The Crucial Role of Nurses in Addressing Social Determinants of Health in Low- and Middle-Income Countries: A Review of Challenges and Opportunities

Abstract

Social Determinants of Health (SDOH), the conditions in which people are born, grow, live, work, and age, have a profound influence on health outcomes and perpetuate inequalities, especially in low- and middle-income countries (LMICs). Nurses, forming the largest global health workforce, are often the initial point of contact for people in underserved areas. Their strong community presence, holistic approach, and continuous patient engagement position them to identify social risks, deliver health education, and facilitate access to essential services. This review examines the role of nurses in SDOH screening, assessment, education, advocacy, and referral in LMICs, while highlighting systemic barriers such as resource shortages, training gaps, administrative burdens, and limited digital infrastructure. It also discusses opportunities for strengthening nursing leadership through primary health care reforms, policy measures, digital innovations, and intersectoral collaboration. Empowering nurses is essential to advancing health equity, reducing preventable disease burdens, and achieving universal health coverage in resource-constrained environments.