introduction about quality education

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What does Quality Education mean?

Breaking down Sustainable Development Goal #4

Aug 31, 2023

Education is essential for ending poverty . Actually, let's rephrase that: quality education is essential for ending poverty.

The word “quality” carries a lot of meanings—and even baggage. Especially in the US, where school rankings can be a stressful topic for both parents and students. In our work, however, quality means something very different, and very specific. This is especially true in countries where education is most under threat, and why Quality Education is one of the UN’s top Sustainable Development Goals . Read on to learn more. 

The UN defines its fourth Sustainable Development Goal (SDG) is “to ensure inclusive and equitable quality education and promote lifelong learning opportunities for all.” 

Education is important, and many areas of the world lack access to free pre-primary, primary, and secondary education — not to mention affordable options for technical, vocational, and university studies. But it’s not enough for education to be accessible. It also has to add value to the lives of the children and young adults attending school. School enrollment in Niger had gone up for primary students pre-pandemic. However, many of these students were graduating school without mastering basic skills like literacy and numeracy.

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Why quality education matters.

Education can help young people break an intergenerational cycle of poverty . But this is only possible if education is approached in a meaningful way. In 2012, the UN’s former Secretary-General Ban Ki-moon said:

“Education is about more than literacy and numeracy — it is also about citizenry. Education must fully assume its central role in helping people to forge more just, peaceful and tolerant societies.” 

This is what we mean by “quality” education: We need a standard to measure how effective an education is in order to set students up for success in the rest of their lives. 

How we measure Quality Education

The UN has outlined several targets within their larger education-related SDG that help us to set a standard of quality. 

1. Building relevant skills for financial success

Extreme poverty is a lack of assets or a lack of return on those assets. One of these assets are skills, including technical and vocational skills. The more relevant these skills are in the 21st Century, the more likely they are to generate a return. This not only means understanding how relevant skills have changed against the digital revolution and automation, but also against climate change, shifting societal norms, and political realities. 

2. Eliminating discrimination in education

Education is a fundamental human right. However, there are 244 million children around the world who aren’t in the classroom. Many of them are excluded due to some form of discrimination. Girls’ education is particularly under threat here, with over 129 million girls missing out on a basic human right. Quality Education means equality in education — at all levels. 

3. Universal literacy and numeracy

According to UNESCO, if all adults had just literacy and numeracy skills, an estimated 171 million people could escape extreme poverty . However, UNESCO also estimates that  there are 781 million illiterate adults around the globe. Many of these adults have completed several years of education but remain unable to read or count due to different barriers.

6 Benefits of literacy in the fight against poverty

"The future starts with the alphabet." Here are 6 benefits of literacy as a tool for breaking the cycle of poverty.

4. Inclusive and safe schools

Environment is crucial to fostering a quality education. This means building and upgrading schools that are child-friendly, disability- and gender-sensitive, and provide safe, nonviolent, and inclusive spaces for kids to learn — and to enjoy being kids. Unfortunately, both physical and psychological aggression and gender biases are still prevalent in far too many schools. 

5. Qualified teachers

One of the UN’s other main goals around education is to increase the number of qualified teachers — especially in low-income countries and remote areas around the world. While many teachers receive some form of training, it’s not always in line with the best education models, nor is it always tailored to teaching in fragile contexts. 

How Concern supports Quality Education

Concern’s work in primary education is grounded in the belief that all children have a right to learn. We believe that education is one of the best routes out of poverty and integrate it into both our development and emergency work to give children living in extreme poverty more opportunities in life and an overall sense of well-being. 

Supporting Syrian students and teachers in Lebanon and Türkiye

We’ve worked with displaced Syrian teachers, as well as local teachers in Turkish and Lebanese host communities, to develop formal and informal learning programs that support children who have been traumatized by war and displacement. We’ve also worked with Syrian adults to build relevant income-generating skills that they can use in their host communities as well as, eventually, when they return home to a country that will need help rebuilding its infrastructure, economy, and communities.

Helping girls succeed in Kenya and Malawi

Project Profile

Right to Learn

An example of finding the right partners to go even further, this education program in Malawi improved gender equality in the classroom.

In an effort to build gender equality in educational systems around the world, we’ve created programs that support retention rates from primary to secondary schools for girls in Kenya and Malawi . In Malawi, we’ve also supported community groups to prevent harmful traditions like child marriage from interrupting education (for boys and girls). Community groups like a local Village Savings and Loan Association in Kenya’s Chalbi Desert have also taken it upon themselves to financially support local girls through their primary and secondary schooling. 

Breaking language barriers in Haiti and Niger

Language barriers in the classroom: From mother tongue to national language

Learn more about how Concern programs have helped students overcome language barriers in classrooms in Haiti and Kenya.

We’ve addressed language barriers in the classroom in countries like Kenya, Niger and Haiti , where local communities often speak languages other than the national tongues (which, in and of themselves, are holdovers of colonial rule). This method is in line with UNESCO’s recommendation for early teaching in the mother tongue and gradually transitioning. 

Creating safe learning environments in Sierra Leone

Concern is working to address school-related gender-based violence (SRGBV) to align quality with equality. In Sierra Leone, our Irish Aid-funded, multi-million-dollar, five-year learning program, the Safe Learning Model, developed a holistic approach to education in the Tonkolili District, addressing SRGBV in the larger community context and creating a model that can be adapted for other countries and settings. 

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Defining and measuring the quality of education

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What is the quality of education? What are the most important aspects of quality and how can they be measured?

These questions have been raised for a long time and are still widely debated. The current understanding of education quality has considerably benefitted from the conceptual work undertaken through national and international initiatives to assess learning achievement. These provide valuable feedback to policy-makers on the competencies mastered by pupils and youths, and the factors which explain these. But there is also a growing awareness of the importance of values and behaviours, although these are more difficult to measure.  

To address these concerns, IIEP organized (on 15 December 2011) a Strategic Debate on “Defining and measuring the quality of education: Is there an emerging consensus?” The topic was approached from the point of view of two cross-national surveys: the OECD Programme for International Student Assessment (PISA) and the Southern and Eastern Africa Consortium for Monitoring Educational Quality (SACMEQ)*.

Assessing the creativity of students

“Students’ capacity to extrapolate from what they know and apply this creatively in novel situations is more important than what the students know”, said Andreas Schleicher, Head of the Indicators and Analysis Division at the Directorate for Education, OECD, and in charge of PISA. This concept is reflected in current developments taking place in workplaces in many countries, which increasingly require non-routine interactive skills. When comparing the results obtained in different countries, PISA’s experience has shown that “education systems can creatively combine the equity and quality agenda in education”, Schleicher said. Contrary to conventional wisdom, countries can be both high-average performers in PISA while demonstrating low individual and institutional variance in students’ achievement. Finally, Schleicher emphasized that investment in education is not the only determining factor for quality, since good and consistent implementation of educational policy is also very important.

The importance of cross-national cooperation

When reviewing the experience of SACMEQ, Mioko Saito, Head a.i of the IIEP Equity, Access and Quality Unit (technically supporting the SACMEQ implementation in collaboration with SACMEQ Coordinating Centre), explained how the notion of educational quality has significantly evolved in the southern and eastern African region and became a priority over the past decades. Since 1995, SACMEQ has, on a regular basis, initiated cross-national assessments on the quality of education, and each member country has benefited considerably from this cooperation. It helped them embracing new assessment areas (such as HIV and AIDS knowledge) and units of analysis (teachers, as well as pupils) to produce evidence on what pupils and teachers know and master, said Saito. She concluded by stressing that SACMEQ also has a major capacity development mission and is concerned with having research results bear on policy decisions.  

The debate following the presentations focused on the crucial role of the media in stimulating public debate on the results of cross-national tests such as PISA and SACMEQ. It was also emphasized that more collaboration among the different cross-national mechanisms for the assessment of learner achievement would be beneficial. If more items were shared among the networks, more light could be shed on the international comparability of educational outcomes.

* PISA assesses the acquisition of key competencies for adult life of 15-year-olds in mathematics, reading, and science in OECD countries. SACMEQ focuses on achievements of Grade 6 pupils. Created in 1995, SACMEQ is a network of 15 southern and eastern African ministries of education: Botswana, Kenya, Lesotho, Malawi, Mauritius, Mozambique, Namibia, Seychelles, South Africa, Swaziland, Tanzania (Mainland), Tanzania (Zanzibar), Uganda, Zambia, and Zimbabwe

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Ensuring Quality Education

UNESCO believes that education is a human right for all throughout life and that access must be matched by quality. The Organization is the only United Nations agency with a mandate to cover all aspects of education. It has been entrusted to lead the Global Education 2030 Agenda through Sustainable Development Goal 4.

UNESCO Office in Tashkent with its national partners implements a number of programmes and projects in areas of quality of education, improving curricula and supporting teacher training and the development of teaching materials, inclusive life-learning for all. UNESCO actively cooperates with the Ministries of Education (Ministry of preschool and school education, Ministry of higher education, science and innovation).

UNESCO works with schools to promote the ideals of UNESCO valuing rights and dignity, gender equality, social progress, freedom, justice and democracy, respect for diversity and international solidarity. The UNESCO Associated Schools Network (ASPnet) connects more than 12,000 schools in 182 countries, more than 45 schools in Uzbekistan are connected to this network and implement concrete actions in three priorities: education for sustainable development, global citizenship education and inter-cultural and heritage learning.

UNESCO also cooperates with educational institutions and universities around the world. UNESCO Chairs and UNITWIN Networks involves over 850 institutions in 117 countries, promotes international inter-university cooperation and networking to enhance institutional capacities through knowledge sharing and collaborative work. Eight UNESCO Chairs at seven universities in Uzbekistan are connected to global network to pool their resources, both human and material, to address pressing challenges and contribute to the development of their societies.

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Quality education

Understanding of what "quality" means may vary between contexts, and different actors may have their own definitions. Broadly, quality education encompasses seven characteristics.

• Rights-based: Quality education is accessible, equitable, protective, participatory, non-discriminatory, and inclusive of all people.
• Contextualized and relevant: Education systems address the needs of the learners by using culturally and linguistically relevant learning materials.
• Holistic development of learners: Quality education promotes cognitive development, social and emotional skills, mental health and psychosocial wellbeing, values of responsible citizenship, economic sustainability, and peacebuilding.
• Teaching and learning: Teachers receive adequate compensation and relevant training so that they understand pedagogic content and have the knowledge and skills they need to support learners’ holistic development.
• Enabling resources: Quality education includes adequate and relevant resources for teaching and learning and fosters links between the resources available in the learning environment, home, and community to improve holistic learning outcomes.
• Learning outcomes: Quality education allows learners to develop the necessary knowledge, skills, and competencies to meet certification requirements, progress through the education system, and access lifelong learning opportunities.
• Learning continuity: Quality education provides sustained learning opportunities across the humanitarian-development-peacebuilding nexus.

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• What is Quality Education?

The word education goes beyond simply “schooling.”

Quality education.

is a process rather than an outcome, and acts as an apprenticeship for democracy; it considers students, teachers, environment, pedagogy, and assessment simultaneously, planning for supportive relational connections between and among each element.

is equitable, ensuring that each student gets what s/he needs with respect to who and where they are (gender, race, ethnicity, socioeconomic status, and geographic location) and respect for where they want to go, and how they want to get there.

is multi-faceted and interdisciplinary whenever possible, rather than being chunked and siloed into separate subject areas. Quality education

assesses competence in life skills as well as academic skills, and most critically, identifies competence based on a range of evidence in different contexts over time.

When EdVisions speaks of quality education we are speaking of authentic learning. EdVisions believes that authentic learning captures each student’s unique identity, interests, aptitudes, strengths, and learning gaps. Learning to learn is a lifelong process as experiences broaden and minds expand. What happens in school is a small chunk of everyone’s life.

EdVisions believes that we must ensure that time in school is worthwhile, connected to life outside of school, and preparing and empowering learners to be happy, healthy, engaged and contributing members of a diverse society both now and in the future.

Because a whole lot of learning takes place outside of school, educators must help students to discover how to learn. Curriculum that springs from the whole child is expansive–helping students make connections between and among experiences and the different communities with which they engage.

Quality education considers and assesses the processes of learning as well as the knowledge and content. It is important to pay attention to not just “what” students know and are able to do, but also to their understanding of “how” they learned what they know, and “why” it is important. It is our aim to assist educators in developing lifelong learners.

Reach out to schedule a free consultation about customized supports for your school needs.

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What is quality education? How can it be achieved? The perspectives of school middle leaders in Singapore

• Published: 12 June 2015
• Volume 27 , pages 307–322, ( 2015 )

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• Pak Tee Ng 1  

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This paper presents the findings of a research project that examines how middle leaders in Singapore schools understand ‘quality education’ and how they think quality education can be achieved. From the perspective of these middle leaders, quality education emphasises holistic development, equips students with the knowledge and skills for the future, inculcates students with the right values and imbues students with a positive learning attitude. Quality education is delivered by good teachers, enabled by good teaching and learning processes and facilitated by a conducive learning environment. The challenge of achieving quality education is to find the balance between lofty ideals and ground realities. One critical implication of the research findings is that policymakers should appeal to the ideals of practitioners to drive change.

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Ng, P.T. What is quality education? How can it be achieved? The perspectives of school middle leaders in Singapore. Educ Asse Eval Acc 27 , 307–322 (2015). https://doi.org/10.1007/s11092-015-9223-8

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Received : 03 July 2014

Accepted : 01 June 2015

Published : 12 June 2015

Issue Date : November 2015

DOI : https://doi.org/10.1007/s11092-015-9223-8

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Quality education

Rebuilding education systems after covid-19.

[goal: 4] aims to provide high-quality education and lifelong learning opportunities for all. Globally, 1.6 billion children were affected by school closures during COVID. The average student saw schools fully or partially closed for 199 days between March 2020 and September 2021. As a result, the average student globally is roughly 1 year behind their expected learning levels, with larger losses in the poorest countries.

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An Education Crisis

Disparities in access to learning.

Source: World Bank World Development Indicators ([link: https://data.worldbank.org/indicator/NY.GNP.PCAP.CD NY.GNP.PCAP.CD], [link: https://data.worldbank.org/indicator/IT.NET.USER.ZS IT.NET.USER.ZS]), [link: https://datacatalog.worldbank.org/int/search/dataset/0038947/Learning-Poverty-Global-Database--Historical-data-and-sub-components Learning Poverty Database], [link: https://covid19.uis.unesco.org/global-monitoring-school-closures-covid19/ UNESCO Global monitoring of school closures caused by COVID-19]

Rising Learning Poverty

Distance learning platforms, % of countries reporting the use of distance learning platform.

Source: World Bank, UNESCO UIS, OECD; [link: https://www.google.com/url?q=https://tcg.uis.unesco.org/survey-education-covid-school-closures/&sa=D&source=docs&ust=1686066926313685&usg=AOvVaw3OV9PjhAUSnC0iqYpYhI5v Survey on National Education Responses to COVID-19 School Closures]

Learning Poverty projected to rise due to COVID-19

Covid-19 learning poverty projections.

Source: World Bank, UNESCO, UNICEF, USAID, FCDO, Bill & Melinda Gates Foundation. [link: https://www.worldbank.org/en/topic/education/publication/state-of-global-learning-poverty "The State of Global Learning Poverty 2022 update."]

Learning losses

of lost learning due to COVID-19

The pandemic caused a dramatic drop in learning activities

Share of children engaged in learning activities.

Source: Dang et al. 2021. [link: http://documents.worldbank.org/curated/en/656051621919132722/Impact-of-COVID-19-on-Learning-Evidence-from-Six-Sub-Saharan-African-Countries Impact of COVID-19 on Learning : Evidence from Six Sub-Saharan African Countries (English).] LSMS COVID-19 Cross Country Brief Washington, D.C. : World Bank Group.

Mathematical and reading ability by socio-economic status in Mexico

Share of 10-15 year olds able to solve 4th grade division or comprehend short text.

Source: Hevia, Vergara-Lope, Velásquez-Durán, and Calderón. 2022. [link: https://doi.org/10.1016/j.ijedudev.2021.102515 "Estimation of the fundamental learning loss and learning poverty related to COVID-19 pandemic in Mexico."] International Journal of Educational Development 88 (2022): 102515.

Dropout rates increased during the COVID-19 Pandemic

Dropout rates pre-covid-19 and during covid-19.

Source: Moscoviz, Laura, and David Evans.2022. [link: https://www.cgdev.org/publication/learning-loss-and-student-dropouts-during-covid-19-pandemic-review-evidence-two-years “Learning Loss and Student Dropouts during the COVID-19 Pandemic: A Review of the Evidence Two Years after Schools Shut Down.”] CGD Working Paper 609. Washington, DC: Center for Global Development.

Test scores in São Paulo dropped below pre-pandemic projections

5th grade national basic education assessment system (saeb) scores.

Source: Azevedo,Joao Pedro Wagner De; Rogers,F. Halsey; Ahlgren,Sanna Ellinore; Cloutier,Marie-Helene; Chakroun,Borhene; Chang,Gwang-Chol; Mizunoya,Suguru; Reuge,Nicolas Jean; Brossard,Matt; Bergmann,Jessica Lynn (2022). [link: https://unesdoc.unesco.org/ark:/48223/pf0000380128 The State of the Global Education Crisis: A Path to Recovery]. Authors’ calculations using data from SEDUC-SP, 2021. SAEB scores range from 0 to 500.

The Recovery

Learn more about sdg 4.

In the charts below you can find more facts about SDG {activeGoal} targets, which are not covered in this story. The data for these graphics is derived from official UN data sources.

SDG target 4.4

Many youth and adults in low and middle income countries lack basic ICT skills such as copying or moving a file or folder.

Proportion of youth (aged 15-24 years) and adults (aged 15 years and above) with basic information and communications technology (ict) skills, most recent value in 2017-20 (%).

* Each dot represents a country.

Source: United Nations Statistics Division (UNSD). Retrieved from [link: https://unstats.un.org/sdgs/dataportal/database UN SDG Portal (4.4)] DOWNLOAD

SDG target 4.6

Adult literacy rates between men and women have converged over time, but gaps still remain

Literacy rate (% of people ages 15 and above) by region, 1980-2020.

Source: UNESCO UIS. Retrieved from World Development Indicators([link: https://data.worldbank.org/indicator/SE.ADT.LITR.ZS SE.ADT.LITR.ZS], [link: https://data.worldbank.org/indicator/SE.ADT.LITR.MA.ZS SE.ADT.LITR.MA.ZS], [link: https://data.worldbank.org/indicator/SE.ADT.LITR.FE.ZS SE.ADT.LITR.FE.ZS]). DOWNLOAD

SDG target 4.5

Despite global progress, gender gaps in primary completion remain in Sub-Saharan Africa and Middle East & North Africa.

Source: UNESCO UIS, Retrieved from World Development Indicators, ([link: https://data.worldbank.org/indicator/SE.PRM.CMPT.ZS SE.PRM.CMPT.ZS], [link: https://data.worldbank.org/indicator/SE.PRM.CMPT.MA.ZS SE.PRM.CMPT.MA.ZS], [link: https://data.worldbank.org/indicator/SE.PRM.CMPT.FE.ZS SE.PRM.CMPT.FE.ZS]). DOWNLOAD

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The impacts of a quality education

Without education, no social, health, economic and political progress is possible. Investing in education is therefore essential for the future of the world. For over 40 years, Action Education acts on the ground to promote access to a quality education for all, mainly for vulnerable and marginalised populations.

Quality education reduces poverty

Quality education prevents disease and malnutrition.

• Quality education can prevent preventable diseases and improve treatment uptake. A child under the age of five is twice as likely to survive if his or her mother can read and write (UN, 2011).
• Quality education reduces malnutrition. At school, children are introduced to good hygiene and nutrition practices. The canteen offers a complete and balanced meal.

Quality education promotes the well-being of children

• Access to quality education enables children to develop and flourish.
• Educated children have more confidence in themselves and their abilities.
• They acquire the keys to solve everyday problems and to prepare their future.

Quality education, a key to women's empowerment

• Girls who complete primary education are more likely to find employment and be financially independent.
• Educating girls has prevented more than 30 million deaths of children and under-fives and more than 100 million deaths of adults aged 15 to 60 (The Learning Generation).
• Universal secondary education could virtually end child marriage (Missed opportunities: the high cost of not educating girls, Worldbank, 2018).

If all girls benefit at least 12 years of schooling, the value of human capital wealth could increase from $15 trillion to $30 trillion (Missed opportunities: the high cost of not educating girls, Worldbank, 2018).

Quality education to promote peace

• If the secondary school enrolment rate is above the average of 10%, the risk of war is reduced by almost 3% (World Bank, 2005).
• Education provides a sense of stability and hope for the future and helps to heal the trauma of pandemic, natural disaster and conflict.

Quality education to adapt to climate change

• Achieving universal access to upper secondary education by 2030 would avert 200,000 disaster-related deaths over the next 20 years (Global Education Monitoring Report, UNESCO, 2016).
• Education is an essential means of raising awareness and adapt to climate change. It has the power to encourage changes in attitude and behaviour.
• To effectively accelerate adaptation to climate change, Action Education advocates integrate education for sustainable development and global citizenship into school curricula.

Education is the real starting point for a virtuous circle whose impact can be seen in every aspect of daily life. Action Education is carrying out 85 actions in 16 countries to develop access to quality education for all. Our goal? "To leave no one behind".

Discover our actions, defending the right to education, education of girls and women, early childhood education, health education, youth and adult education, inclusive education.

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Sustainable Development Goal 4

Ensure inclusive and quality education for all and promote lifelong learning.

Sustainable Development Goal 4 is to “provide quality education for all”, according to the United Nations .

The visualizations and data below present the global perspective on where the world stands today and how it has changed over time.

Further information on education and learning can be found across several Our World in Data topic pages on Education , Teachers and Schools , Education Spending , and Literacy .

The UN has defined 10 Targets and 11 Indicators for SDG 4. Targets specify the goals and indicators represent the metrics by which the world aims to track whether these targets are achieved. Below we quote the original text of all targets and show the data on the agreed indicators.

Target 4.1 Free primary and secondary education

Sdg indicator 4.1.1 achieving proficiency in reading and mathematics.

Definition of the SDG indicator: Indicator 4.1.1 is the “proportion of children and young people (a) in grades 2/3; (b) at the end of primary; and (c) at the end of lower secondary achieving at least a minimum proficiency level in (i) reading and (ii) mathematics, by sex” in the UN SDG framework .

In the interactive visualizations, this is shown as the share of students in each country at each stage of education who reach at least the minimum reading and mathematics proficiency level.

Target: By 2030 “ensure that all girls and boys complete free, equitable and quality primary and secondary education leading to relevant and effective learning outcomes.”

More research: Further data and research on primary and secondary education can be found at the Our World in Data topic pages on Education and Literacy .

SDG Indicator 4.1.2 Ensuring children complete their education

Definition of the SDG indicator: Indicator 4.2.1 is the “completion rate (primary education, lower secondary education, upper secondary education)” in the UN SDG framework .

This indicator is defined as the share of a cohort of children or young adults aged 3-5 years older than the intended age of the last grade of each educational level who have completed that grade.

Shown here in the interactive visualizations is data for this indicator on the national average completion rate for primary education (first chart), lower secondary education (second chart), and upper secondary education (third chart).

Target: By 2030, “ensure that all girls and boys complete free, equitable and quality primary and secondary education leading to relevant and effective learning outcomes.”

More research: Further data and research can be found at Our World in Data topic pages on Education .

Target 4.2 Equal access to quality pre-primary education

Sdg indicator 4.2.1 ensuring children are developmentally on track.

Definition of the SDG indicator: Indicator 4.2.1 is the “proportion of children aged 24–59 months (2-5 years) who are developmentally on track in health, learning and psychosocial well-being, by sex” in the UN SDG framework .

Since internationally comparable data for this indicator is not currently available, this is measured by the United Nations through a proxy indicator defined as the proportion of children aged 36-59 months in each country who are developmentally on-track in at least three of the following four domains: literacy-numeracy, physical, socio-emotional and learning.

Data for this indicator is shown in the interactive visualization.

Target: By 2030, “ensure that all girls and boys have access to quality early childhood development, care and pre-primary education so that they are ready for primary education.”

More research: Further data and research can be found at Our World in Data topic page on Education .

SDG Indicator 4.2.2 Participation in pre-primary education

Definition of the SDG indicator: Indicator 4.2.2 is the “participation rate in organized learning (one year before the official primary entry age), by sex” in the UN SDG framework .

The participation rate in organized learning is the share of children participating in one or more organized learning programs (including programs that incorporate both education and care) in the year prior to a country’s official entry age.

Target: By 2030 “ensure that all girls and boys have access to quality early childhood development, care and pre-primary education so that they are ready for primary education.”

More research: Further data and research can be found at the Our World in Data topic page on Education .

Target 4.3 Equal access to affordable technical, vocational and higher education

Sdg indicator 4.3.1 equal access to further education.

Definition of the SDG indicator: Indicator 4.3.1 is the “participation rate of youth and adults in formal and non-formal education and training in the previous 12 months, by sex” in the UN SDG framework .

Data for this indicator is shown in the interactive visualization. We also show the enrollment in tertiary education.

Target: By 2030 “ensure equal access for all women and men to affordable and quality technical, vocational and tertiary education, including university.”

Target 4.4 Increase the number of people with relevant skills for financial success

Sdg indicator 4.4.1 information and communications technology (ict) skills.

Definition of the SDG indicator: Indicator 4.4.1 is the “proportion of youth and adults with information and communications technology (ICT) skills, by type of skill” in the UN SDG framework .

Having a skill in this context refers to having undertaken a certain ICT-related activity in the past three months. This indicator includes multiple ICT skills, including using basic arithmetic formulas in a spreadsheet and verifying the reliability of information found online.

Data for one component of the indicator is shown in the interactive visualizations. The first chart shows the share of youth and adults (aged 15-24 years old) in each country with skills in creating electronic presentations with presentation software. The second chart shows this measure by sex.

Target: By 2030 “substantially increase the number of youth and adults who have relevant skills, including technical and vocational skills, for employment, decent jobs and entrepreneurship.”

Target 4.5 Eliminate all discrimination in education

Sdg indicator 4.5.1 disparities in educational access.

Definition of the SDG indicator: Indicator 4.5.1 is “parity indices (female/male, rural/urban, bottom/top wealth quintile and others such as disability status, indigenous peoples and conflict-affected, as data become available) for all education indicators on this list that can be disaggregated” in the UN SDG framework .

Parity indices measure the ratio of the value of a measure for one group to the value for another, with the likely more disadvantaged group placed in the numerator.

In the interactive visualizations, data for this indicator is shown for gender parity in primary school completion (first chart), lower secondary school completion (second chart), and upper secondary school completion (third chart).

Target: By 2030 “eliminate gender disparities in education and ensure equal access to all levels of education and vocational training for all.” 1

Additional charts

• Primary-school-age children who are out of school by world region

Target 4.6 Universal literacy and numeracy

Sdg indicator 4.6.1 universal literacy and numeracy.

Definition of the SDG indicator: Indicator 4.6.1 is the “proportion of population in a given age group achieving at least a fixed level of proficiency in functional (a) literacy and (b) numeracy skills, by sex” in the UN SDG framework .

Data for this indicator is shown in the interactive visualizations for young people (first chart), the literacy of adult men and women (second and third chart), and their numeracy (fourth and fifth chart).

Target: By 2030 “ensure that all youth and a substantial proportion of adults, both men and women, achieve literacy and numeracy.”

More research: Further data and research can be found at the Our World in Data topic page on Literacy .

• Literate and illiterate world population
• Literacy rates of younger vs. older population

Target 4.7 Education for sustainable development and global citizenship

Sdg indicator 4.7.1 education on sustainable development and global citizenship.

Definition of the SDG indicator: Indicator 4.7.1 is the “extent to which (i) global citizenship education and (ii) education for sustainable development are mainstreamed in (a) national education policies; (b) curricula; (c) teacher education; and (d) student assessment” in the UN SDG framework .

These measures reflect characteristics of country education systems, as reported by government officials, and measure what governments intend rather than what is implemented in practice. For each component, a score is calculated by combining a number of criteria to give a single score of one to zero.

Data for this indicator is shown in the interactive visualizations for the components related to teacher education (first chart), curricula (second chart), student assessment (third chart), and national education policies (fourth chart).

Target: By 2030 “ensure that all learners acquire the knowledge and skills needed to promote sustainable development.” 2

Target 4.a Build and upgrade inclusive and safe schools

Sdg indicator 4.a.1 inclusive and safe schools.

Definition of the SDG indicator: Indicator 4.a.1 is the “proportion of schools offering basic services, by type of service” in the UN SDG framework .

Data for this indicator is shown for a variety of basic services, including access to electricity, handwashing facilities, and access to drinking water.

Target: “Build and upgrade education facilities that are child, disability and gender sensitive and provide safe, non-violent, inclusive and effective learning environments for all.”

More research: Further data and research can be found at the Our World in Data topic page on Teachers and Schools .

Target 4.b Expand higher education scholarships for developing countries

Sdg indicator 4.b.1 scholarships for developing countries.

Definition of the SDG indicator: Indicator 4.b.1 is the “volume of official development assistance flows for scholarships by sector and type of study” in the UN SDG framework .

This indicator is disbursements of official development assistance (ODA) for scholarships, defined as financial aid awards for individual students and contributions to trainees, where students and trainees are nationals of recipient countries.

Official development assistance refers to flows to countries and territories on the Organization for Economic Co-operation and Development’s Development Assistance Committee (DAC) and to multilateral institutions which meet a set of criteria related to the source of the funding, the purpose of the transaction, and the concessional nature of the funding.

Target: By 2020 “substantially expand globally the number of scholarships available to developing countries.” 3

Unlike most SDG targets which are set to be achieved by 2030, this indicator has a target year of 2020.

More research: Further data and research can be found at Our World in Data topic page on Financing Education .

Target 4.c Increase the supply of qualified teachers in developing countries

Sdg indicator 4.c.1 supply of qualified teachers.

Definition of the SDG indicator: Indicator 4.c.1 is the “proportion of teachers with the minimum required qualifications, by education level” in the UN SDG framework .

This indicator is measured as the share of pre-primary, primary, lower secondary and upper secondary teachers who have received the minimum organized pedagogical teacher training required for teaching at the relevant level in a given country.

Data for this indicator is shown in the interactive visualizations for pre-primary education (first chart), primary education (second chart), lower secondary education (third chart), and upper secondary education (fourth chart).

Target: By 2030 “substantially increase the supply of qualified teachers.” 4

More research: Further data and research can be found at Our World in Data topic page on Teachers and Schools .

• Pupil-teacher ratio in primary education

Full text: “By 2030, eliminate gender disparities in education and ensure equal access to all levels of education and vocational training for the vulnerable, including persons with disabilities, indigenous peoples and children in vulnerable situations.”

Full text: “By 2030, ensure that all learners acquire the knowledge and skills needed to promote sustainable development, including, among others, through education for sustainable development and sustainable lifestyles, human rights, gender equality, promotion of a culture of peace and non-violence, global citizenship and appreciation of cultural diversity and of culture’s contribution to sustainable development.”

Full text: “By 2020, substantially expand globally the number of scholarships available to developing countries, in particular least developed countries, small island developing States and African countries, for enrolment in higher education, including vocational training and information and communications technology, technical, engineering and scientific programmes, in developed countries and other developing countries.”

Full text: ”By 2030, substantially increase the supply of qualified teachers, including through international cooperation for teacher training in developing countries, especially least developed countries and small island developing States.”

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• Open access
• Published: 09 September 2024

Approximately half of the nursing students confirmed their willingness to participate in caring for older people: a systematic review and meta-analysis

• Yunhua Wang 1 ,
• Fengli Lv 2 ,
• Hongyu Zeng 2 &
• Jiancheng Wang 2 , 3  

BMC Geriatrics volume  24 , Article number:  745 ( 2024 ) Cite this article

Metrics details

Global population aging poses a significant global challenge, necessitating an increased demand for proficient caregivers specialized in elderly care. In our study, a systematic review and meta-analysis were conducted to synthesize the evidence concerning nursing students’ willingness to participate in caring for older people.

Eligibility criteria focused on cross-sectional studies involving nursing students’ willingness to participate in caring for older people and were reported in English or Chinese. PubMed, Web of Science, Embase, Cochrane Library, China National Knowledge Infrastructure (CNKI), and WANFANG databases were searched from inception until July 24, 2022. The methodological quality assessment in the included studies was evaluated using the AHRQ instrument. The pooled effects of the nursing students’ willingness to participate in caring for older people were computed using a random-effects model. Funnel plots and Egger’s test were employed to evaluate publication bias. Meta-regression and subgroup analysis were performed to explore the sources of heterogeneity. Sensitivity analysis was conducted to verify the robustness of the meta-analysis findings. All statistical tests were conducted with Stata 16.0 software.

A total of 68 studies of medium or high quality met the eligibility criteria, involving 30,328 nursing students. The rate of nursing students’ willingness to participate in caring for older people was 49.0% (95% CI = 46–53%, I 2  = 98.1%, P  = 0.000). The results of meta-regression analysis showed that the following four predictor variables were significantly associated with nursing students’ willingness to participate in caring for older people: experience of living with and caring for older people, nursing as their first choice and their year-level in education, respectively. Subgroup analyses for these four predictor variables revealed the following pooled estimates of nursing students’ willingness: having experience of living with older people (0.54, 95% CI = 0.46–0.62) vs. no such experience (0.38, 95% CI = 0.30–0.46), having experience of caring for older people (0.55, 95% CI = 0.48–0.63) vs. no such experience (0.38, 95% CI = 0.30–0.46), nursing as their first choice (0.54, 95% CI = 0.51–0.58) vs. not their first choice (0.44, 95% CI = 0.35–0.53), being in the first year of nursing education (0.44, 95% CI = 0.34–0.55), second year (0.45, 95% CI = 0.34–0.56), and third and fourth year (0.62, 95% CI = 0.53–0.71).

The study found that approximately half of the nursing students confirmed their willingness to participate in caring for older people.The present study can serve as a resource for policymakers to increase the willingness of nursing students to participate in caring for older people.

Peer Review reports

Introduction

Global aging has emerged as a critical global concern, with the older population expected to reach unprecedented levels in the forthcoming decades. As of 2022, the global population aged 65 years and older numbered 771 million, tripling since 1980 [ 1 ]. The United Nations predicts that the older population is expected to reach 994 million by 2030 and 1.6 billion by 2050 [ 1 ]. China is notably confronting a substantial challenge posed by its aging population, with over 190 million individuals aged 65 or older in 2020, constituting 13.5% of its total population [ 2 ]. This places China as the country with the largest elderly population and the fastest-growing aging demographic globally.

Health problems associated with an aging population, such as disability, dementia, depression, and chronic diseases, pose substantial challenges to health services globally. Approximately 1 billion people, constituting 15.6% of the global population, experience varying degrees of disability [ 3 ]. In Australia, half (49.6%) of all older Australians had a disability in 2019, with 1.3 million older Australians needing assistance with daily activities [ 4 ]. The rate of instrumental activities of daily living (IADL) disability among Japanese adults aged 65 and above reportedly ranges from 7.9 to 23.2% in different regions [ 5 ]. By 2040, more than 27.0% of older individuals are projected to experience limitations in performing three or more activities of daily living (ADL) and encounter restrictions in social functioning [ 5 ]. In China, the number of older people with disabilities or semi-disabilities reached 40 million in the year 2019. Further, there were 10 million individuals diagnosed with dementia [ 6 ]. The number of older individuals with disabilities and dementia is expected to further increase.

The growing population of disabled and semi-disabled older individuals, coupled with the rising prevalence of chronic diseases, has resulted in a substantial increase in demand for care services. These services encompass long-term care, medical treatment, rehabilitation, psychological support, emergency assistance, and end-of-life care for older adults [ 7 , 8 ]. As such, there is a growing need for skilled service providers to deliver care services to older people. However, nursing students’ willingness to participate in caring for older people as a career remains relatively low due to the perceived low degree of specialization, high labor intensity, and lack of recognition in caring for older people. The proportion of nursing students from Hong Kong (7.7%) and Mainland China (3.6%) who are willing to take care of older people is deficient [ 9 ]. Moreover, 8.0% of nursing students in Australia [ 10 ], 5.1% of nursing students in Sri Lanka [ 11 ], and 1.6% of Baccalaureate Nursing Students in Western Pennsylvania are reportedly considering eldercare as a potential career path [ 12 ].

“Willingness” typically denotes a subjective intention to engage in an activity. Nonetheless, there is currently no universally agreed-upon definition regarding willingness to participate in caring for older people. Many experts and scholars emphasize that fostering willingness among students for employment requires close collaboration among governmental bodies, educational institutions, and the job market. Additionally, active engagement from students and their families is crucial in shaping this willingness [ 13 ]. In this study, based on the existing literature, nursing students’ willingness to participate in caring for older people is defined as their intention to provide care to older people, taking into account individual, familial, and environmental factors. Related concepts such as “attitude” and “interest” are also pertinent. “Attitude” refers to a psychological construct characterized by a learned and relatively stable tendency to react to people, ideas, and situations in an evaluative manner [ 10 ]. Culture, age, gender, education, experience, and previous relationships with older people have been identified as factors that influence nursing students’ attitudes toward older people [ 14 ]. “Interest,” within philosophy, education, and psychology, refers to an individual’s consciousness and psychological propensity that fosters learning. Ebbinghaus suggests that interest influences the objects of our attention and memory [ 15 ]. The interest in participating in eldercare reflects nursing students’ inclination towards providing care for older adults. Several studies suggest that positive attitudes towards older adults play a crucial role in fostering nursing students’ engagement in geriatric care post-graduation [ 11 , 16 , 17 ]. Cheng et al. demonstrated that personal interest among nursing students is a pivotal factor influencing their decision to pursue geriatric care as a career post-graduation [ 17 ]. Nursing students’ attitudes towards older people and their interest in eldercare can reflect their willingness to participate.

Negative perceptions towards older people among care providers can lead to the formation of negative attitudes. These attitudes, in turn, can significantly impact care providers’ willingness to participate in caring for older people [ 18 ]. Research has shown a positive relationship between nursing students’ attitudes toward older people and the willingness to participate in caring for older people. At the same time, positive perceptions and attitudes toward older people can be cultivated through education [ 19 , 20 ]. Nursing students, with their specialized education, constitute a vital and indispensable segment of the nursing workforce dedicated to caring for older people. At this critical stage of their education, nursing students can be positively influenced and guided to cultivate empathetic attitudes towards older individuals through targeted educational initiatives. By addressing common misconceptions about older people in their education, nursing students can develop more accurate and positive perceptions of elderly individuals, enhancing their readiness to provide effective and compassionate care [ 21 ]. The willingness of nursing students to actively participate in caring for older people not only influences their post-graduation employment decisions but also significantly contributes to the quality of care delivered to older people [ 22 ].

With the global trend of population aging becoming more pronounced, researchers have increasingly focused on studying nursing students’ willingness to participate in caring for older people in recent years. This has led to numerous cross-sectional studies on the topic, but findings across these studies vary. As an example, Okuyan et al. surveyed 688 nursing students in Turkey, with only 29 expressing a willingness to pursue a career in caring for older people [ 18 ]. This resulted a low willingness rate of 4.2% among nursing students to care for older people, as observed by Okuyan et al. In contrast, Carlson et al. surveyed 183 nursing students in Sweden and found that 106 expressed a willingness to work with older people [ 23 ]. This reflects a relatively high willingness rate of 57.9% among nursing students to participate in caring for older people. Yet, significant global differences exist in nursing students’ willingness to participate in caring for older people, influenced by factors such as sample size, survey regions, and individual characteristics of respondents. Despite qualitative reviews of nursing students’ willingness to engage in geriatric care [ 21 ], there is still a lack of comprehensive and integrated analyses of nursing students’ willingness to participate in caring for older people and the related influencing factors. Understanding accurate data on willingness rates and the factors influencing them is crucial for governments and nurse educators to prioritize interventions effectively. As such, in this study, a systematic review and meta-analysis were conducted to synthesize nursing students’ willingness rates to participate in caring for older people. The aim was to explore potential factors influencing nursing students’ willingness to participate in caring for older people. This exploration is timely and necessary, given the anticipated surge in demand for caregivers for older populations worldwide due to aging demographics.

Materials and methods

Registration.

This meta-analysis was reported following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines (PRISMA). The PRISMA 2020 checklist items are presented in Supplementary Table 1 , detailing the specific reporting aspects considered in this study. The study protocol was registered with the Prospective Register for Systematic Reviews (PROSPERO) under the registration number CRD42022348244.

Search strategy

During the literature search phase, two researchers independently and comprehensively searched six English and Chinese databases, including PubMed, Web of Science, Embase, Cochrane Library, China National Knowledge Infrastructure (CNKI), and WANFANG from inception to July 24, 2022. The Medical Subject Headings (MESH) terms and keywords used in the search were as follows: (“Students, Nursing” OR “undergraduate nurs*” OR “nursing undergraduat*” OR “nursing student*” OR “student nurs*” OR “BSN student*” OR “bachelor of nursing student*” OR “baccalaureate nursing student*” OR “student nurse”) AND (“Geriatric Nursing” OR “geriatric care” OR “geriatric nurs*” OR “aged care” OR “gerontology nurs*” OR “old people” OR “elderly” OR “old age” OR “older adults” OR “older population” OR “elder care”) AND (“willingness” OR “intent*” OR “attitude” OR “perception*” OR “knowledge” OR “belief*” OR “opinion*” OR “preference*”). Detailed information on the complete search strategy, including the specific search terms and their combinations, can be found in Supplementary Table 2 . To ensure a thorough exploration of relevant studies, a process of reference tracking was employed. This included reviewing the references cited in the included articles and consulting pertinent systematic reviews and meta-analyses to identify additional studies that met our inclusion criteria. This method helped to comprehensively gather relevant literature for the analysis.

Inclusion and exclusion criteria

The inclusion criteria for the study included: (1) cross-sectional studies; (2) studies that exclusively examined nursing students as the study population; and (3) the percentage of nursing students’ willingness to participate in caring for older people was explicitly reported in the study or could be calculated using the formula: willingness to participate = (number of students willing to participate / total number of students sampled) × 100.0%. The exclusion criteria included: (1) duplicate publications; (2) studies not published in English or Chinese; and (3) those lacking essential data. When multiple studies were available on the same population, only the most recent data were considered to avoid redundancy.

Study selection and data extraction

Two reviewers independently screened the aforementioned studies, extracted and cross-checked information, and consulted a third reviewer to resolve disagreements. For missing information from the included studies, the authors of the studies were contacted via email to obtain the necessary information. The screening process involved initial assessment through title and abstract reading, followed by exclusion of irrelevant articles, and subsequent full-text review to finalize inclusion based on predefined criteria. Two independent reviewers conducted data extraction from the selected studies, capturing key details such as first author, publication year, study location, investigation timeframe, sampling methodology, sample size, gender distribution, students’ origin, only-child status, year-level in education, and the number and percentage of nursing students’ willingness to participate in caring for older people.

Methodological quality assessment

The methodological quality of the included studies was assessed using the methodological checklist recommended by the Agency for Healthcare Research and Quality (AHRQ). The AHRQ methodology checklist is regarded as an exceptional tool for evaluating the quality of cross-sectional studies [ 24 ]. It is also a widely accepted tool that scholars use to assess the methodological quality of cross-sectional studies [ 25 ]. The checklist is available at http://www.ncbi.nlm.nih.gov/books/NBK35156/ [ 26 ]. The tool comprises 11 components encompassing data sources, criteria for inclusion and exclusion, timing and sequence of patient enrollment, subjective factors influencing evaluators, quality assurance assessments, explanation of exclusions, control of confounding variables, management of missing data, response rates, and follow-up procedures. The 11th component, pertaining to potential bias from loss to follow-up, was excluded as it applies specifically to prospective studies. Hence, the present investigation assessed the included studies based on the remaining 10 components. Each component was assessed a rating of “Yes,” “No,” or “Unclear,” with a score of 1 assigned for “Yes” and no score assigned otherwise. A cumulative score of < 4 indicated “Low” methodological quality, 4 to 7 indicated “Medium” methodological quality, and > 7 indicated “High” methodological quality. The evaluation was conducted independently by two reviewers, with discrepancies resolved through discussions involving a third reviewer.

Meta-regression

Univariate meta-regression analyses were used to explore potential predictors of nursing students’ willingness to participate in caring for older people. In developing the review protocol, members of the research team, through a comprehensive review of the literature and several rounds of expert consultation, concluded that gender [ 8 , 23 , 27 , 28 , 29 ], origin of students [ 8 , 29 , 30 , 31 ], year-level [ 23 , 32 , 33 , 34 ] and only-child status [ 8 , 30 , 35 , 36 , 37 ] may serve as predictors of nursing students’ willingness in caring for older people. These four predictor variables were predefined for analysis. The findings from numerous empirical studies suggest that several factors may influence nursing students’ willingness to participate in caring for older people. These factors include the experience of caring for older people [ 8 , 38 , 39 , 40 , 41 ], the experience of living with older people [ 8 , 30 , 31 , 42 ], have taken courses on elderly care [ 29 , 38 , 42 , 43 ], nursing as their first choice [ 29 , 44 , 45 , 46 , 47 ] and geographical location [ 8 , 10 , 19 , 20 ]. Based on these insights, the research team incorporated these five predictor variables post hoc into our analysis. As such, the meta-regression analysis ultimately included nine predictor variables: gender (male vs. female), students’ origin (urban vs. rural), only-child status (yes vs. no), the experience of living with older people (yes vs. no), the experience of caring for older people (yes vs. no), have taken courses on elderly care (yes vs. no), nursing as their first choice (yes vs. no), year-level (first, second, third and fourth), country (China vs. others). Data on the sub-groups’ willingness to participate in caring for older people were extracted from the publications included in the study.

Subgroup analysis

Subgroup analyses focused on variables that showed statistical significance in univariate regression analyses. The goal was to ascertain pooled estimates of willingness among subgroups of students who demonstrated significant variations in their willingness to participate in caring for older people.

Data analysis and synthesis

Statistical analysis was conducted out using Stata 16.0 software. The percentage of nursing students willing to participate in caring for older people was extracted from the included studies. For studies that did not explicitly report a willingness rate, it was calculated by dividing the total number of nursing students willing to participate in caring for older people by the total number of nursing students. Moreover, 95% CIs were calculated for these proportions. The pooled results were reported using a weighted point estimate of the nursing willingness rate and 95% CIs. Heterogeneity among the included studies was assessed using the χ 2 test with a significance level of α = 0.10, and the extent of heterogeneity was quantified using the I 2 statistic. For the meta-analysis, I 2 values > 50% and P -values < 0.10 indicated moderate or high heterogeneity, and the random effects model was used; otherwise, the fixed effects model was used. To test the stability of the findings, sensitivity analyses were conducted by systematically excluding one study at a time and observing the resulting changes in the pooled willingness rates from the remaining studies. Additionally, sensitivity analyses were restricted to studies of moderate quality to further validate the stability of the results. Publication bias was assessed using a funnel plot, and asymmetry in the funnel plot was determined using Egger’s test. A P -value above 0.05 indicated a low risk of publication bias. A significance level of P  < 0.05 was considered statistically significant.

Search results

A total of 4,961 studies were obtained by preliminary search. After removing 911 duplicates, 4,050 studies underwent further screening.Finally, 68 studies on the willingness of nursing students to participate in caring for older people were included [ 8 , 10 , 16 , 19 , 20 , 22 , 23 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 67 , 68 , 69 , 70 , 71 , 72 , 73 , 74 , 75 , 76 , 77 , 78 , 79 , 80 , 81 , 82 , 83 , 84 , 85 , 86 , 87 ]. Figure  1 provides an overview of the search and selection process.

PRISMA flow diagram of literature search and selection

Studies characteristics [ 8 , 10 , 16 , 19 , 20 , 22 , 23 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 67 , 68 , 69 , 70 , 71 , 72 , 73 , 74 , 75 , 76 , 77 , 78 , 79 , 80 , 81 , 82 , 83 , 84 , 85 , 86 , 87 ]

The characteristics of the included studies are presented in Table  1 . Sixty-eight articles were ultimately included. A total of 30,328 nursing students were surveyed, and 14,495 were willing to participate in caring for older people. Xiao et al. employed two questionnaires to investigate 256 Australian nursing students and 204 Chinese nursing students, respectively. As a result, each dataset from Xiao et al. was treated as distinct records in the present meta-analysis [ 32 ]. The sample sizes ranged from 51 to 1335. Among the 68 studies included, 46 studies were conducted in China [ 8 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 37 , 38 , 39 , 40 , 41 , 43 , 44 , 47 , 49 , 50 , 52 , 57 , 58 , 59 , 60 , 61 , 62 , 65 , 66 , 67 , 68 , 69 , 70 , 71 , 72 , 76 , 77 , 78 , 79 , 80 , 82 , 83 , 84 , 85 , 86 , 87 ], and eight studies originated from other countries [ 10 , 16 , 19 , 20 , 22 , 23 , 32 , 48 ], such as Australia, Italy, Israel, Sweden, Nepal, and Turkey. For the remaining studies, while the geographic area was not explicitly reported, the countries were determined based on the affiliations of the first authors’ institutions [ 36 , 42 , 45 , 46 , 51 , 53 , 54 , 55 , 56 , 63 , 64 , 73 , 74 , 75 , 81 ]. Sixteen studies reported the willingness rates for first-year-level nursing students to participate in caring for older people [ 23 , 30 , 31 , 32 , 33 , 37 , 42 , 44 , 56 , 58 , 63 , 64 , 65 , 68 , 73 , 76 ], 13 reported rates for second-year-level nursing students [ 30 , 31 , 37 , 42 , 44 , 49 , 63 , 65 , 68 , 72 , 74 , 75 , 76 ], nine reported rates for third year-level nursing students [ 30 , 31 , 37 , 42 , 44 , 63 , 65 , 68 , 76 ], and five reported rates for fourth year-level nursing students [ 30 , 45 , 58 , 65 , 70 ]. The quality assessment of all included studies exhibited a minimum score of 4 and a maximum score of 8.

Methodological quality assessment results

The study quality assessment revealed that 1 (1.5%) study had high quality [ 59 ] and 67 (98.5%) studies had medium quality. All included studies clearly defined the source of information. In the majority of included studies, assessments for quality assurance purposes (98.5%) and summaries of response rates and data completeness (97.1%) were reported. However, none of the studies described the impact of evaluators’ subjective factors on their findings or detailed how missing data were handled in their analyses. Further details can be found in Supplementary Table 3 .

Meta-analysis results

The random effects model analysis outcomes, conducted across the 68 included studies, indicated a nursing students’ willingness rate of 49.0% (95% CI = 46–53%, I 2  = 98.1%, P  = 0.000). A forest plot is shown in Fig.  2 .

Meta-analysis for the nursing students’ willingness to participate in caring for older people

The outcomes of the meta-regression analyses reveal significant associations between nursing students’ willingness to participate in caring for older people and four out of the nine predictor variables examined: the experience of living with older people, the experience of caring for older people, nursing as their first choice and the year-level of nursing students ( P < 0.05). Further details are shown in Table  2 .

Subgroup analyses for the four predictor variables with significant associations in the meta-regression revealed the following pooled estimates of nursing students’ willingness to participate in caring for older people: having experience of living with older people (0.54, 95% CI = 0.46–0.62) vs. no such experience (0.38, 95% CI = 0.30–0.46), having experience of caring for older people (0.55, 95% CI = 0.48–0.63) vs. no such experience (0.38, 95% CI = 0.30–0.46), nursing as their first choice (0.54, 95% CI = 0.51–0.58) vs. not their first choice (0.44, 95% CI = 0.35–0.53), being in the first year of nursing education (0.44, 95% CI = 0.34–0.55), second year (0.45, 95% CI = 0.34–0.56), and third and fourth year (0.62, 95% CI = 0.53–0.71). Further details are provided in Table  3 .

Sensitivity analysis

The robustness of the results was evaluated through leave-one-out analyses, where each study was individually excluded, resulting in a slight variation in the willingness rate of nursing students to participate in caring for older people, ranging from 49.0 to 49.9%. This minimal fluctuation around the overall combined willingness rate suggests the stability and reliability of the study findings. Further, sensitivity analysis was performed by including only 67 studies of moderate quality. In these studies, the willingness rate of nursing students to participate in caring for older people ranged from 49.3 to 50.3%. This reaffirms the stability and reliability of the study results across studies of moderate quality.

Publication bias

Egger’s test results show that publication bias was not present among the studies on the willingness rate of nursing students to participate in caring for older people ( P  = 0.121 > 0.05). A funnel plot is shown in Fig.  3 .

Funnel plot of publication bias

Among the 68 studies included in the present review, the findings reveal that approximately half of the nursing students (49.0% (95% CI = 46–53%)) confirmed their willingness to participate in caring for older people. The following factors can influence nursing students’ willingness: the experience of living with older people, the experience of caring for older people, nursing as their first choice, and the year level of nursing students.

The subgroup analysis results reveal that nursing students with experience of living with and caring for older people tended to be more inclined to participate in caring for older people [ 17 ]. This suggests that direct interaction with older individuals positively influences nursing students’ willingness to participate in caring for older people. Previous studies have consistently supported this perspective [ 7 , 88 ]. This demonstrates the advantages of practice-based learning in nursing education. Through such approaches, nursing students actively engage in real-world situations of caring for older individuals, allowing them to apply theoretical knowledge in clinical settings. Experiential teaching methods, like immersive simulations, role-playing, and educational games, are integral to practice-based learning. Research consistently supports these methods for improving nursing students’ attitudes, knowledge, and willingness to participate in caring for older people, thereby fostering competent and compassionate healthcare professionals [ 89 , 90 ]. In addition, nursing educators should organize voluntary service activities for nursing students in nursing homes, health service stations to increase the opportunities for nursing students to engage with older people and increase their willingness to participate in caring for older people.

Third and fourth year-level nursing students exhibited the highest inclination to participate in caring for older people, followed by second year-level students and first year-level students. In general, third and fourth-year nursing students often have prior exposure to courses on elderly care. Studies suggest that educational programs focusing on aging can significantly influence students’ perceptions and willingness to participate in caring for older people [ 91 ]. A positive relationship has been observed wherein nursing students with a better grasp of aging tend to exhibit more favorable attitudes toward older people, leading to a heightened readiness to participate in caring for older people [ 10 , 12 ]. Therefore, it is crucial to enhance nursing students’ understanding and mastery of aging knowledge. This includes developing comprehensive educational programs that equip students with a deeper understanding of the aging process and the complexities of eldercare. Additionally, the present review underscores that nursing students who select nursing as their primary career choice demonstrate a greater willingness to participate in caring for older people post-graduation. This inclination may stem from their inherent preference for the nursing profession and a more positive attitude towards older people [ 8 ].

Existing literature on “factors influencing students’ willingness to participate in caring for older people” categorizes relevant factors into five main groups: demographics, education, experience, family, and attitude [ 7 , 10 , 11 , 12 , 16 ]. Within the domain of attitude factors, nursing students with more positive attitudes toward older individuals are more likely to participate in caring for them [ 11 , 16 , 17 ]. Concurrently, upon comparing the evidence regarding “factors influencing students’ willingness to participate in caring for older people” and “factors influencing nursing students’ attitudes towards older people,” a notable similarity was identified in the influencing factors between the two. For example, positive experiences gained through interactions with older individuals and educational strategies focused on gerontology have been linked to a beneficial impact on nursing students’ attitudes towards older people [ 92 ]. Other studies have also indicated that positive attitudes were associated with education about caring for older people, knowledge about aging, contact with older family members and willingness to work with older people after graduation [ 93 ]. Based on existing evidence, nursing students with positive attitudes are more inclined to engage in caring for older individuals, and those with a strong willingness tend to develop more positive attitudes. Therefore, educators play a critical role in fostering these attributes among nursing students. They should focus on developing a comprehensive understanding of older people in nursing students through specialized courses and experiential learning. By enhancing students’ knowledge and empathy towards older populations, educators can effectively cultivate positive attitudes and increase their willingness to participate in caring for older people.

The results of this study reveal that among the 68 studies included, 88.2% studies were conducted within China. This suggests an unequal geographical distribution of studies on this topic across different countries. This disparity in nursing students’ willingness to participate in caring for older people across countries may stem from variations in the aging population and its growth rates worldwide. Additionally, discrepancies in levels of disability and prevalence of chronic diseases among older individuals globally could contribute to differential research emphasis on nursing students’ attitudes towards eldercare. Further analysis and exploration are needed to better understand the underlying reasons for these geographic differences. Future studies should delve into these factors to provide insights into how cultural, demographic, and health-related factors influence nursing students’ willingness to participate in caring for older people across diverse national contexts.

Limitations

The present meta-analysis had several limitations. The included studies in this analysis were predominantly cross-sectional and exhibited considerable heterogeneity. Uncertain confounding factors, such as survey methods, measurement instruments, timing of surveys, and geographical diversity, likely contributed to this variability. Despite analyzing various predictor variables, none effectively mitigated this heterogeneity. One possible explanation is that this study focused solely on studies explicitly reporting proportions of nursing students willing to participate in caring for older people, potentially overlooking studies employing more nuanced measurement instruments [ 91 , 94 ]. However, heterogeneity is often unavoidable in meta-analyses of observational studies and does not necessarily invalidate meta-analysis results [ 95 ]. Notably, because the included studies were cross-sectional, mediators and moderators of nursing students’ willingness to participate in caring for older people could not be identified. Therefore, more studies are needed to explore this area in depth to provide guidance for future research on related concepts.

The findings indicate that approximately half of the nursing students confirmed their willingness to participate in caring for older people. The main predictor variables of nursing students’ willingness to participate in caring for older people are the experience of living with older people, the experience of caring for older people, nursing as their first choice and year-level. However, there remains a critical need for more high-quality studies with representative samples to further validate these findings. We suggest that future research could leverage the findings of this study as a foundation to conduct more sound experimental studies aimed at evaluating the targeted manipulation of crucial factors, such as “nursing students’ experience of caring for older people,” and identifying predictors, mediators, moderators, and their underlying mechanisms that influence nursing students’ willingness to participate in caring for older people. For example, through early supervised volunteer work of adolescents in social and care services for older people or by revising the syllabus of undergraduate nursing programmes. Furthermore, policymakers can utilize the insights from this study as a resource to develop targeted strategies aimed at increasing nursing students’ willingness to participate in caring for older people. By comprehensively addressing these factors, policymakers can effectively support and enhance eldercare within the nursing profession.

Data availability

The datasets and any other materials of our study are available from corresponding author on request.

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Acknowledgements

We thank all members of our study team for their whole-hearted cooperation and the original authors of the included studies for their wonderful work.

This work was supported by the National Natural Science Foundation of China (72264002), Gansu Provincial Science and Technology Programme for Outstanding PhD Students (24JRRA503), Key Grant Project of Chinese Medicine Education Association (2022KTZ010). The funders who supported this study had no role in study design, preparation of the paper, data collection and analysis, decision to publish.

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YHW and JCW planed and designed the research; YHW and FLL provided methodological support/advice; JCW and HYZ tested the feasibility of the study; YHW and HYZ extract data; JCW performed the statistical analysis; YHW wrote the manuscript; all authors approved the final version of the manuscript.

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Wang, Y., Lv, F., Zeng, H. et al. Approximately half of the nursing students confirmed their willingness to participate in caring for older people: a systematic review and meta-analysis. BMC Geriatr 24 , 745 (2024). https://doi.org/10.1186/s12877-024-05321-6

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Received : 05 October 2023

Accepted : 21 August 2024

Published : 09 September 2024

DOI : https://doi.org/10.1186/s12877-024-05321-6

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