Shortages, unequal distribution and outmigration of nurses are all obstacles to achieving universal health access and coverage for all

Washington, D.C., 12 May 2015 (PAHO/WHO) - On International Nurses Day, May 12, the Pan American Health Organization/World Health Organization (PAHO/WHO) is calling for more nurses to be trained to provide skilled care while also urging steps to address inequities in their distribution and the problem of outmigration.

Many countries in Latin America and the Caribbean currently face shortages of nursing personnel, presenting an obstacle to achieving the goal of universal health access and coverage for all people in the Americas, said experts at PAHO/WHO.

"Nurses are an important human resource for health," said Silvia Cassiani, PAHO/WHO's regional advisor on nursing and health technicians, noting that nursing personnel make up 60% of the health workforce and cover 80% of healthcare needs. "We have to do much more to train more professionals, to make sure they are distributed equitably according to the needs of the population, and to retain them in their workplaces."

According to WHO, approximately 23 doctors, nurses and midwives are needed for every 10,000 inhabitants to provide essential health services. In the Americas, some 70% of countries have the number of personnel they need, or even more, but they face challenges in their distribution and training.

One-fourth of the world's registered nurses are in the Americas, yet about 57% of these (nearly 3 million) are in North America. Proportionally, there are 110.7 nurses per 10,000 inhabitants in North America but only 13.8 per 10,000 on average in Central and South America and the Caribbean.

Outmigration has a major impact on nursing human resources. The number of nurses from the English-speaking Caribbean who are working abroad is estimated to be three times the number of those working in the countries where they were trained. Approximately 42% of nursing positions in the English-speaking Caribbean are vacant due to outmigration.

Establishing mechanisms to improve workforce retention and working conditions in public health services are among the measures that can reduce outmigration of health workers.
Other causes of nursing shortages include lack of access to quality education, excessive school dropout rates, poor curriculum content and teaching methods, lack of continuing education among professors, and poor political and administrative infrastructure in schools.

PAHO/WHO is working with countries throughout the region to promote nursing education and to strengthen capacity for producing, evaluating and using scientific evidence in nursing, while also evaluating the situation of nursing human resources to promote adequate policies and plans and facilitate communication and dissemination of scientific information.