Nigeria’s health sector is facing a severe shortage of skilled personnel due to a wave of migration of healthcare workers. The United Kingdom (UK) National Statistics reveal that in 2021, 4,087 healthcare workers migrated to the UK. In 2022, this number increased to 11,629, and it further rose to 26,074 in 2023, raising concerns.
Nigeria’s health workforce density is below the World Health Organization’s (WHO) minimum recommendation of 20 nurses, midwives, and doctors per 10,000 people. With a nursing and midwives density of 15.6 per 10,000 population, and a doctor density of 3.9 per 10,000, the health workforce shortage in Nigeria has significantly hindered the achievement of health-related sustainable development goals.
With the current migration of healthcare professionals, Nigeria currently has just 55,000 doctors for a population of 220 million, according to Nigeria’s Health Minister, Muhammad Ali Pate. He adds that there is a huge distribution challenge because doctors and other high-level professionals are concentrated in Lagos, Abuja, and a few other urban centers.
In a report published in March of 2023, the World Health Organization (WHO) warned that, by 2030, there will be a global shortage of 10 million healthcare workers. The shortage will especially affect low-income countries, such as Nigeria, due to workers going abroad in search of opportunities.
Nigeria needs 363,000 doctors to serve its more than 200 million people, according to Uche Rowland, president of the Nigerian Medical Association (NMA).
Policies To Limit Migration
In 2023, the Nigerian government in a bid to reduce the migration of health workers to developed countries approved the appointment of retired doctors, nurses, and other clinical healthcare workers as contract staff. About two weeks into February, the Nursing Council in Nigeria announced a new policy to curb the migration of the nursing workforce. This policy, which will come into effect in March, will require that entry-level nurses work for a minimum of two years before applying for verification of their nursing licence for overseas work.
This resulted to protest from Hundreds of nurses, who stormed health regulator’s offices in Abuja and Lagos demanding the withdrawal of the policy
Also, in April last year, lawmakers proposed a five-year mandatory service for entry-level doctors before applying for full licensure for practice. These lawmakers argued that the measure was a way for doctors to give back to society after enjoying the dividends of subsidised education.
However, according to Dr. Nzube Ifediba, an early career health economist and health policy researcher, posited that coercive policies like deterrents not only perform poorly but worsen the pressure to leave.
She emphasized that Rather than use deterrents to curb the migration of health workers, policymakers should consider non-monetary incentives.
“ Mentorships from the senior health workforce may help retain entry-level nurses. Research has shown that mentorships can retain the healthcare workforce, by as much as 25%. In a study done in Northern Uganda, health workers were more likely to remain in remote public health centres if they felt valued and respected by senior colleagues. Unlike the hierarchical apprenticeship style that characterises most clinical training, the mentorship style of training encourages mutual respect and trust.
“It also creates a conducive environment for advocacy, career progression and job satisfaction. Furthermore, since most of the health workforce is employed by the government, employers should optimize recruitment in such a way that spaces left by migrated workers are quickly filled by the unemployed. This is significant, in light of the menace of ghost workers that plague most public facilities in Nigeria ”, she said.
Dr. Nzube concluded that the Medical and Dental Council and Nursing and Midwifery Council should strengthen advocacy efforts.
“They should advocate the need for better remuneration, working conditions, and smoother career progression. They should also advocate the need for employers in private practice to employ registered nurses, and not unprofessional “auxiliary nurses” in a bid to save cost.” she noted.
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