The world is experiencing a shortage in the stock of nursing workforce estimated at 5.9 million nurses, largely because of the ageing population of nurses globally. The number of new nurses is not measuring up.
But for Nigeria and some low- and lower middle-income countries which account for the largest shortages, poor income level is mainly responsible for the shortage.
Nigeria falls among countries shouldering 89 percent of the world’s shortages because of poor welfare provision, according to the ‘State of the World’s Nursing Report 2020’ by the World Health Organisation (WHO).
In 2016, the WHO Global Strategy on Human Resources for Health estimated that by 2030 there would be a global shortage of 7.6 million nurses and midwives in countries with a density below a benchmark of 4.45 physicians, nurses and midwives per 1,000 population – a threshold value that excluded most high-income countries.
Nigeria faces an estimated shortage range of 500,000 to 600,000 by 2030, with current density of 5.6 nursing personnel per 10,000 population, a 3.8 percent of gross domestic product (GDP) health expenditure and a $74 health expenditure per capita. The consequences of declining number of nurses would be too telling on Nigeria should the current coronavirus pandemic, which has entered community transmission level, spread further in rural communities.
As of 2019, Nigeria had over 110,000 nurses, depleting the stock from its 200,000 level in 2016.
Although the nursing profession retains the largest share within the health workforce, the country risks an excessive loss to countries which are over-reliant on migrant nurses, if it fails to make additional investment in multiplying and retention.
Johnson Akomolafe, secretary, National Association of Nigerian Nurses and Midwives (NANNM), Lagos University Teaching Hospital (LUTH), earlier told BusinessDay that the productivity of healthcare providers was often compromised by working conditions that lack tools smart enough to enhance efficiency, overburden them with tasks and expose them to different health risk.
The hazard allowance for Nigerian doctors dangles around a staggering N5,000 monthly, $12, an amount about three times less than the allowance of professionals in non-clinical sectors.
Osagie Ehanire, minister of health, on Thursday said he was unaware if medical doctors and other health workers managing the coronavirus disease 2019 (COVID-19) patients in Nigeria were paid any hazard allowance, attracting heavy criticisms from many Nigerians and even resignation calls.
Poor welfare and other factors have occasioned a continued rise in voluntary resignation of nurses, who want to pursue better working conditions that help skills to flourish and appreciate hard work.
From 699 nurses handed over to Akomolafe’s administration in November 2018, 618 were left at the end of September 2019. The data does not cover for statutory retirements which, if included, speculations say overall number of nurses now available would be about 400. Meanwhile, the government is not proactive to renew this shrinking staff strength.
“If we fall sick presently in Nigeria, there is no provision for sickbay or medical help or financial assistance for you as a staff. You have to go through the normal process that people go through as outpatient. You will wait until it gets to your turn, whether you are on duty or not,” Akomolafe said.
According to WHO, countries affected by shortages will need to increase funding to educate and employ at least 5.9 million additional nurses, estimating that nursing education are in the range of US$ 10 per capita in low- and middle-income countries. Further investments would be required to employ nurses upon graduation.
“In most countries this can be achieved with domestic funds. Actions include review and management of national wage bills and, in some countries, lifting restrictions on the supply of nurses. Where domestic resources are constrained in the medium and long term, for example in low-income countries and conflict-affected or vulnerable contexts, mechanisms such as institutional fund-pooling arrangements should be considered,” the report says.
Development partners and international financing institutions can help by transferring human capital investments for education, employment, gender, health and skills development into national health workforce strategies for advancing primary healthcare and achieving universal health coverage. Investments in the nursing workforce can also help drive progress in job creation, gender equity and youth engagement.
Temitayo Ayetoto
