Beyond Brain Drain: Nigeria’s Healthcare Workforce Crisis

Grace Akan-FrancisMarch 11, 20244 Mins read287

On November 29, 2023, no fewer than five wards, comprising about 150 beds, were closed at the Lagos University Teaching Hospital, Idi-Araba, due to a shortage of health workers. Many health workers at LUTH, especially nurses and doctors, have departed from the once-reputable teaching hospital in search of better opportunities.

“The alarming rate of migration of health workers is fast becoming a national embarrassment.”

– Dr. Amos Magaji, the Chairman of the House of Representatives Committee on Health in Lagos State.

Recently, Nigeria has experienced a significant exodus of its medical professionals, leading to debates over whether this should be considered a brain drain or if there are potential advantages to consider. While this move provides these professionals with better incentives and improved structures, Nigerians who cannot afford costly private medical care suffer the consequences. The Nigerian Medical Association has warned that the country might lose more than 50 per cent of its skilled healthcare workforce by 2025 due to the mass migration of doctors and nurses.

Dr John Odedele, a medical doctor in Ibadan, Oyo State, said factors such as “the harsh economic conditions, escalating security challenges, poor remuneration, and inadequate top-notch diagnostic facilities, with doctors expected to work with primitive tools, have contributed immensely to the migration.”

The departure of experienced healthcare professionals has raised concerns about its impact on the nation’s healthcare system and its ability to provide adequate medical services to the populace. For Dr Ajayi, the pressure to relocate began one afternoon as he walked from the operating theatre to his office. After completing a 72-hour shift, he was exhausted. As he settled at his desk, his phone beeped with a bill of N250,000 from the mechanic who had repaired his car over the weekend.

“I looked at my account balance and realised all the stress I’m going through isn’t worth it, especially considering what my counterparts abroad are earning. I can’t even afford to pay my bills, yet I’m expected to work non-stop. I really can’t do it anymore.”

Like Dr Ajayi, many healthcare professionals’ migration decisions stemmed from long working hours and poor remuneration, among other factors.

“As long as these issues persist, medical practitioners will continue to leave in droves, and there’s nothing anyone can do about it,” said Dr Ajayi.

A Matter of Life and Death

With only about two weeks left in her one-year internship at the Lagos State Teaching Hospital, Odan, Dr Vwaere Diaso left her room on the 9th floor of the doctors’ residence to pick up food from a dispatch rider. Unbeknownst to her, this simple errand would end tragically. The elevator crashed as soon as she entered. Eyewitness reports stated she lay in the ruins of the crashed elevator while emergency rescue took an hour to arrive. She eventually died in the emergency room. According to reports, the elevator had been faulty for over three years, and despite numerous complaints and reports, no concrete action was taken to repair it.

A doctor residing in that building, identified only as Oluchi, wrote on X (formerly known as Twitter), “I can’t count how many times we didn’t have water or electricity in that useless HSC. We were even robbed several times. We complained about the elevator, but all they did was patch it up and tell us to be grateful we had quarters to stay in.”

For some health workers, leaving Nigeria has become a matter of life and death.

“Many times we have had to improvise due to the lack of resources, for instance, using a carton as an incubator or performing surgery by candlelight due to the country’s erratic power supply,”

– Matron at a primary health center in Bayelsa State.

In addition to the deplorable working conditions, the low salaries compared to what their international counterparts earn is another major issue for Nigerian health workers. In 2019, the Federal Government increased the minimum wage for workers, affecting all categories of workers under its payroll, including medical doctors. However, doctors’ salaries still pale compared to what is offered in many countries where Nigerian doctors migrate. Data from the National Salary, Income, and Wages Commission (NSIWC) showed that in 2019, an entry-level medical doctor received N1,812,600 ($5,911.94) per annum. This is less than 10 per cent of what doctors in some other countries earn.

The impact of this talent migration on Nigeria’s healthcare system and the quality of life for its citizens is significant.

In rural areas, the shortage of skilled personnel strains healthcare delivery, especially where the need is great. Patients may experience longer wait times, limited access to specialised care, and decreased service quality. “The departure of seasoned professionals not only reduces the capacity of the country’s health system to care for those in need but also undermines efforts to tackle public health issues like infectious diseases, maternal and child mortality, and non-communicable diseases, potentially leading to the imminent collapse of the healthcare system,” Dr Odedele explained.

Despite these challenges, some argue that the migration of health workers could also benefit Nigeria. Some medical practitioners replicate their professional exposure and experience by building facilities that can compete with those abroad. In contrast, others give back by establishing NGOs affiliated with international bodies.

“Nigerian medical professionals living abroad can act as conduits for sharing knowledge and fostering collaboration between Nigeria and other countries,” Dr Odedele said.

By leveraging international connections and collaborations, Nigeria can access important resources, knowledge, and technology to improve its healthcare system.

He added, “This exchange of ideas and best practices has the potential to inspire innovation, enhance healthcare systems, and promote global health cooperation.”

Ultimately, the departure of Nigerian health workers presents a complex situation with various challenges and potential benefits. While brain drain can negatively affect the country’s healthcare system and overall development, it may also offer opportunities for economic growth, international collaborations, knowledge sharing, and skill development.

However, the critical question remains: what happens when five hospital wards with 150 beds in a public hospital are shut down? Due to this exodus, what happens to Nigerians who cannot access timely medical interventions? Does the return of medical practitioners to the country after two or three decades abroad to build state-of-the-art medical facilities compensate for the immediate losses caused by the collapsing health system?

Read: Niger state govt renames airport after Tinubu, after bowing to him in circulating picture