The World Health Organisation (WHO) has said that Africa has one of the lowest nurse-to-patient ratios globally, and more than tenfold lower than high-income countries.
According to WHO, nurses account for 66% of the region’s projected shortfall of 6.1 million health workers by 2030, limiting access to essential services, from maternal and child health to chronic disease care, and slowing progress towards universal health coverage.
It expressed worry that 42% of nurses in the region also report an intention to emigrate, an alarming trend that risks draining critical talent and undermining our most fragile systems.
WHO Acting Regional Director for Africa, Dr Chikwe Ihekweazu, who disclosed this on Saturday in a massage to mark the 2025 International Nurses Day, said that while the global nursing workforce has grown to 29.8 million, up from about 28 million in 2018, this progress conceals dangerous inequities as nearly 80% of nurses serve only 49% of the world’s population.
He noted that in the African Region, recent investments in nursing education and training are yielding results as the number of nurses has nearly doubled, from 900,000 in 2018 to 1.7 million in 2023, increasing the nurse-to-population ratio from 8.7 to 14.1 per 100,000 people.
Ihekweazu, however, observed that this number remains one of the lowest nurses ratios globally, and more than tenfold lower than in high-income countries.
He said, “At the same time, while 43% of our nursing workforce is under the age of 35, many lack access to mentorship or clear career pathways. High-income countries continue to recruit nurses from lower-income settings, with foreign-born nurses comprising nearly a quarter of their nursing workforce.
“In our region, 42% of nurses also report an intention to emigrate, an alarming trend that risks draining critical talent and undermining our most fragile systems.”
Ihekweazu stated that constrained budgets add a further layer of complexity, pointing out that on average, African countries face a 43% shortfall in health workforce financing and as a result, nearly one in three health workers, mostly nurses and midwives, are unemployed or underemployed.
Highlighting the importance of nurses in the health care system, Ihekweazu emphasized that nurses are more than caregivers; they are educators, innovators, and frontline responders, often working in the most remote, under-resourced, or crisis-affected areas.
He recalled that in May 2024, African leaders endorsed the Africa Health Workforce Investment Charter, setting the stage for long-term progress, adding that several countries are now generating data, building consensus through national dialogues, and developing Investment Compacts that align with their specific needs.
Ihekweazu stated that Zimbabwe’s new Investment Compact, for example, is expected to mobilize an additional US$166 million annually over the next three years to strengthen its health workforce.
He emphasised the need to move beyond words to action and commit to building a future in which nurses are trained, protected, respected, and empowered to lead.
He said, “Today, on International Nurses Day, we honour the commitment, compassion and courage of nurses across Africa and the world. Representing nearly 70% of the health workforce, nurses are the foundation of our health systems, essential every day, and indispensable in times of crisis.”
Ihekweazu noted that this year’s theme, “Our Nurses. Our Future. Caring for Nurses Strengthens Health Systems and Economies” was a reminder that supporting nurses is key to building resilient, equitable, and thriving health systems.
The Regional Director said that the 2025 report outlines a clear path forward like expanding nursing education, including digital and clinical training, strengthen regulation and introduce advanced practice roles, improve working conditions, including mental health support and fair pay, closing the gender pay gap: still at 7%, despite women comprising 85% of nurses and investing in nursing leadership, including empowered Government Chief Nursing Officers.
WHO
