Nursing workforce challenges in gulf cooperation council countries: A systematic review of factors influencing shortage and retention

The Gulf Cooperation Council countries are experiencing a significant nursing workforce shortage, compounded by rapid population growth, a rising burden of chronic diseases, and heavy dependence on expatriate nurses. With the World Health Organization forecasting a global shortfall of 4.5 million nurses by 2030, this review aims to systematically explore the key factors contributing to nursing workforce shortages in the Gulf Cooperation Council region and offer evidence-based recommendations for improving retention.

A systematic review was conducted in accordance with PRISMA guidelines. A comprehensive literature search was performed across PubMed, Embase, Web of Science, and Scopus databases to identify relevant primary research published in English up to January 2025. Studies focused on nursing workforce issues in Gulf Cooperation Council countries were included. A total of eight eligible studies were critically appraised using the Newcastle-Ottawa Scale and the Critical Appraisal Skills tool.

The findings highlight a complex interplay of factors influencing nurse shortages in the Gulf Cooperation. A poor work environment, lack of interprofessional collaboration, and inadequate leadership support were strongly associated with high turnover intention. Excessive workloads, reported by 59.4% of nurses, and emotional exhaustion, affecting over 60%, were key stressors. Additional barriers included cultural challenges, limited access to professional development, and weak organizational support systems. Leadership was identified as the most influential factor negatively correlated with nurse retention.

Addressing the nursing workforce crisis in the Gulf Cooperation Council requires multifaceted interventions. Priority areas include leadership development, structured career pathways, and improved cultural integration efforts. Further longitudinal and regionally inclusive research is recommended.