全球发展中心-尼日利亚和英国在护理方面的全球技能合作（英）-2021.7_36页_1mb

报告摘要

Summary of the Global Skill Partnership in Nursing between Nigeria and the UK

Core Content

This document explores the potential for a Global Skill Partnership (GSP) in nursing between Nigeria and the UK, aiming to address the global shortage of nurses and create mutually beneficial migration pathways. It highlights the structural challenges in both countries' health systems, the impacts of health worker migration, and the policy frameworks that could support a sustainable and equitable GSP.

Main Points

Global Context of Nurse Shortages

By 2030, the world will need an additional 15 million nurses to achieve universal health coverage (UHC).
Nigeria and the UK both face significant nurse shortages, despite differing needs and contexts.
Nurses are the largest occupational group in the health sector, making up 59% of the workforce.
The WHO defines health workers broadly, including nurses, doctors, midwives, and support staff.

Health Worker Migration Trends

The number of migrant doctors and nurses in OECD countries has increased by 60% over the last decade.
One in eight nurses globally practices outside their country of birth or training.
South-South migration is growing, with countries like the Philippines being the largest global supplier of nurses.
Migration can incentivize training in origin countries but may also exacerbate shortages and create dissatisfaction among those who remain.

WHO Recommendations and Global Skill Partnerships

The WHO Resolution 57.19 encourages governments to support training in origin countries and ensure a genuine development benefit.
The WHO Global Code of Practice discourages private recruitment from countries with shortages but supports G2G agreements.
The CGD-World Bank report outlines a model for GSPs, aiming to create legal migration pathways that benefit both origin and destination countries.

Key Information

Nigeria's Health Care System

Nigeria has a three-tier health system: Federal, State, and Primary Healthcare.
73% of health facilities are public, while 27% are private.
Nursing and midwifery dominate the health workforce, with 180,709 nurses and 120,870 midwives registered as of 2018.
Female nurses make up 87% of the workforce, and 72% are between 30 and 60 years.
Nigeria's nurse-to-population ratio is 1:1,135, far below the WHO's recommended 4.45 per 1,000 population.

Challenges in Nigeria

Critical shortages exist in specialties such as Cardiothoracic, Anesthesia, and Mental Health.
Training infrastructure is uneven, with 50% of nursing schools concentrated in Southern states.
Public funding for health care is low, and healthcare budgets have declined.
Nurses often migrate to countries like the UK, US, and UAE, contributing to a brain drain effect.

UK's Health Care System

The NHS is the main public health system, funded by direct taxation.
The UK spends £214.4 billion annually on health care, with a high demand for skilled nurses.
Nurses from Nigeria are among the top five countries passing the US nurse licensure exams.

Proposed Global Skill Partnership

Design of the Partnership

The GSP should support training in Nigeria and ensure employment opportunities in the UK.
It should aim to increase the number of trained nurses in Nigeria and improve their retention.
Legal pathways need to be developed to facilitate ethical migration and governance.
Funding should support training infrastructure, equipment, and management systems in Nigeria.

Risks and Mitigation Measures

Brain drain could occur if Nigeria cannot retain trained nurses.
Inequitable migration may lead to overburdening of remaining staff.
Lack of alignment between training and workforce needs could lead to maldistribution.
Mitigation strategies include:
- Improving working conditions and remuneration in Nigeria.
- Enhancing training curricula to match local and international demands.
- Supporting nursing councils and training institutions in Nigeria.
- Establishing G2G agreements that ensure development benefits for Nigeria.

Funding and Support

Donor funding for health worker training has grown from $34 million in 1990 to $1.5 billion in 2016, but it remains only 4% of health development assistance.
WHO estimates that $10 per capita is needed to increase nursing education funding in low- and middle-income countries.
Corvus Health provides a model for sustainable recruitment, supporting training institutions in countries like Tunisia, Kenya, and Ghana and placing graduates in destination countries such as Canada.

Conclusion

A Global Skill Partnership in Nursing between Nigeria and the UK could provide a solution to both countries' nurse shortages, while ensuring ethical migration and development benefits for Nigeria. It requires policy alignment, investment in training, and improved governance to be effective. The WHO's Global Code of Practice and International Platform on Health Worker Mobility offer guidance and frameworks for such a partnership, emphasizing the need for cooperation, data sharing, and mutual benefit.