亚开行-加强亚太地区的护理教育和培训（英）-2025.11_8页_304kb

Summary of Document: Enhancing Nursing Education and Training in Asia and the Pacific

Core Content

The document outlines the challenges and opportunities in nursing education and workforce development across five Asia and Pacific developing member countries (DMCs): Bangladesh (BAN), the Lao People's Democratic Republic (LAO), the Philippines (PHI), Sri Lanka (SRI), and Viet Nam (VIE). It emphasizes the importance of innovation in infrastructure, medical products, system reform, and human resources to achieve quality health care and universal health coverage (UHC). Key areas of focus include:

• Strengthening nursing education and training systems
• Enhancing accreditation and licensure processes
• Addressing low nurse-to-population ratios and nurse migration
• Improving nurse compensation and working conditions
• Expanding access to nursing education in underserved regions

Main Viewpoints

1. Importance of Nursing in Health Care

• Nurses are the largest occupational group in the global health workforce, representing about 59% of all health professionals.
• They are essential for advancing UHC and achieving the Sustainable Development Goals (SDGs) by providing essential services, promoting health, and ensuring patient safety.
• However, the current nursing workforce is insufficient to meet UHC and SDG targets, with a disproportionate concentration of nurses in high-income economies.

2. Disparities in Health Outcomes and Spending

• Health indicators such as life expectancy and infant mortality rates vary widely across the region, with low- and lower-middle-income economies lagging behind.
• Health expenditure remains low in Bangladesh and the Lao PDR, contributing to inadequate health care coverage.
• Nurse-to-population ratios are generally low, with significant migration of English-proficient nurses to high-income economies, exacerbating shortages in low-resource settings.

3. Challenges in Nursing Education and Workforce Development

• Nursing education in low-income economies is often under-resourced, with outdated curricula and limited clinical training opportunities.
• There is a need for stronger accreditation systems and national licensure examinations to ensure the quality and standardization of nursing education.
• The lack of fair compensation and poor working conditions discourages nurses from staying in their home countries and contributes to workforce migration.

Key Information

1. National Licensure Examination for Nurses (NLEN)

• The Philippines has the most established NLEN system, administering exams twice a year with both written and practical components.
• Bangladesh introduced its NLEN in 2015, while the Lao PDR has a system supported by the Japan International Cooperation Agency (JICA).
• Sri Lanka and Viet Nam are in the process of establishing their NLEN systems, with Viet Nam planning to introduce one by 2028.

2. Accreditation Systems

• Accreditation of nursing institutions is vital to ensuring quality education and practice.
• In high-income economies, accreditation systems are well-established and regularly updated, while in the DMCs, these systems are either absent or in early stages of development.
• The document highlights the need for functional, transparent accreditation systems to support long-term workforce sustainability.

3. Nurse-to-Population Ratios and Migration

• Nurse-to-population ratios are low across the five DMCs, with significant migration to high-income countries.
• In Bangladesh, the nurse-to-physician ratio is 0.9, and in Viet Nam, it is 1.3, which strains primary and preventive care services.
• The migration of skilled nurses has been exacerbated by the pandemic, leading to burnout and reduced patient safety.

4. Workforce and Educational Challenges

• Nurses in the Lao PDR and Sri Lanka face poor working conditions and low pay, which discourage them from pursuing the profession.
• Nursing education institutions are often concentrated in urban areas, limiting access for students in rural and underserved regions.
• There is a need for updated curricula, better clinical training, and improved educational resources to align with global health priorities.

5. Recommendations for Improvement

• Expand access to nursing education in rural and underserved areas through new institutions, facility upgrades, and digital learning tools.
• Improve nurse compensation and working conditions to retain skilled professionals and reduce migration.
• Strengthen accreditation and licensure systems to ensure quality education and practice.
• Invest in faculty development and support to enhance teaching and clinical training.
• Promote regional collaboration to support the implementation of national licensing and accreditation systems.
• Integrate emerging global health issues into curricula, such as climate change, population aging, and ethnic language training.

Conclusion

The document underscores the critical role of nursing in achieving UHC and improving health outcomes. It highlights the urgent need for systemic reforms in nursing education, accreditation, and workforce management across the five DMCs. By addressing these challenges through targeted investments and policy changes, the region can build a more resilient and competent nursing workforce, ultimately contributing to better health care delivery and sustainable development.