ICN Asia Workforce Forum highlights widening gap in global supply and demand of nurses

7 March 2023
PR 08

Nurse leaders gathered at a meeting in Thailand warned of the growing global nurse shortage at a time when the demand for nurses is increasing. The nurse leaders addressed the issue of nurse shortages and the linked subject of nurse migration, highlighting the widening gap in supply and demand of nurses.

Nurse leaders from 10 National Nurses Associations1 across Asia, representing eight million nurses, participated in the 21st Asia Workforce Forum (AWFF), co-hosted by International Council of Nurses (ICN) and the Nurses’ Association of Thailand and held in Bangkok, Thailand, 1-2 March 2023. The focus of the Forum was to discuss current nursing and health priorities across the region, and share strategies to effectively support nurses across Asia.

The Forum was convened at a time when the impact of the COVID-19 pandemic continues to challenge health system rebuild, whilst also having been a major cause of nurse stress, burnout and turnover. One key focus for the AWFF was to assess how the pandemic nurse workforce challenges can best be analysed and addressed. Participants reviewed and verified these challenges, and explored strategies for cooperation among countries. Nursing shortages, ageing populations and other key concerns were discussed.

Howard Catton, ICN Chief Executive Officer, who represented ICN at the meeting, described the paradox of the Forum’s discussions:

“Nurse shortages are biting hard across Asia and undermining universal health coverage, yet when countries put in place new facilities or models of care to increase access they need nurses to run them! Health for All is not going to happen without investment in nurses.

What we have heard at the Forum, directly from nursing representatives from India and the Philippines, who have traditionally been suppliers of nurses to the world, is a story of increasing shortages and demands for nurses in their countries. This should be an alarm bell for those higher-income countries who have relied on these countries as sources of nurses to address their own shortages that this will no longer be a viable or sustainable solution. Nurses must not be reduced to commodities. It is higher-income countries who are going on this global shopping trip, they are taking from shelves that are already very bare and can least afford to lose nurses.

The Global Strategic Directions for Nursing and Midwifery (GSDNM), developed by ICN and WHO provides a roadmap for addressing the shortages and need for investment in nursing but what we are hearing from some delegates at the Forum is that there are significant variations in awareness and implementation of the GSDNMs in different countries. This must be addressed.”

Prof. Dr. Siriorn Sindhu, President of the Nurses’ Association of Thailand added:

“The Nurses’ Association of Thailand was honoured to host this important Forum to discuss the many challenges and opportunities that nurses in the region are facing. We are grateful to ICN for bringing us together to learn from each other’s experiences and strategize about how to deal with issues confronting nursing in many countries. The need to invest in nursing, address the nursing shortage, ageing populations and other challenges are critical to the sustainability and growth of global health.”

At the end of the AWFF, participants released a communique which highlighted the important topics discussed. These included:

  • Participants at the Forum reported that all countries and regions face significant and increasing difficulties due to the growing shortage of nurses.
  • Ageing of the population in many of the countries participating in the Forum is another identified source of increased demand, and therefore increased requirement for nurses.
  • The Forum expressed deep concern about the detrimental impacts of increasing levels of active international recruitment by high-income countries on the ability of lower- and middle-income countries to maintain safe and accessible health services to their populations. ICN has been raising the alarm over the increase in international recruitment of nurses and the damage this causes on the already depleted nursing workforces in developing countries.
  • The Forum recognised that the pandemic has accelerated the need for effective primary care and chronic care, which will also be driven by ageing populations, and there is increasing recognition of the value of advanced practice nurses working in these areas, often as the main first point of contact for communities.
  • Participants agreed that securing sufficient and well qualified nurses is a critical and central step in supporting health system rebuild, and achieving UHC. There is an urgent need to support the recovery of the nurse workforce.
  • The Forum agreed that all national nursing associations must work with other stakeholders to improve retention, advance career development and professionalism of nurses by securing, recognising and rewarding excellence in nursing practice. Continuous professional development is the most effective way to retain competent nurses for patient-centred care, particularly when it is linked with a career structure with real prospects for promotion.
  • The Forum also agreed that it is critical that during the process of health system rebuild, and to enable recovery of the nursing workforce, senior nurses are fully involved in the policy-making process within their countries, and internationally, in order to ensure that the central role of the nursing workforce is fully represented.
  • The Forum agreed that not only investment in the nursing workforce is essential to improve global health, achieve UHC and deliver the SDGs but that it is also fundamental to patient safety and the security and sustainability of health systems. Investment in health is also a key enabler and accelerator of economic growth.
  • The Forum underscored that the Strategic Directions for Nursing and Midwifery (SDNM) 2021-2025 developed by WHO and ICN and adopted by the World Health Assembly (WHA) was the roadmap to both support our global nursing workforce and rebuild our health systems and must be implemented in all countries.

Read the full communiqué here.

ICN’s three Board members from the Asian region, Lian-Hua Huang, ICN’s 3rd Vice President, (Taiwan Nurses Association), Nanthaphan Chinlumprasert (Nurses’ Association of Thailand) and Megumi Teshima (Japanese Nursing Association) were also in attendance. Expert speakers at the Forum included: Prof. James Buchan, WHO Collaborating Centre expert on global workforce issues; Meredith Wyse, Senior Social Development Specialist, Asian Development Bank; Ms. Ai Tanimizu, Regional Advisor for Nursing, WHO SEARO; and Ms. Eriko Anzai, Nursing Officer, WHO Regional Office for the Western Pacific.

Download the press release here


1Chinese Nursing Association, Indian Nursing Council, Indonesian Nurses Association, Japanese Nursing Association, Nurses Association of Macau, Malaysian Nurses Association, Philippine Nurses Association, Singapore Nurses Association, Taiwan Nurses Association, Nurses’ Association of Thailand.