Low salaries and gender discrimination are driving Iran’s nurses from their jobs, impairing an already wobbly healthcare system.
Burnout, sexual harassment, and unsustainably poor pay. These are just some of the grievances voiced by Iran’s predominantly female nursing workforce—and why many now say they are leaving the profession despite having achieved what on paper appear to be large wage increases in recent years.
Iranian women have been steadily abandoning the nursing field since the COVID pandemic, leaving the country’s healthcare sector with a critical shortage of at least 100,000 nurses, almost half the number currently employed. According to the latest figures announced by the Ministry of Health’s Nursing Department, approximately 213,000 people currently work in hospital-based nursing groups, a 5.7 percent decrease since 2024, when Tehran Bureau last reviewed the available data. Approximately 75 percent of these nurses are women, according to the ministry.
The exploitation of Iran’s nurses and other healthcare workers has long been a catalyst for labor activism. During the nationwide Woman, Life, Freedom demonstrations of 2022, protestors expressed support for healthcare workers based on their experience of gender discrimination, in particular the broad gap between their high educational levels and everyday on-the-job realities. In subsequent years, a small but robust national labor movement pressured the government to raise minimum wages for all workers in line with inflation and lift restrictions on overtime compensation. In addition to overtime pay, performance-based payments were introduced to help make up for nurses’ inadequate salaries.
The average monthly earnings for Iranian nurses has risen from 7 million tomans in 2020 to a reported 25 to 28 million tomans (currently $96–108 USD at free-market currency exchanges, per Bonbast.com). But the recent pace of 89 percent year-on-year inflation means that nominal increase has not translated into greater purchasing power—far from it. According to the Supreme Labor Council’s 2023–24 salary and wage report, the minimum monthly salary for nurses during that period was the equivalent of $163.
As a consequence, nurses’ doubts about whether to remain in the profession are reaching a breaking point. One female nurse wrote last month on the Telegram channel of the Council of Iranian Retirees, a coalition of professional and labor organizations:
“Yesterday was my last shift. To enter this profession, you first have to get through the highly competitive university entrance exam and then navigate the difficult hiring process. Yet what ultimately awaits a nurse is an enormous workload, back-to-back shifts, and intense psychological and physical pressure.”
Deep and growing staff shortages
“Our nurses have concluded that if they give up a salary of 25 million tomans and stay home, they will suffer less wear and tear and will actually be better off financially,” Mohammad Sharifi-Moghaddam, secretary-general of the Nurses’ House, a professional association that advocates for nurses’ rights, said in an interview earlier this month with Khabar Online.
Though the growing shortage of nurses has been widely covered in the Iranian press as a critical labor issue, the exploitation of female nurses warrants further examination from the perspective of gender rights. In 2024, Tehran Bureau conducted a gender-focused study of the challenges faced by Iran’s healthcare workers. Based on dozens of interviews with healthcare workers and a review of publicly available data, the study concluded that, in the healthcare sector, being female significantly raises workers’ chances of underpayment (relative to peers with similar experience), job insecurity, occupational hazards, and sexual harassment.
“In general, as you move up the management chain, the proportion of men tends to increase along with the salary,” a male nurse working in one of Iran’s hospitals told Tehran Bureau in 2024. “Men get paid better and receive better benefits … Often, they get extra hours and assignments, so they can earn more money.”
Although Iranian universities reportedly admit between 12,000 and 18,000 students to nursing and related programs annually, many graduates never enter the profession. Meanwhile, around 5,000 nurses have been leaving the profession each year, according to Ministry of Health figures cited by Dr. Ahmad Nejatian, head of the Iranian Nursing Organization, in a July 27 interview with Jahan-e Sanat. Estimates of the number of qualified nurses no longer practicing vary: Nejatian declined to confirm reports that 60,000 were inactive, while the secretary-general of the Nurses’ House put the figure at 70,000.
As a result, hospitals are finding it increasingly difficult to fill vacancies in their nursing staffs. “In Tehran, authorization to hire nurses exists, but no one is applying,” Nejatian told Shargh in August, adding that he was aware that facilities in Hormozgan province were facing similar recruitment problems.
The consequences are becoming more apparent by the month. Three years ago, publicly available data showed there were just under 0.8 nurses for each hospital bed in Iran, well below the standard of 1.8 nurses per bed in developed countries. In February 2024, Nejatian estimated the shortage of nurses at 100,000. If even that enormous figure had somehow been filled, it would have closed less than half the nurse-per-bed gap.
With the shortage having only grown in the last two and a half years, the remaining staff face outsized patient loads that raise grave safety concerns, while some hospitals have closed wards or been unable to bring recently completed facilities online. According to Nejatian, some new hospitals have never opened their doors despite possessing the necessary infrastructure and equipment, solely because they cannot recruit enough nurses.
Gender pay gap and sexual harassment
Despite making up the vast majority of Iran’s nursing workforce, women often earn less than male colleagues with identical seniority doing identical jobs. Under Article 68 of the Civil Service Management Law, married men are entitled to family and child allowances, while women generally qualify only if they are widowed, unmarried, have an incapacitated husband, or are solely responsible for supporting their children. The result is a gender pay gap written into law.
Responding to protests over these discriminatory provisions, lawmakers have pledged reform. In July, Nasrollah Pejmanfar, chairman of the Majles’s Article 90 Commission, acknowledged the demands to extend family benefits to working and retired women. An amendment is reportedly under government review.
The disparity extends beyond nursing. A 2019 study of 666 Iranian general practitioners published by BMC Health Service Research found that women earned just 65 percent as much as men, although the figures reflect overall earnings rather than differences in pay for equivalent work.
In addition to high job stress, overwork, and contract insecurity, many female healthcare workers are subjected to sexual harassment. Largely overlooked by lawmakers, sexual harassment is an underreported crisis in Iran, with as many as 89 percent of women reporting that they have experienced it at some point, according to a 2021 study by the Cheragh Academy educational platform.
Respondents to Tehran Bureau’s own surveys mention witnessing sexual harassment, including in work environments where most of their colleagues were also female.
“Our workplace mostly has women, so we don’t really deal with harassment or abuse about gender among ourselves,” a 33-year-old female laboratory assistant told Tehran Bureau in 2024. “But, sadly, we’ve had a few times where patients have sexually harassed us, saying things or even getting physical.”
Violent behavior toward women working in healthcare is far from a rarity in Iran. In a 2020 Journal of Interpersonal Violence study among female clinical staff in Kerman, almost all participants (97.5%) said they had experienced domestic violence at least once. The most common types of violence they identified were psychological/verbal (58%), physical (29%), and sexual (10%).
In this environment of physical risk and financial exploitation, Iran’s female nurses find themselves “fighting on two fronts,” Sima Ebrahimi, a board member of the Nursing Organization in Shirvan, wrote in a commentary published two weeks ago on the group’s website:
“We who have stood on the front lines of care, in hospitals and amid the suffering of others, giving everything we have, now find ourselves caught in an unprecedented dual crisis. On the one hand, the physical and psychological exhaustion inherent in the demanding, self-sacrificing nature of nursing has pushed us to the brink of collapse. On the other, relentless inflation and economic insecurity have stripped us of stability and peace in our own lives.”