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As Health Care Demand in North and Central America Grows, Supply and Quality of Nurses in Region Could Benefit from Increased Harmonization of Qualifications in Nursing
Press Release
Thursday, March 12, 2015

As Health Care Demand in North and Central America Grows, Supply and Quality of Nurses in Region Could Benefit from Increased Harmonization of Qualifications in Nursing

WASHINGTON – With aging populations and rising rates of chronic diseases, governments in North and Central America are giving new policy focus to ways to increase both the quantity of nurses and quality of nurse education. One promising, yet largely unexplored avenue for regional cooperation in this area is the harmonization of qualifications in nursing, according to a report released today by the Migration Policy Institute (MPI).

The report, Building Skills in North and Central America: Barriers and Policy Options toward Harmonizing Qualifications in Nursing, produced by MPI’s Regional Migration Study Group, identifies promising opportunities that would allow countries facing similar health-sector challenges to work together to develop an understanding of one another’s training and education systems, identify gaps between these systems and create strategies to bridge these gaps over time.

The Study Group is an MPI-led initiative that focuses on human-capital development in the United States, Mexico and the countries of Central America’s Northern Triangle (El Salvador, Guatemala and Honduras) as a key to fostering people-centered development while strengthening the competitiveness of the region as a whole. The report continues the second phase of the Study Group’s work, which aims to promote greater regional cooperation on education and workforce development in high-growth sectors with large pools of available jobs in the middle-skill range, including nursing.

As the report notes, the benefits of aligning neighboring health and nursing systems include increased quality of care in all countries involved, greater opportunity for nurses to practice where their skills are needed, enhanced prospects for nurses to take advantage of new job opportunities in medical tourism and tele-health, and decreased brain waste and deskilling of health professionals—an all-too frequent consequence of migration—all of which would mean more and better care for those who need it.

“When nurses who cross national borders can get their qualifications recognized without spending months or years tangled in administrative red tape, their human capital is less likely to be squandered,” said Study Group convenor and MPI President emeritus Demetrios Papademetriou.  “While emerging regional attempts to harmonize nurse qualifications make eminent sense, it must be noted that there are significant roadblocks to be overcome, not the least of which are administrative barriers, second-language skills and the resistance of regulatory bodies that determine nursing curricula and licensing requirements.”

The report, by MPI policy analyst Victoria Rietig and New York University College of Nursing assistant professor Allison Squires, makes the case that there are two avenues to harmonization that can tackle these barriers: alignment of the region’s education systems to create nursing graduates with more comparable skills and, post-graduation, the bridging of language, skills and knowledge on a case-by-case basis after nurses have joined the profession.

While demand for qualified nurses is high across the region, the shortage in Central America is worrisome, with just 1.7 nurses per 1,000 people in El Salvador and a mere 0.5 per 1,000 in Guatemala (compared to 9.3 nurses per 1,000 people in Canada, 8.5 in the United States and 2.5 in Mexico).  In the United States alone, there will be an estimated 5.6 million vacancies for health care professionals at all skill levels between 2010 and 2020.

The report recommends:

  • Investment in nursing-specific academic exchange programs to increase mutual understanding of the region’s nursing systems and to improve second-language capacities of the next generation of nurses
  • Expansion of common licensing standards and processes in the region through a shared licensing exam or other standard convergence or recognition
  • Promotion of initiatives to facilitate the integration of internationally educated nurses into the region’s labor markets, including state-level legislation to give temporary or conditional licenses to nurses educated abroad
  • Building of regional platforms for exchange between the members of the nursing profession.

The report can be downloaded at: https://www.migrationpolicy.org/research/building-skills-north-and-central-america-barriers-and-policy-options-toward-harmonizing.

For more on the Regional Migration Study Group and its work, click here: https://www.migrationpolicy.org/programs/regional-migration-study-group


The Migration Policy Institute (MPI) is an independent, non-partisan, non-profit think tank in Washington, D.C. dedicated to analysis of the movement of people worldwide. MPI provides analysis, development and evaluation of migration and refugee policies at the local, national and international levels. For more on MPI's work, visit www.migrationpolicy.org.