Nurse workforce shortage and health system challenges in Bangladesh: A narrative review

Bangladesh has experienced substantial socioeconomic development since its independence in 1971. Bangladesh is also experienced rapid population growth and urbanization. However, shortages in the healthcare workforce, such as nurses, continue to challenge the healthcare system. This review focused on the nursing workforce shortage, evaluated distribution, compared regional healthcare metrics, and proposed numerous recommendations. A narrative review approach was utilized for synthesizing literature from PubMed, Google Scholar, and specialized healthcare portals. This review included relevant research articles, reports, and policy documents regarding the workforce shortage. For screening and data extraction, a structured template was followed. Qualitative data were synthesized using a narrative review approach. Quantitative data were analyzed using descriptive statistics and graphical visualizations in software R (version 4.4.0). Bangladesh currently has 153,613 registered nurses, including midwives, compared to 123,853 physicians, 12,940 dentists, and 30,795 medical technologists. The nurse-to-physician ratio is 1.1:1, which is below the WHO-recommended standard 3:1. Nurse and midwife density stands at 6.6 per 10,000 population in Bangladesh. This density is lower than in regional countries such as Nepal (40.9 per 10,000 population) and the Maldives (50.2 per 10,000 population). This density ranks Bangladesh among the lowest in South Asia, but above Pakistan and Afghanistan. Nursing workforce shortages in Bangladesh require strategic investment and multi-stakeholder collaboration for quality care delivery. Efforts should be made to achieve the WHO-recommended standards for nursing staff metrics to support a universal, equitable, and sustainable healthcare system in Bangladesh.