Pakistan’s Nursing Paradox: Shortage at Home, Demand Abroad

August 06, 2025 (MLN): Pakistan is eyeing its nurses as the next big export, a move to swell remittances even as hospitals at home run short‑staffed.

With demand abroad surging, Pakistani nurses are leaving faster than the country can train replacements, and the world is lining up to hire them.

Despite one of the lowest nurse-to-population ratios globally, 5.2 per 10,000 people, far below the WHO’s critical threshold of 30, nurses have become the fastest-growing segment of Pakistan’s skilled worker exports, surging at a compound annual rate of 54.2% between 2019 and 2024, according to the Pakistan Business Council’s new report, “Pakistan’s Nursing Workforce: Export Potential, Challenges and Recommendations.”

The report warns that this exodus is driven by a doctor-centric health system, underinvestment in nursing education, and poor working conditions.

Pakistan produces only 5,600 nursing graduates annually, far fewer than India and Bangladesh, leaving hospitals understaffed and nursing colleges struggling to retain qualified faculty.

Globally, the nurse shortage is projected to hit 4.1 million by 2030, with the Gulf and developed economies competing for foreign-trained staff. In Qatar and the UAE, foreign-born nurses account for more than 98% of the workforce; in Australia, 42%; and in the US, 17%.

For Pakistani nurses, Gulf postings offer tax-free salaries, while Western destinations promise residency pathways, but Pakistan’s inclusion on the WHO’s “red list” means recruiters in countries like the UK cannot directly hire them through agencies.

Nurses represent only 0.4% of Pakistan’s professionals abroad, but their contribution is disproportionately valuable. They send stable, higher-than-average remittances, helping swell the $34.7 billion sent by overseas workers in 2024, which tipped the country’s current account into a $0.8 billion surplus.

Most Pakistani workers abroad remain unskilled labourers, 50.1% in 2024, with Saudi Arabia, Oman, and the UAE as top destinations.

But the PBC notes that the quality of nursing in Pakistan is eroding. Underpaid and overworked nurses are leaving hospitals, replaced in many cases by less-qualified allied health workers.

Poor public perceptions, fueled by negative media portrayals, have also discouraged new entrants, though rising pay abroad is slowly attracting more men to the profession.

Education Gaps Hold Back Global Prospects

The report flags “mushroom” nursing institutes that lack proper facilities, contributing to a theory-practice gap and tarnishing Pakistan’s international reputation.

Curriculum inconsistencies, outdated training equipment, and a lack of specializations mean many graduates fail to meet licensing requirements overseas.

Competing countries like the Philippines and India produce far more nurses with globally aligned skills, better soft skills, and a stronger willingness to exceed job descriptions.

Barriers Abroad

Pakistani nurses face slow and inconsistent document verification at home, expensive licensing exams and pre-departure training, and limited support from Pakistani embassies.

Cultural adaptation, language proficiency, and restrictions on relocating without family further constrain mobility.

PBC’s Prescription

The report recommends raising and standardizing salaries, reducing workloads, and creating clear career paths to retain nurses domestically.

On the education front, it calls for standardized admissions and assessments, subsidized simulation labs, expanded specializations, and tighter regulation of nursing schools.

For exports, it urges targeted training for specific countries, aligning curricula with international terminology, pursuing global accreditations, and negotiating government-to-government recruitment deals to bypass middlemen.

The report calls for urgent public-private partnerships to conduct manpower gap analyses and develop a data-driven export strategy.

Without reliable migration data and demand forecasts, Pakistan risks missing out on lucrative opportunities in global healthcare markets.

By the Numbers:

Speaking to Mettis Global, Farah Naz Ata, Senior Economist at the Pakistan Business Council (PBC), emphasized that the latest study uncovers a “significant, yet often overlooked” opportunity for Pakistan to harness its skilled nursing workforce for national gain.

According to her, the findings point to a structural imbalance in Pakistan’s healthcare system, one that has long been doctor-centric, with the nursing profession relegated to the sidelines.

“This neglect has not only stunted the professional growth of nurses but has also held Pakistan back from tapping into the immense global demand for qualified nursing professionals,” she noted.

She further asserted that the country stands at a strategic inflection point.

“By implementing our recommendations, we can uplift healthcare standards at home, empower our nurses, and unlock a powerful stream of foreign remittances,” she said.

“This is the time for Pakistan to shift its perception of the nursing profession, from undervalued to indispensable, and convert a persistent challenge into a long-term economic advantage,” she added.

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