Several rural areas in Southern and Eastern Europe (EU) are grappling with severe shortages in their healthcare workforce, particularly among nurses.
This crisis is driven by a combination of demographic ageing, retirement waves, and the migration of medical professionals to wealthier nations.
With immigration restrictions tightening in traditional destinations like the United Kingdom (UK), United States (UK), and Canada, Nigerian nurses may increasingly consider Southern and Eastern European countries as alternative migration options.
Croatia faces a critical shortage of nurses, straining healthcare services, especially in rural areas and among its ageing population. The country’s nurse-to-population ratio is 7.7 nurses per 1,000 residents, far below the EU average of 9 per 1,000. As of 2024, Croatia needed at least 4,000 additional nurses, with demand expected to rise due to demographic pressures.
Many emigrants have moved to Germany, Austria, Ireland, or Sweden. Hospitals and primary care centers, particularly in remote regions, struggle to provide adequate care for elderly patients who require complex, long-term support.
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This brain drain is stripping the system of crucial expertise just as demand is escalating. With elderly citizens expected to make up 30 percent of the EU’s population by 2050, Croatia’s healthcare system faces increasing pressure, especially in under-resourced care homes and geriatric services.
Spain is also experiencing similar challenges, with a nurse-to-population ratio of 6.17 per 1,000 inhabitants, according to Statista. The country is projected to lose as many as 50,000 nurses by 2035, primarily due to retirement, exacerbating existing gaps in care provision, particularly in rural and under-resourced areas. Despite Spain’s relatively strong healthcare infrastructure, replenishing the workforce quickly enough to meet rising demand remains a major challenge.
Bulgaria faces a precarious situation, with a nurse-to-population ratio of 4.34 per 1,000 inhabitants. Approximately 20 percent of the country’s nursing workforce is at retirement age, with the majority of professionals concentrated in Sofia, leaving rural areas severely underserved. The lack of young professionals entering the field, coupled with persistent brain drain, has placed immense pressure on the healthcare system. Without targeted investments in training and incentives, Bulgaria risks a healthcare workforce collapse in the near future.
Meanwhile, Portugal has seen a significant outflow of medical professionals from its public healthcare system. Between 2019 and 2024, over 6,000 clinicians, including doctors and nurses, left the public sector, seeking better pay, working conditions, and career prospects either in private healthcare or abroad.
This trend has weakened Portugal’s ability to meet patient needs in public hospitals and clinics. Its nurse-to-population ratio stands at 7.9 per 1,000 inhabitants.
Bosnia and Herzegovina also faces a crisis, having lost approximately 4,000 nurses and 2,000 doctors over the past decade. With a nurse-to-population ratio of 5.81 per 1,000 residents, sustained emigration has severely weakened the healthcare system.
Many workers have migrated to Germany, Austria, and other Western European countries due to better compensation and career opportunities, leaving Bosnia struggling to maintain adequate staffing levels, especially in specialized care and rural services.
What this may mean for Nigeria
According to the World Health Organisation (WHO), Nigeria has a density of only 1.83 skilled health workers per 1,000 people, far below the recommended 4.45 per 1,000.
The ongoing mass emigration of healthcare workers to the UK, US, and Canada has exacerbated the shortage. The National Association of Nigeria Nurses and Midwives (NANNM) recently reported that more than 75,000 nurses and midwives left Nigeria in the past five years in search of better opportunities abroad.
Given the severe healthcare worker shortages in Southern and Eastern Europe, Nigerian nurses may increasingly view these regions as viable alternatives, especially as restrictions tighten in traditional destinations.
This shift may occur due to high demand in Croatia, Spain, Bulgaria, Portugal, and Bosnia, where critical shortages create opportunities for foreign-trained nurses. To address workforce gaps, some of these countries may introduce more flexible policies to attract foreign healthcare workers.
While salaries may not match those in the UK, US or Canada, better living conditions compared to Nigeria, easier licensing processes, clearer career prospects, and lower costs of living compared to wealthier countries may make these destinations attractive options.
For many Nigerian nurses, migrating to these regions might become a necessity rather than a preference. If Southern and Eastern European nations actively begin recruiting, a significant wave of healthcare migration could follow, potentially worsening Nigeria’s already fragile healthcare system.
