Forecasting the Saudi nursing workforce: a detailed quantitative analysis of saudization, gender, and sectoral distribution towards the future

Saudi Arabia’s healthcare transformation under Vision 2030 heavily relies on the strength of its nursing workforce. This study aims to address the quantitative projections for nursing workforce planning by nationality, gender, and sector using time-series analysis and to forecast the Saudi nursing workforce. The study used the complete available data on the nursing workforce of KSA for the years 2007 to 2025 obtained from the Saudi Ministry of Health and the World Bank. The dataset comprised complete annual nursing workforce counts disaggregated by gender, nationality, and sector (MOH and private). Data stationarity was assessed using the Augmented Dickey-Fuller (ADF) and KPSS tests. The Ljung test was applied to check the assumption of autocorrelation between the residuals. After satisfying the assumptions, an Autoregressive Integrated Moving Average (ARIMA) with or without drift model was fitted to forecast workforce trends. Model reliability was validated via rolling-window out-of-sample backtesting, reporting Root Mean Square Error (RMSE) and Mean Absolute Percentage Error (MAPE). Forecast uncertainty is reported as 95% prediction intervals (PI). All statistical analyses and projections were performed in RStudio. The study indicated that the nurse density is 6.09 per 1,000 people, with the production of new graduates at 11 per 100,000 inhabitants. Under the central projection, total Saudi nurses are expected to reach approximate parity with foreign nurses around 2039 (166,944 vs. 166,171); however, the 95% prediction intervals for the two groups overlap substantially, so the crossover year should be regarded as approximate. The total workforce is projected at 340,295 (95% PI: 299,197–381,393), with Saudi nurses reaching 171,432 (95% PI: 150,349–192,515). Within the MOH, Saudi females reach 123,598 (95% PI: 107,065–140,132), while private sector Saudi females reach 5,234 (95% PI: 3,865–6,602). The annual workforce growth rate is estimated at 2.9%, projecting an increase from 226,580 in 2026 to 340,295 by 2040. The findings of this study indicated steady workforce growth by 2040, and Saudi nationals are projected to reach approximate parity with foreign nurses around 2039. However, sustaining this numerical progress will require addressing the current low domestic graduate production rate. Therefore, the policy focus on recruitment must be accompanied by a supportive work environment to ensure the long-term retention of the national healthcare workforce.