurses in 2018 to approximately 29.8 million in 2023. Despite this growth, the estimated global nursing shortage remained approximately 5.8 million nurses in 2023.
The WHO projects that this shortage could fall to approximately 4.1 million nurses by 2030 if current improvements continue. Other current WHO summaries estimate a 2030 shortage of approximately 4.5 million nurses, reflecting differences in methodology and reporting. Either way, the underlying conclusion is the same: millions of additional nurses will be required during this decade.
More importantly, the global average hides an enormous geographical imbalance.
Approximately 78% of the world's nurses are concentrated in countries representing only around 49% of the global population. Meanwhile, some of the world's most severe nursing shortages occur in countries with considerably fewer resources to educate, employ and retain additional nurses.
This creates a paradox.
The world is producing more nurses, but the countries with the greatest need often have the least capacity to increase their nursing workforce.
At the same time, high-income countries are increasingly recruiting internationally. OECD data show that more than 800,000 foreign-trained nurses were working across OECD countries in 2023, approximately 69% more than in 2010. In some countries, international nurses have accounted for the majority of recent workforce growth.
International recruitment will therefore remain an important part of healthcare workforce planning.
However, the numbers also demonstrate why international recruitment must be conducted responsibly.
This is not simply a story about a shortage of nurses.
It is a story about where nurses are located, where nurses are needed, why nurses leave, and how countries can expand their workforces without creating new shortages elsewhere.
The Global Nursing Workforce at a Glance
The simplest way to understand the global nursing situation is through a handful of numbers.
Nurses worldwide 2018: 27.9 million
Nurses worldwide 2023: 29.8 million
Increase from 2018-2023: 1.9 million
Global Nursing Shortage 2020: 6.2 million
Global Shortage 2023: 5.8 million
Projected Shortage 2030: 4.1-4.5 million
Nurses' share of global health workforce: Largest Occupational Group
Nurses concentrated in countries representing ~49% of global population: 78%
Foreign-trained nurses in OECD countries, 2023: >800,000
Sources: WHO State of the World's Nursing 2025, WHO nursing and midwifery data and OECD Health at a Glance 2025.
These numbers demonstrate something important.
The global nursing shortage is not primarily caused by a complete inability to train nurses.
The world has increased the number of nurses significantly.
The problem is that growth in the nursing workforce has been uneven.
29.8 Million Nurses — But Not Where They Are Needed
The global nursing workforce reached approximately 29.8 million in 2023, up from 27.9 million five years earlier.
That represents an increase of roughly 1.9 million nurses, or about 7%.
At first glance, this appears encouraging.
And it is.
The WHO reports that the estimated global nursing shortage declined from approximately 6.2 million in 2020 to 5.8 million in 2023. If current trends continue, the shortage could decline further to approximately 4.1 million by 2030.
But global averages conceal enormous inequalities.
Approximately 78% of the world's nurses are concentrated in countries that contain only around 49% of the global population.
In other words, nearly four out of every five nurses are located in roughly half of the world's population.
The remaining population has access to a much smaller proportion of the global nursing workforce.
This is one of the most important facts about the global nursing shortage.
The problem is not simply:
"There are not enough nurses."
It is:
"There are not enough nurses in the right places."
Where Is the Shortage Greatest?
The largest workforce gaps are concentrated disproportionately in lower-income regions.
The WHO identifies particularly significant shortages in Africa, South-East Asia and the Eastern Mediterranean Region, alongside significant gaps in parts of Latin America.
This creates a difficult structural problem.
Countries experiencing the greatest shortages often also have:
lower healthcare spending;
limited nursing education capacity;
fewer training institutions;
fewer nursing faculty;
lower salaries;
poorer working conditions;
weaker rural healthcare infrastructure;
higher rates of international migration;
and limited ability to create additional public-sector nursing positions.
Consequently, simply telling these countries to "train more nurses" does not solve the problem.
They need the capacity to educate, employ and retain those nurses.
The WHO's 2025 report therefore places considerable emphasis on investment in nursing education, jobs, working conditions and leadership.
Africa: The Region Facing Some of the Greatest Challenges
Africa contains some of the world's most severe nursing workforce inequalities.
Many African countries have substantially fewer nurses per population than high-income healthcare systems.
This does not necessarily mean that African countries are incapable of producing nurses.
A major problem is the transition from education to employment.
A country can graduate healthcare professionals but still have a workforce shortage if there are insufficient funded positions to employ them.
Retention is another major issue.
Healthcare professionals may leave because of:
inadequate pay;
limited career progression;
unsafe working environments;
excessive workloads;
insufficient equipment;
limited specialist training;
political or economic instability;
or international opportunities.
This creates a cycle.
A country invests in training a nurse.
The nurse becomes qualified.
A foreign healthcare system offers significantly better employment conditions.
The nurse emigrates.
The source country loses part of the workforce it invested in educating.
The destination country gains an experienced professional without having to provide the entire cost and time associated with initial training.
This is one reason the international recruitment debate has become closely connected to global health equity.
South-East Asia: A Major Global Source of Nurses
South-East Asia occupies an unusual position in the international nursing market.
Several countries in the region have developed significant nursing education systems and have become major sources of internationally mobile healthcare professionals.
The Philippines is perhaps the best-known example.
The country has developed a large international nursing workforce and has become one of the principal sources of nurses working abroad.
India is another major source country.
OECD data identify the Philippines, India and Poland as the three leading countries of origin for nurses working in OECD countries.
This creates an important distinction.
A country can simultaneously have:
a large nursing education system, a large domestic nursing workforce and significant international migration.
Therefore, "source country" should not automatically be interpreted as "country that has too many nurses."
The actual workforce situation can be much more complicated.
The Philippines: One of the World's Most Important Nursing Exporters
The Philippines has become one of the most significant sources of internationally mobile nurses.
OECD data indicate that approximately 270,000 Filipino nurses were working in OECD countries around 2020–2021, making the Philippines the largest country of origin for nurses working across the OECD.
This reflects several decades of international migration.
Filipino nurses work throughout:
the United States;
the United Kingdom;
Canada;
Australia;
New Zealand;
the Middle East;
Europe;
and other international healthcare markets.
For destination countries, Filipino nurses can offer an established international workforce with substantial experience navigating international registration and migration systems.
For the Philippines, however, international migration also creates a complicated policy challenge.
The country benefits economically from overseas workers and the professional opportunities available to its citizens.
At the same time, policymakers must ensure that domestic healthcare services retain an adequate nursing workforce.
This is precisely the type of balance that modern ethical international recruitment policies are intended to address.
India: A Growing International Nursing Workforce
India is another major source of internationally mobile nurses.
The country's enormous population and expanding healthcare education system mean that India has become an increasingly important source of healthcare professionals for international markets.
OECD data identify India as the second-largest country of origin for nurses working in OECD countries, with approximately 120,000 Indian nurses working in OECD countries around 2020–2021.
Indian nurses are increasingly visible in healthcare systems across:
the United Kingdom;
Australia;
the United States;
Canada;
Germany;
Ireland;
the Middle East;
and other destinations.
India's size also makes it different from smaller source countries.
International migration represents a significant workforce movement, but India's enormous population means that the effects are not necessarily equivalent to those experienced by a small island state losing a comparable number of healthcare professionals.
This demonstrates why responsible international recruitment requires country-specific analysis rather than simplistic global rules.
Europe: A Major Destination for International Nurses
Europe is experiencing its own nursing workforce challenges.
Ageing populations are increasing demand for healthcare and long-term care while significant numbers of nurses are approaching retirement.
At the same time, many European healthcare systems have struggled to recruit and retain enough domestic workers.
As a result, international recruitment has become increasingly important.
OECD data show that the number of foreign-trained nurses has increased significantly across many European countries.
Ireland provides one of the clearest examples.
In 2023, approximately 52% of Ireland's nursing workforce had been trained abroad, according to OECD data. By 2024, the proportion had increased further to approximately 54%.
This is extraordinary by international standards.
It demonstrates that international recruitment is no longer a marginal component of healthcare staffing in some countries.
It is a structural component of the healthcare workforce.
The United Kingdom: International Nurses Have Driven Workforce Growth
The United Kingdom provides another striking example.
Between 2010 and 2023, foreign-trained nurses accounted for approximately 83% of the increase in the UK's nursing workforce, according to OECD analysis. The number of foreign-trained nurses increased from roughly 70,000 to 170,000 during this period.
This means that international recruitment has played an enormous role in the expansion of the British nursing workforce.
The implication is important.
If international recruitment were suddenly removed from the equation, the UK would need to replace a very substantial component of its recent nursing workforce growth through domestic education, retention and re-entry.
This is one reason why international nurse recruitment remains an important workforce policy issue.
It is also why ethical recruitment matters.
When a healthcare system becomes highly dependent on nurses trained elsewhere, the relationship between source and destination countries becomes part of the wider sustainability of the global healthcare workforce.
Ireland: An Extreme Example of International Dependence
Ireland provides perhaps one of the clearest numerical examples.
OECD data show that foreign-trained nurses accounted for 92% of the growth in Ireland's nursing workforce between 2021 and 2024.
The country reportedly received more than 5,000 foreign-trained nurses in 2024, compared with roughly 200 in 2010.
Meanwhile, annual domestic nursing graduate output remained around 1,600 during much of this period.
The implication is straightforward.
Ireland has not simply used international recruitment as an occasional solution.
International recruitment has become an essential mechanism for expanding its nursing workforce.
This raises an important question for healthcare workforce planning:
How much international recruitment can a country sustainably depend upon?
There is no universal numerical answer.
The appropriate balance depends on domestic education capacity, retirement, population growth, retention, workforce participation and the policies of source countries.
New Zealand and Australia
New Zealand and Australia are also major users of internationally trained nurses.
OECD data indicate that foreign-trained nurses accounted for more than half of recent nursing workforce growth in New Zealand and around one-third in Australia.
New Zealand also has one of the highest proportions of foreign-born nurses among OECD countries.
This reflects the country's geographic location, relatively high wages and persistent healthcare workforce requirements.
Australia similarly recruits internationally to supplement its domestic workforce.
For countries such as Australia and New Zealand, international recruitment is particularly relevant because geographical isolation can make domestic workforce shortages difficult to address rapidly.
International recruitment can therefore provide a relatively fast mechanism for increasing the number of qualified healthcare professionals.
But again, it does not eliminate the need for domestic education and retention.
The United States: Scale Matters
The United States has one of the world's largest nursing workforces.
It also has one of the world's largest healthcare systems and therefore enormous absolute workforce requirements.
The scale of the American healthcare system means that even relatively small percentage shortages can represent very large numbers of individual positions.
The US also attracts internationally educated nurses, particularly from countries with established nursing education systems and English-language training.
The broader trend is clear across the OECD: international healthcare migration has increased substantially over the past two decades as destination countries have attempted to respond to workforce shortages.
The OECD Has More Than 800,000 Foreign-Trained Nurses
Perhaps the clearest measure of the importance of international nurse recruitment is the OECD-wide figure.
In 2023, OECD countries employed more than 800,000 foreign-trained nurses.
That represented a 69% increase since 2010.
The international nursing workforce is therefore not a small phenomenon.
It represents a major component of healthcare provision across wealthy economies.
However, the distribution is highly concentrated.
The United States, United Kingdom and Germany together employ more than 60% of foreign-trained nurses across the OECD, while the ten largest destination countries account for approximately 92%.
This means that a relatively small number of destination countries drive much of the world's demand for internationally trained nurses.
The Top International Sources of Nurses
According to OECD data, the leading countries of origin for nurses working in OECD countries include:
Philippines ~ 270,000
India ~ 120,000
Poland ~ 64,000
Nigeria ~ 54,000
*Approximate figures based on foreign-born nurses working in OECD countries around 2020–2021; definitions and reference years vary by dataset.
These four countries alone demonstrate the global nature of nursing migration.
The international nursing workforce is not dominated by a single region.
It involves Asia, Europe, Africa, the Americas and other parts of the world.
The Brain Drain Question
International nurse migration creates legitimate benefits.
A nurse may earn substantially more abroad.
They may receive better training.
They may gain specialist experience.
They may send money home to their family.
They may eventually return home with new skills.
Their destination country gains an experienced healthcare professional.
Migration can therefore produce significant individual and economic benefits.
But there can also be a cost.
When large numbers of nurses leave countries that already have severe shortages, the source country's healthcare system can become weaker.
This is commonly described as health-worker brain drain.
The problem is particularly serious when a small or low-income country loses a large proportion of its trained professionals.
OECD data show that around 257,000 nurses working in OECD countries were born in countries included on the WHO Health Workforce Support and Safeguards List, which identifies countries facing significant workforce pressures.
The countries involved include significant numbers from Nigeria, Haiti and Ghana.
This does not mean these nurses should be prohibited from migrating.
Rather, it demonstrates why international recruitment needs to consider the wider consequences of workforce mobility.
International Recruitment Is Not the Enemy
It is tempting to frame the global nursing shortage as an argument against international recruitment.
That would be too simplistic.
International recruitment can be extremely valuable.
Training a new nurse from the beginning can take several years.
Recruiting an already-qualified professional can address an immediate vacancy far more quickly.
OECD countries themselves recognise this.
The OECD states that international recruitment can provide a faster solution to immediate workforce shortages, although it can also exacerbate shortages in countries of origin.
The real issue is therefore balance.
Countries need to:
train more nurses;
retain more nurses;
improve working conditions;
support nurses returning to practice;
improve geographical distribution;
expand healthcare capacity;
and use international recruitment responsibly.
International recruitment is one tool among many.
It cannot replace workforce planning.
The Ageing Nurse Workforce
Another major challenge is retirement.
Many countries have ageing nursing workforces.
This creates a double pressure.
Healthcare demand is increasing as populations age.
At the same time, experienced nurses are approaching retirement.
The result can be a widening gap between:
the number of nurses leaving the workforce
and
the number of new nurses entering it.
Increasing nursing education capacity can help, but education cannot instantly replace retiring professionals.
This is another reason international recruitment can become important.
International recruitment can provide an immediate source of experienced professionals while domestic education systems expand.
Why More Nurses Alone Is Not Enough
The global nursing problem cannot be solved simply by increasing the number of nursing graduates.
A healthcare system needs to be able to employ and retain those graduates.
A country might produce 10,000 additional nursing graduates.
If only 7,000 can find appropriate employment, the remaining 3,000 do not solve the health system's staffing problem.
Similarly, if 10,000 nurses enter employment but 8,000 leave within several years because of poor working conditions, the system remains unstable.
This is why WHO's 2025 nursing report emphasises education, employment, working conditions and leadership rather than education alone.
The nursing shortage is therefore fundamentally a workforce system problem.
The Geography of Nursing Matters
One of the most overlooked aspects of the global shortage is geographical distribution.
Even countries with relatively high numbers of nurses can experience severe shortages in particular areas.
Urban hospitals may attract large numbers of healthcare professionals while rural and remote communities struggle.
This creates another form of inequality:
national sufficiency does not necessarily mean local sufficiency.
The WHO notes that difficulties deploying health workers to rural, remote and underserved areas contribute to workforce shortages.
For recruiters, this creates an important opportunity.
International recruitment does not necessarily have to focus exclusively on major cities.
Regional hospitals, rural health systems and underserved communities can also benefit from carefully designed international workforce programmes.
What Happens Between Now and 2030?
The next four years will be important.
The WHO's projected global nursing shortage of approximately 4.1–4.5 million nurses in 2030 represents improvement from the current situation, but it remains an enormous gap.
At the same time:
populations are ageing;
chronic disease is increasing;
healthcare demand is rising;
nurses are retiring;
some nurses are leaving the profession;
countries are expanding healthcare coverage;
and international migration continues.
The world therefore cannot assume that the shortage will simply disappear.
The number could fall while individual countries still experience serious workforce crises.
What This Means for International Healthcare Recruitment
For healthcare employers, the numbers point toward a continued need for international recruitment.
For recruitment companies, however, the market is changing.
The future will not simply belong to organisations capable of finding the largest number of candidates.
It will increasingly belong to organisations capable of understanding the global workforce environment.
That means knowing:
which countries have nursing surpluses or shortages;
which countries are major recruitment markets;
which destinations are expanding international recruitment;
professional registration requirements;
language requirements;
immigration pathways;
ethical recruitment standards;
candidate expectations;
retention challenges;
and the workforce implications for source countries.
A successful international recruitment programme should ultimately result in a nurse who is qualified, supported, properly employed and likely to remain in the healthcare system.
A placement that ends in early resignation is not a successful recruitment outcome.
The Role of Ethical Recruitment
The scale of global nurse migration makes ethical recruitment increasingly important.
The WHO Global Code of Practice on the International Recruitment of Health Personnel provides an international framework for balancing the interests of:
healthcare professionals;
destination countries;
source countries;
employers;
and global health systems.
The WHO amended the Code in 2026, explicitly expanding its scope to internationally recruited care workers, clarifying its application during emergencies and placing greater emphasis on co-investment in health systems and health workforces.
This represents an important evolution.
The future of international recruitment should not be based on simply moving healthcare professionals from countries with fewer resources to countries with greater resources.
It should aim to create sustainable workforce partnerships.
The Global Nursing Shortage in Perspective
Perhaps the most useful way to understand the crisis is to consider what the numbers mean.
The world has approximately 30 million nurses.
Yet it still needs millions more.
The workforce has grown by almost 2 million nurses in five years, but significant shortages remain.
Nearly four out of every five nurses are concentrated in countries representing only about half of the world's population.
More than 800,000 foreign-trained nurses work in OECD countries.
In countries such as Ireland, international nurses now represent more than half of the nursing workforce.
In the United Kingdom, foreign-trained nurses accounted for approximately 83% of nursing workforce growth between 2010 and 2023.
These numbers tell a clear story.
International nursing recruitment is no longer a peripheral part of healthcare. It is a major component of the global healthcare workforce.
But it is also only one part of the solution.
Conclusion: The World Needs More Nurses — and Better Workforce Planning
The global nursing shortage is one of the defining workforce challenges of modern healthcare.
The numbers are enormous.
Approximately 29.8 million nurses were working globally in 2023, yet the world still faced a shortage of approximately 5.8 million nurses.
Even under improving projections, millions of additional nurses will be required by 2030.
The distribution of those nurses is perhaps even more important than the headline shortage.
Approximately 78% of nurses are concentrated in countries representing only 49% of the global population.
Some countries have large and growing nursing workforces.
Others face severe shortages.
Some countries are major sources of international nurses.
Others have become heavily dependent on recruiting nurses from abroad.
And many countries occupy both positions simultaneously.
This makes the global nursing workforce an interconnected system.
There is no single solution.
Governments need to invest in nursing education.
Healthcare organisations need to improve working conditions and retention.
Countries need to create enough jobs for newly qualified nurses.
Healthcare systems need to improve workforce distribution.
And international recruitment will continue to play an important role in filling immediate and persistent shortages.
But international recruitment must be conducted responsibly.
The goal should not simply be to move nurses from one country to another.
The goal should be to create a global healthcare workforce in which migration can provide opportunity for individual nurses while supporting, rather than undermining, the health systems that depend upon them.
For healthcare employers and recruitment organisations, that represents both a responsibility and an opportunity.
The global nursing shortage is measured in millions.
The challenge is ensuring that the nurses the world does have are trained, supported, employed and located where they are needed most.
Sources
World Health Organization — State of the World's Nursing 2025
WHO's principal global report on the nursing workforce, covering workforce numbers, distribution, education, employment, leadership and international migration.
World Health Organization — Nursing Workforce Grows, But Inequities Threaten Global Health Goals (12 May 2025)
Provides the headline global figures of 29.8 million nurses in 2023, the reduction in the global nursing shortage from 6.2 million in 2020 to 5.8 million in 2023, and the projection of approximately 4.1 million by 2030.
World Health Organization — Nursing and Midwifery Fact Sheet (17 July 2025)
Provides current WHO estimates of approximately 29 million nurses globally and a projected shortage of 4.5 million nurses by 2030, as well as regional information on workforce gaps.
World Health Organization — Health Workforce
WHO's broader analysis of the global health workforce, including the projected shortfall of approximately 11 million health workers by 2030 and the challenges of education, employment, retention and geographical distribution.
World Health Organization — Nursing and Midwifery
WHO's current nursing workforce resource and global workforce information.
OECD — Health at a Glance 2025: International Migration of Nurses
Provides data on foreign-trained nurses in OECD countries, including the more than 800,000 foreign-trained nurses working across OECD countries in 2023 and the 69% increase since 2010.
OECD — International Migration Outlook 2025: International Migration of Health Professionals
Provides detailed analysis of international healthcare migration, including the principal source countries for nurses, destination countries and the contribution of international recruitment to workforce growth.
OECD — Health Workforce
Overview of healthcare workforce shortages, international recruitment, training capacity and retention across OECD countries.
World Health Organization — WHO Global Code of Practice on the International Recruitment of Health Personnel
International framework for ethical international recruitment and protection of healthcare workers and health systems.