The 2016 Global Conference on Health Promotion launched a multi-lateral, global agenda aimed at achieving the 2030 Sustainable Development Goals (SDGs). The resultant declaration identified health and wellbeing as crucial to achieving targets set for all 17 SDG goals. However, given the current crisis in human resources for health (HRH), certain nations face persistent difficulties in efforts health promotion and disease prevention. Because nurses comprise a large sector of the global health workforce, shifts in labor markets and variation in the distribution of skilled nursing workforce, can prove detrimental to health promotion, both at national and global levels. This poster provides an analysis on the impact of nurse migration and maldistribution on quality and equitable care for at risk populations.
The current nursing workforce crisis has received significant attention on a global scale. The World Health Organization (WHO, 2013) reports the current global shortage of nursing workforce stands at 7.2 million with the number expected to grow to 12.9 million by 2035. This profound nursing shortage threatens sustainability of health systems and thwarts any efforts aimed at attaining Sustainable Development Goals. The crisis in HRH is further delineated by impact of global nurse migration and maldistribution patterns. An analysis of the 2030 SDG targets implies vast areas of opportunity for nursing professionals at all levels.
Methods:
Current data shows that every country is experiencing a shortage of nurse professionals. While high income countries face ever growing labor demands for nurses, low income countries are unable to retain enough of their educated and skilled workforce. Additionally, national migration patterns resulting in maldistribution of healthcare professionals continues to contribute towards growing health disparities relating access. While source countries/regions may have the capacity to educate new professionals, the issue remains how to target and retain skilled workers in areas with high demand such as rural areas. Contributing factors to nurse migration are diverse and range in complexity. “Push factors” for migration and maldistribution include educational and training opportunities, pay rate, working conditions, governing systems, recruitment practices and socio-geo-political environments (Dumont, et. al., 2017). This poster provides a high-level summary on high traffic patterns of nurse migration according to research, limited to English texts, from 2008-2017. Push factors such as recruitment practices and international policy, able to exacerbate HRH disparities and waste are outlined and discussed.
Results:
The data and statistics analyzed offer a summary of major issues identified in the global discourse around HRH solutions, and how they relate to 2030 SDGs. The authors analyze both national and global approaches currently implemented and suggested to resolve the nursing workforce shortage. Given the persistent reality of nurse shortages, emphasis was given to challenging existing/accepted rationales as a means to gain greater understanding of the phenomenon. The impact of globalization on any country’s efforts towards establishing a sustainable health system, can result in major complexities and paradoxes inherent in previously unchallenged “solutions.”
The International Council of Nurses (ICN) defines the nursing profession as encompassing “... autonomous and collaborative care of individuals of all ages, families, groups and communities, sick or well and in all settings” (ICN, 2014). Nursing encompasses the promotion of health, prevention of illness, and the care of ill, disabled and dying people. Professional functions include advocacy, health promotion and education (ICN, 2014). Given this complex definition, and similarly complex collaborations inherent in SDG work, this poster puts argues for prioritization of policy formulation which facilitate the following, both at national and international
Conclusion:
- Strategic long-term planning characterized by focus on solutions for maldistribution of nurses.
- Development of uniform standards for recruitment that maximize utility of finite resources allowing for mutual wins between collaborators.
- Implementation of sustained measuring processes that allows for objective performance analysis and data production.
- Promotion of a culture that supports ethical recruitment policies and practices.
- Establishment of systems anticipates and address nurse shortages and health disparities.
- Leadership (both at national and international levels) that looks beyond personal/organizational profitability to solemn responsibility of health promotion.
- Avoidance of oversimplification of processes and preoccupation with failure.
- Emphasis on policies/procedures that promote just and ethically sound work
This poster pivots the nursing profession as a critical determinant to achieving SDGs. To this end, an argument has made for acceleration in educational activities aimed at understanding SDGs and a shift in emphasis towards formulating actionable goals for all targets. While all nurses have an opportunity to contribute at a personal and local level, sustained success will require global commitment to collective priorities. To this end, the authors propose that the most effective starting point be identification of lasting solutions to the issue of nurse migration and maldistribution of human resource for health.