Pathways to Economic Growth for Nursing and Midwifery Workforce

A Research Agenda

Yin Li, PhD; Joanne Spetz, PhD; Jeannie P. Cimiotti, PhD, RN, FAAN


Nurs Econ. 2021;39(6):265-274,284. 

In This Article

Abstract and Introduction


Investing in the nursing and midwifery workforce has direct effects on improving individual and population health. Indirect effects may include economic output, social protection, social cohesion, innovation development, economic diversification, and health security. Guided by a conceptual framework of six pathways to economic growth, existing knowledge on the impact of investing in the nursing and midwifery workforce on economic growth are discussed, and directions for future research identified.


As the largest component of healthcare professionals globally, nurses and midwives play a pivotal role in all healthcare systems. Nurses and midwives are the center of healthcare teams and make enormous contributions to global health and well-being. Without nurses and midwives, who compose half the health workforce, adequate health coverage would not be possible (Crisp et al., 2018). Beyond their contributions to health, nurses and midwives also contribute to other global goals such as quality education, gender equity, adequate jobs, economic growth, and reduced inequality (Buchan et al., 2017). Investing in an expanded, transformed, interdependent, and sustainable health workforce is critical for achieving inclusive economic growth, job creation, and social and economic stability and security (World Health Organization [WHO], 2016).

United Nations High-level Commission on Health Employment and Economic Growth developed a conceptual framework (see Figure 1), in which Lauer and coauthors (2017) show that investing in the health system can contribute to six determinants of economic growth: health, economic output, social protection, social cohesion, innovation and diversification, and health security. Recent studies in high-income countries also found investing in the nursing workforce promotes local economic growth and creates more jobs (Conover & Richards, 2015; Eilrich, 2016). Nevertheless, there is a lack of a global consensus on the return on investment (ROI) in the nursing and midwifery workforce on economic growth. Using the United Nations' conceptual framework, the link between investment in nursing and midwifery and economic growth under each pathway; policy implications for nurse leaders, educators, and policymakers in terms of nurses' contributions to economic growth; and proposed opportunities for future research are described.

Figure 1.

Pathways to Economic Growth
Source: WHO (2016). Reproduced with permission.