Addressing the Causes and Consequences of Brain Drain in Nigeria’s Health Sector
By Lawal Dahiru Mamman
The departure of highly skilled and educated individuals from Nigeria has escalated to an epidemic level, impacting virtually every sector.
Talking particularly about the health sector, in recent years, the country has witnessed a rapid outflow of medical professionals seeking better opportunities abroad. This has become a thing of worry looking at the inestimable value of human life the medics deal with.
As more healthcare workers leave the country, Nigeria’s doctor-patient ratio worsens. The President of the Nigerian Medical Association (NMA), Dr. Ojinmah Uche, stated during a recent policy dialogue that Nigeria has about 24,000 actively licensed physicians caring for its over 200 million population. By implication, Nigeria has one doctor to 10,000 patients.
Triggering the migration of health workers are issues ranging from salary structures to payment of arrears, welfare packages, quality of hospital equipment, funding for training programmes among others. Another problem is the implementation of the guidelines on one-for-one replacement of clinical staff that have left Nigeria in search of better working conditions in the diaspora.
The call for replacement of healthcare workers has been a pressing issue lately due to an obvious scarcity of skilled professionals in the country. This shortage not only impacts the quality of healthcare services available for citizens but also burdens the dedicated care providers who choose to remain, diminishing their effectiveness and productivity.
Various statistics show that over 5,000 Nigerian medical doctors migrated to the United Kingdom (UK) alone between 2015 and 2022. The Registrar of the Nursing and Midwifery Council of Nigeria (NMCN), Faruk Abubakar, in February, 2024 disclosed that 42,000 nurses had left the country in the last three years. Out of this number, over 15,000 left the country in 2023.
However, the appointment of Prof. Muhammad Ali Pate as Minister of Health and Social Welfare by President Bola Ahmed Tinubu, has been the first step to addressing the problem of brain drain.
The Minister has adopted a two-prong strategy in tackling the issue. He is not only recruiting new health workers to ensure Nigerians don’t suffer massively from the ‘japa’ syndrome among medical professionals, he is also putting in place the necessary policies and facilities to make life livable for the patriotic ones who have chosen to stay and work in Nigeria.
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Aside improvement in salaries, allowances and benefits, the administration is also investing in modern healthcare facilities, ensuring that professionals have access to state-of-the-art equipment and resources for treating patients. They have also emphasised continuous professional development, encouraging healthcare professionals to enhance their skills and knowledge.
To address the perennial issue of one-for-one replacement, the Minister recently said the federal government had recruited more than 2,000 health workers in the last seven months, adding that additional 1,400 health facilities now have skilled birth attendants to assist in deliveries across the country.
“In the last six months, the federal government of Nigeria recruited 2,497 doctors, midwives/nurses, and Community Health Extension Workers (CHEWs) to bridge the gaps due to attrition, this effort has increased the number of health facility deliveries as high as 230,000 deliveries per month,” the minister stated during a ministerial press briefing last month.
The inclusion of 1,400 new CHEWs could not have come at a better time. The report published by the Journal of Global Health Report puts maternal mortality ratio (MMR) in several low-and-middle-income countries at an alarming level, with about 34% of global maternal deaths occurring in Nigeria and India alone.
According to the World Health Organisation (WHO), the MMR of Nigeria is 814 per 100,000 live births. The lifetime risk of a Nigerian woman dying during pregnancy, childbirth, postpartum or post-abortion is 1 in 22, in contrast to the lifetime risk in developed countries estimated at 1 in 4,900.
The replacement of health workers that leave often takes a very long time because of bureaucratic bottlenecks but Professor Pate is fixing that and his ideas are working magic.
During a visit to the National Hospital, Abuja, after his appointment, he said, “human resource is one of the most important elements in the health sector, not just the building and the equipment. So, we need to support them and improve the circumstances of their work to reduce the stress level.
“Some health workers are leaving because of work overload and other circumstances, the replacement of those health workers can be expedited and we will work with other agencies of government to lift the embargo on health professionals’ employment. This is to ensure that when clinical staff members exit, hospitals can replace them to avoid creating unnecessary burden for others,” the Minister had said.
While economists see brain drain as brain gain since Nigerian professionals who leave for greener pastures often end up adding value to the economy through diaspora remittances and investments/job opportunities, Professor Pate and his colleagues in the Health Ministry see it as a wind that doesn’t blow the health and well-being of Nigerians any good.
As far as the Minister is concerned, only wealthy Nigerians can afford to go abroad to access the best medical care. As for poor folks who are in overwhelming majority in Nigeria, their only hope is the doctor, nurse, laboratory staff and pharmacists that are available here.
The Minister has therefore vowed to do everything within his power to fight brain drain to a standstill.
