The global health workforce crisis toward 2030: A scoping review and systems-based policy framework

To integrate global workforce indicators and narrative evidence in order to develop a systems-based policy framework informing coordinated workforce sustainability strategies toward 2030.

Scoping review with mixed-methods synthesis.

A structured scoping review was conducted of peer-reviewed literature, global datasets, and institutional policy documents published between 2014 and 2024. A mixed-methods synthesis combined quantitative analysis of workforce indicators with qualitative thematic analysis of structural drivers, governance gaps, and health system impacts.

Global projections indicate a shortfall of approximately 11.1 million health workers by 2030. The global nursing shortage was estimated at 5.9 million in 2018, while up to 13 million additional nurses may be required over the following decade when existing shortages, projected retirements, and future demand are considered together. An aging workforce, intensified migration flows, insufficient domestic training capacity, and deteriorating working conditions contribute to persistent shortages. Five systemic drivers were identified: deteriorating working conditions, weak retention mechanisms, demographic pressures, governance failures, and unmanaged migration flows. Impacts include increased mortality, reduced continuity of chronic care, weakened emergency response capacity, and widening geographic inequalities in workforce distribution between high-income and low- and middle-income countries. The Systems-Based Workforce Sustainability Framework integrates macro-, meso-, and micro-level determinants and identifies reinforcing feedback loops sustaining workforce instability.

The global workforce crisis is structural and self-reinforcing. Sustainable solutions require coordinated long-term planning, strengthened retention and wellbeing strategies, ethical migration governance, and expansion of domestic training capacity. The proposed framework supports multi-level policy coordination toward workforce sustainability by 2030.