Hynes Terence, Caulfield Paul, O'Connor Peter, Cullinan John
Department of Health, Block 1 Miesian Plaza, 50-58 Lower Baggot Street, Dublin 2, D02 XW14, Ireland.
Discipline of Economics, University of Galway, University Road, Galway, H91 TK33, Ireland.
Hum Resour Health. 2025 Aug 21;23(1):44. doi: 10.1186/s12960-025-01004-4.
World Health Organization (WHO) projections point to an increasing global demand for nurses and midwives, leading to shortages in many countries, particularly in less developed regions. Ireland, the context for this study, currently relies heavily on foreign educated nurses and midwives to meet its demand, with Government policy moving towards a domestic recruitment model. This paper estimates the recruitment requirement and associated nursing and midwifery student intake over time under different reform scenarios. It also highlights policy considerations for countries, like Ireland, aiming to comply with the WHO Code of Conduct on the International Recruitment of Health Personnel.
This paper develops and applies a system dynamics model of the domestic and foreign educated workforce supply by age and gender and is based on regulatory data on stocks and flows from the national professional regulator for nurses and midwives. The model scope and design was informed by a problem statement developed in a series of workshops with officials in the Office of the Chief Nursing Officer. A range of scenario and sensitivity analyses are also undertaken.
In 2021, the base year of our projection horizon, we estimate that Ireland needed to recruit 3019 professionally active whole-time-equivalent (WTE) nurses and midwives. This would have required 3965 student places four years earlier in 2017 to meet this demand domestically. This is 153% higher than the 1570 student places that were available in that year. The recruitment requirement rises to 4497 by 2051, a 49% increase on 2021 levels. Foreign educated nurses and midwives, in terms of WTEs, start at 45% of projected demand in 2021 and range from 57% in the baseline scenario to 16% in the most ambitious reform scenario in 2051.
The analysis suggests that Ireland requires a significant increase in nursing and midwifery student places to achieve self-sufficiency and that this will take time to achieve. Moreover, in addition to a sufficient domestic supply of nurses and midwives, self-sufficiency will also depend on managing demand volatility. Finally, countries anticipating a shift to a predominantly older population should ensure they have enough student places available before the demographic transition occurs to meet the associated health workforce requirements through the domestic education system.
世界卫生组织（WHO）的预测表明，全球对护士和助产士的需求在不断增加，这导致许多国家出现短缺，尤其是在欠发达地区。爱尔兰是本研究的背景国家，目前严重依赖受过国外教育的护士和助产士来满足其需求，政府政策正朝着国内招聘模式转变。本文估计了在不同改革情景下，随着时间推移的招聘需求以及相关的护理和助产专业学生招生情况。它还强调了像爱尔兰这样旨在遵守WHO《卫生人员国际招聘行为守则》的国家的政策考量。
本文开发并应用了一个按年龄和性别划分的国内外受过教育的劳动力供应系统动力学模型，该模型基于国家护士和助产士专业监管机构关于存量和流量的监管数据。模型的范围和设计参考了与首席护理官办公室官员在一系列研讨会上制定的问题陈述。还进行了一系列情景分析和敏感性分析。
在我们预测期的基准年2021年，我们估计爱尔兰需要招聘3019名全职等效（WTE）的专业活跃护士和助产士。这在四年前的2017年需要3965个学生名额才能在国内满足这一需求。这比当年可用的1570个学生名额高出153%。到2051年，招聘需求增至4497名，比2021年的水平增加了49%。就全职等效人数而言，受过国外教育的护士和助产士在2021年占预计需求的45%，在基准情景下到2051年占57%，在最雄心勃勃的改革情景下占16%。
分析表明，爱尔兰需要大幅增加护理和助产专业的学生名额以实现自给自足，而这需要时间才能实现。此外，除了国内有足够的护士和助产士供应外，自给自足还将取决于应对需求波动。最后，预计人口将主要老龄化的国家应确保在人口结构转变发生之前有足够的学生名额，以便通过国内教育系统满足相关的卫生人力需求。
