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PubMed2026

Investing in Canada's nursing workforce: a comprehensive review to inform policy innovations and directions.

BACKGROUND: Health systems worldwide face persistent health workers challenges including nursing shortages, workforce strain, and inequities. In Canada, these challenges have prompted renewed national and provincial reforms to strengthen recruitment, retention, leadership, and sustainability. This paper compares nursing workforce policy directions across Canada, and international jurisdictions to inform policy and planning. METHODS: A cross-country comparative analysis of policies building on a comprehensive national funded review that included an umbrella review of 69 systematic reviews, a comparative policy review of nursing workforce strategies in five jurisdictions, and validation through national horizon-scanning and policy dialogues (n >100). Evidence was analyzed across system, organizational, and individual levels. RESULTS: At the system level, international jurisdictions demonstrate comprehensive, legislated approaches integrating data, governance, and multi-year funding have advanced key nursing strategies. In Canada, the advances show the importance of strategies to have national and provincial/territorial alignment emphasizing leadership, flexibility, and inclusion as key levers. Organizational and individual-level reforms such as mentorship, leadership development, and wellness initiatives are expanding but remain variably evaluated. Experts identified national workforce data strategies and policy integration with embedded evaluation as key enablers to inform scalability and sustainability of implemented strategies. CONCLUSIONS: Canada's nursing workforce reforms are advancing toward coordinated, equity-driven, and evidence-informed strategies. Continued investment in evaluation, leadership, and national integrated data systems along with integrating nursing workforce planning within broader intersectoral planning will consolidate these gains and position Canada as an international leader in sustainable nursing workforce policy.

Canada↗
PubMed2005

Viewpoint: HIV/AIDS and the health workforce crisis: what are the next steps?

In scaling up antiretroviral treatment (ART), financing is fast becoming less of a constraint than the human resources to ensure the implementation of the programmes. In the countries hardest affected by the acquired immunodeficiency syndrome (AIDS) pandemic, AIDS increases workloads, professional frustration and burn-out. It affects health workers also directly, contributing to rising sick leave and attrition rates. This burden is shouldered by a health workforce weakened already by chronic deficiencies in training, distribution and retention. In these countries, health workforce issues can no longer be analysed from the traditional perspective of human resource development, but should start from the position that entire societies are in a process of social involution of a scale unprecedented in human history. Strategies that proved to be effective and correct in past conditions need be reviewed, particularly in the domains of human resource management and policy-making, education and international aid. True paradigm shifts are thus required, without which the fundamental changes required to effectively strengthen the health workforce are unlikely to be initiated.

Africa, Southern↗
PubMed2006

Medical workforce policy-making in Canada, 1993-2003: reconnecting the disconnected.

The authors set out to review Canadian medical workforce policies for 1993 to 2003 and assess if data existed in the 1990s that could have reversed the policy decision to curtail the supply of physicians from Canada's medical schools just as Canada was about to experience a developing shortage. The authors reviewed existing descriptive data sources regarding Canadian physician workforce size and activity from 1986 to 2003, including the Canadian Medical Association workforce database. The review indicated that a significant loss of physicians to retirement was imminent. Physician workforce productivity had started to fall by the early 1990s. Emigration to the United States had risen above traditional levels in the early 1990s and remained higher into the late 1990s. Despite these existing findings, an integrated adjustment to physician workforce policies taken in 1993-94 only occurred after 1999. The authors recommend that policy makers and managers must monitor the numbers from existing sources. To optimize these sources, planned data tracking and linkages are essential. The period in question demonstrated major disconnects in coordinating implementation, wherein subject experts monitoring data trends were not adequately utilized by policy makers. Finally, in complex systems with regional differences, policy decisions based on normative data are insufficient.

Canada↗
PubMed2006

Health services delivery: reframing policies for global migration of nurses and physicians--a U.S. perspective.

One half of all of the nurses and physicians in English-speaking countries practice in the United States, yet future shortages of both professions are projected. Because the United States has failed to create sufficient educational capacity for its own needs, it is dependent on foreign health professionals. The magnitude of this dependency has a significant impact on the health care systems of source countries, particularly developing countries, from which the majority of foreign nurses and physicians coming to the United States emigrate. Even emigration from the United Kingdom and other developed countries affects developing countries because it triggers recruitment from developing countries to replace this emigration. To achieve a higher level of self-sufficiency, the United States must establish a national health care workforce policy that gives priority to building adequate educational infrastructure, while also providing assistance to developing countries to train and retain adequate numbers of health professionals.

Developed Countries↗
PubMed1987

Canada.

Explore the source record for details and available documents.

Americas↗
PubMed1997

Regionalization, economic restructuring and labour migration in Singapore.

"This paper documents the impact of economic development on changes in employment and labour migration in Singapore. High export-led growth and the relaxation of immigration policies in the late 1960s enabled employment of substantial numbers of unskilled foreign labour in manufacturing, construction and domestic service sectors....Economic development in the 1990s, characterized by the regionalization drive which relocates relatively resource-intensive operations of Singapore-based companies overseas, has led to increased retrenchments and a moderation of demand for foreign workers. The upgrading of remaining production operations in Singapore is expected to increase demand for workers with higher skill levels. Emigration of highly educated and skilled professionals from Singapore became a national concern in the late 1980s. However, with regionalization, the new challenge in the 1990s has become one of encouraging Singaporeans to temporarily take up overseas positions." (SUMMARY IN FRE AND SPA)

Asia↗
PubMed1996

The migration transition in Malaysia.

"Exploring the unique experience of migration transition in Malaysia, this paper identifies the turning points in relation to the level and nature of economic and labor market developments in Malaysia. Examining the development dynamics that mark the passage from exporting labor to depending on foreign labor, the paper concludes that such dynamics are influenced not only by economic but also sociocultural, demographic and policy factors. Several lessons from the Malaysian experience are drawn at the end to be utilized by other countries that still have to reach the turning points of the migration transition."

Asia↗
PubMed1981

Employment policy and labor supply of foreign workers in the Federal Republic of Germany: a theoretical and empirical analysis.

"This study is an attempt to investigate the economic determinants of international immigration and remigration into and out of the Federal Republic of Germany. Moreover, employment policy measures with respect to foreign workers are described and their impact on the inflow and outflow of guest workers [is] analyzed." The author notes that the ability of the government to influence migration flows through legislation is limited because of the free movement of labor within the Common Market countries. It is suggested that in-migration of foreign labor slows wage increases for the native worker, may retard rationalization, and increases the social costs of unemployment, particularly during periods of recession.

Demography↗
PubMedDate not supplied

An educational partnership to develop acute care nurse practitioners.

Hospitals currently are involved in a restructuring of the medical and nursing workforce as fiscal restraint and downsizing proceed. Changes in organizational structure, reductions in medical school enrollments and available resident positions, and the reconfiguration of nursing positions are common events. Noted gaps in the provision of care to patients are creating an opportunity to develop a new provider, an acute care nurse practitioner (ACNP). The need for ACNPs was identified in a series of consultations between the Faculty of Nursing at the University of Toronto and affiliated hospitals. In response to this need the Faculty of Nursing, with the assistance of the Max Bell Foundation, developed a three month post masters Fast Track Acute Care Nurse Practitioner Program in collaboration with 10 hospitals. Fifty-nine masters prepared nurses successfully completed one of four cycles of a concentrated program which included courses in Pharmacology, Advanced Assessment and Clinical Decision Making, Roles and Issues, and a four-week Clinical Practicum. Evaluation of graduates' competence to fulfil the nursing and medical role expectations included focus group discussions, an external review of case studies, and a questionnaire to hospital partners about their satisfaction with the program graduates.

Acute Disease↗
PubMed1995

The population of Cuba: the growth and characteristics of its labor force.

"This paper analyzes Cuba's current demographic picture, and emphasizes the characteristics of its labor force that will influence dynamic change. Overall, the contribution of the labor force to the development of a market economy is likely to be positive, given its low dependency ratio, the high level of education, and the value placed on entrepreneurship."

Americas↗