Editorial
Better Conditions For Health Workers
Deeply worried about the brain drain in Nigeria’s health sector, the House of Representatives has called on the federal government to strongly discourage the migration of health workers to other countries. The House specifically urged the Ministry of Labour, Employment and Productivity to review the salaries, allowances and welfare of medical practitioners in the country.
The Representatives equally urged the ministry to quickly expand the rapidly shrinking size of medical workers to create employment for the unemployed and develop a functional strategy that would captivate Diaspora medical personnel to work at the nation’s teaching hospitals and other health institutions.
The resolution followed a motion of urgent public importance moved by Hon. Ganiyu Johnson during the plenary. Moving the motion, Johnson said that despite Nigeria being among the highest producers of Diaspora doctors in the world, the nation faces a critical shortage of medical practitioners. He blamed the brain drain in the sector on poor remuneration and working conditions.
“Nigeria has over 90,000 qualified medical doctors practising abroad, and in fact, an average of 50 doctors who had their primary medical education in Nigeria are said to be registering for practice every week in the United Kingdom (UK), United States of America (USA), Canada and other oil-rich countries”, said Johnson.
We share the concerns or apprehension of the Representatives. The exodus of medical practitioners in Nigeria is worrisome and has particularly gone out of control, contributing to acute shortages of specialised and experienced health professionals in the country. If not curbed, it will be very tough for Nigeria to tackle the increasing poverty rate given that health is wealth.
At independence, this nation built a health system structured basically along with the model of the colonialists. From the 60s through the mid-80s, the health system was anchored and led by seasoned health administrators who coordinated the health manpower comprising pharmacists, doctors, nurses, laboratory scientists, physiotherapists, radiographers and other cadres of health workers.
The University College Hospital (UCH), Ibadan, since the 1960s through mid-1970s, was the ‘Mecca’ of medicine in Africa and indeed medical tourism. It ranked the fourth best university teaching hospital in the Commonwealth where Saudi kings came for treatment; queens were delivered of princes and princesses. By 1975, it was a designated Centre of Excellence in medicine.
However, by mid-1980s, the finest medical teachers started leaving for the Middle East and the West and the young physicians they trained moved to the West mostly for postgraduate trainings. Human capital, quality research, medical education and patient care suffered greatly while infrastructure decayed from poor funding and management. The few decades that followed witnessed a continued downturn in both human capital and infrastructure, resulting in human capital flight, brain drain and medical tourism.
Brain drain is a major challenge facing the Nigerian health system, leading to a dramatic reduction in the number of doctors and medical practitioners in the country. According to the Organisation for Economic Co-operation and Development (OECD), Nigeria is one of the three leading African sources of foreign-born doctors and general medical professionals. This is unacceptable and doesn’t tell well of the country.
The exodus has led to a drastic drop in the quality of health care services following the absence of skilled personnel. It is scandalous that despite the severe nature of this provocation and how it has badly affected the health sector, the Nigerian government is unable to reverse the trend, largely for lack of concern. Curiously, Nigeria was the only African country listed among the 20 top exporters of doctors in 2004, with a loss of 5, 499 doctors up from 1, 519 in 1991.
Clearly, at this rate, health indicators may keep declining in the absence of aggressive interventions to stop the trend. More doctors leaving the country will eventually lead to a depletion of Nigerian medical doctors. This, in turn, will add to the stress and dissatisfaction among those remaining. The poor will not be able to access health care while the rich will travel out of the country for medical attention.
A reason doctors and other health professionals leave for greener pastures is impoverished pay. Apart from abysmally low pay packages, the actual payment of salaries is often irregular. An equally major driver is miserable working conditions. This includes having to work extra hours due to inadequate staff, lack of diagnostic facilities and sometimes the need to support monthly incomes.
These problems emanate from the government’s low funding of the sector. Surprisingly, in the 2020 budget of N10.33 trillion, the health sector received only 4.14 per cent, that is, N427.03 billion out of the total budget. This is much lower than the estimated 13.5% of South Africa’s national expenditure dedicated to health. The lack of funding has brought about insufficient remuneration, the dearth of medical facilities and inadequate infrastructure in the sector.
To reverse the brain drain, the Nigerian government should rejig the entire health care system in the country. The introduction of a workable national health policy is imperative at this time. A renewed health care system will certainly create the required environment for medical practitioners to function. This includes the provision of basic equipment and infrastructure.
We support the call by the House for a review of our health workers’ pay. It is also our opinion that they be given a special salary scale. There is a need for an extension of their retirement age since at 60, when they are expected to disengage from service, many are often still fit and active. If judges, lecturers and of recent teachers could be granted such consideration, health practitioners who perform the all-important duty of saving lives must not be denied similar largesse.
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INEC’s Threat Alert Deserves Urgent Attention
The Independent National Electoral Commission’s (INEC) disclosure of an alleged plot to target its ad hoc personnel ahead of the 2027 general elections demand urgent national attention. The reported arrest of suspects, with intelligence support from the Department of State Services (DSS), is encouraging, but must not breed complacency. Any attack on electoral workers threatens not only human lives but also Nigerians’ constitutional right to choose their leaders through credible elections. The alleged conspiracy must be thoroughly investigated, its sponsors identified and all those found culpable prosecuted.
Particularly troubling is the reported targeting of National Youth Service Corps (NYSC) members, who play a vital role in Nigeria’s electoral process. Many serve far from home and undertake sensitive assignments at polling units and other electoral locations. As civilians, they should not be exposed to intimidation, abduction or violence without adequate protection. If election workers are vulnerable, the safety of other officials, observers and voters cannot be guaranteed.
Nigeria’s electoral history offers painful lessons. Human Rights Watch reported in Nigeria’s Post-Election Violence, published in May 2011, that more than 800 people died in the violence following the 2011 general elections. NYSC members serving as electoral officials were among the victims. This tragedy underscores the deadly consequences of political tension, incitement and disputed outcomes. Nigeria must act on the latest warning before another preventable disaster occurs.
INEC deserves recognition for uncovering the alleged plot, while the DSS and other security agencies merit commendation for their reported assistance. However, arrests are only the beginning. Investigators must establish the suspects’ identities, motives, networks and intended targets, ensuring that evidence is admissible in court. The process must remain impartial and free from political interference. Credible public updates are also necessary, provided they do not compromise investigations or operational security.
The authorities must adopt a comprehensive, intelligence-led security strategy for 2027. INEC’s proposed security conference should produce practical measures developed in collaboration with the Inter-Agency Consultative Committee on Election Security (ICCES), the police, the DSS and other relevant agencies. Threat assessments should guide personnel deployment, secure transportation, emergency communications, evacuation procedures and rapid response. Protection must extend beyond polling day to the distribution of sensitive materials, collation centres and the safe return of ad hoc personnel.
Those who provide intelligence must also be protected from retaliation. Confidential reporting channels and appropriate safeguards should be established for informants and others assisting investigations. Equally, security deployments must not intimidate voters or facilitate political repression. Personnel should act professionally, impartially and proportionately, within the law. Clear mechanisms for reporting misconduct and investigating abuses are essential to maintaining public confidence.
The threat also highlights broader concerns about trust in the electoral system. The European Union Election Observation Mission’s June 2023 final report identified shortcomings in transparency and operational implementation during Nigeria’s 2023 general elections, alongside concerns about the legal framework and electoral dispute resolution. Credible elections require more than security; they depend on transparent procedures, accountable officials and consistent enforcement of electoral laws. INEC must demonstrate measurable progress in addressing previously identified weaknesses.
Voter apathy presents another challenge. INEC’s published figures indicate that approximately 25 million people voted in the 2023 presidential election, out of about 93.5 million registered voters, a turnout of roughly 26.7 per cent. Although insecurity is not the sole cause of low participation, threats against electoral personnel can heighten public anxiety and discourage voters from exercising their franchise. INEC should strengthen civic education, improve polling accessibility and communicate procedures clearly. Political parties, civil society and the media must promote peaceful participation and reject electoral intimidation.
Misinformation and manipulated digital content pose additional risks. False reports, fabricated announcements and deepfake videos can inflame tensions, impersonate officials and mislead voters. INEC should establish a well-resourced, rapid-response communication system supported by verified digital channels and timely public statements. Collaboration with credible media organisations and fact-checkers would help counter falsehoods without suppressing legitimate criticism. Clear, consistent communication is indispensable, as administrative confusion and delayed explanations often allow rumours to spread.
Electoral integrity must also begin within INEC itself. The chairman’s warning against partisanship, negligence, extortion and ethical misconduct deserves serious attention. Security measures cannot compensate for officials who abuse their positions or disregard established procedures. INEC should strengthen staff training, ensure transparent recruitment and deployment, provide secure channels for reporting misconduct and enforce disciplinary rules consistently. Allegations of bribery and political interference must be investigated regardless of rank, while ad hoc personnel should receive adequate briefing, support and prompt payment.
The legal framework also requires clarity and consistent enforcement. INEC should explain the precise provisions and applicability of Section 26 of the Electoral Act 2026, including the obligations of electoral officials and security personnel, and publish authoritative guidance on neutrality and professional conduct. Complaints by opposition parties that they have been prevented from campaigning in certain states must likewise be investigated impartially. Any established violations should attract appropriate corrective action. Electoral fairness requires not only impartial polling officials but also lawful campaigning, access to competing viewpoints and freedom from intimidation.
The alleged plot against INEC’s ad hoc personnel is a warning against complacency ahead of the 2027 general election. Governments, security agencies, INEC, political parties and civil society must work together to prevent violence, punish misconduct and protect citizens’ participation. The commission should communicate its security priorities, maintain accessible threat-reporting channels and provide periodic updates on preparedness. Nigeria’s democracy cannot be safeguarded by assurances alone; it requires demonstrable preparation, impartial law enforcement and an unwavering commitment to free, fair and credible elections.
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