Achieving SDGs Through Nursing: A Systematic Review of Care Quality, Patient Satisfaction, and Health System Capacity Across 11 Countries
Description
This study is a systematic review and meta-analysis conducted to evaluate global disparities in nursing care quality, health system readiness, and patient satisfaction, with particular reference to Sustainable Development Goal (SDG) progress. Following PRISMA 2020 guidelines, a comprehensive search was performed across PubMed, CINAHL, Scopus, Web of Science, Cochrane Library, and gray literature sources (WHO, World Bank, OECD). The search covered evidence from 11 countries representing diverse health system contexts: • Fragile/LICs: Burundi, Afghanistan, South Sudan • LMICs: Bangladesh, Cambodia, Philippines • UMICs: Brazil, Albania • HICs: Germany, South Korea, United States Studies were included if they reported on nursing-sensitive quality indicators (NSQIs) such as staffing ratios, pressure injuries, patient falls, mortality, technology readiness, and patient satisfaction. Objectives 1. To compare nursing workforce capacity, hospital facilities, and SDG-related progress across different income groups. 2. To evaluate patient satisfaction outcomes across contexts through meta-analysis. 3. To assess risk of bias and certainty of evidence (ROBINS-I, JBI, GRADE). 4. To identify evidence gaps for nursing-sensitive quality indicators globally. Key Findings • Fragile states had the weakest nurse-to-patient ratios, lowest hospital readiness, and minimal SDG progress. • LMICs showed improvements but persistent rural–urban disparities and migration challenges. • UMICs achieved moderate outcomes but faced regional inequities. • HICs demonstrated advanced facilities, high patient satisfaction, and stronger SDG integration, though workforce burnout was reported. • Meta-analysis revealed significantly higher patient satisfaction in HICs compared to LICs (SMD = 0.62; 95% CI 0.50–0.74). • Risk of bias was higher in LIC/LMIC studies, while publication bias was suggested by funnel plot asymmetry. Implications Findings highlight that nursing care quality reflects broader global health inequities. Strengthening the nursing workforce, infrastructure, and patient-centered strategies is essential to advance SDGs, particularly in fragile and low-resource contexts.