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.