Challenging work environment, immigration of Nigeria’s health workers weaken sector

Health sector data on the availability, distribution and trends in human resource for the sector has been lacking. This has prevented effective planning. ANTHONIA OBOKOH writes on the urgent need to tackle data-related challenges with regards to health workers’ retention and movement, both locally and internationally.

Nigeria has one of the leading stocks of human resources for health in Africa. But this is failing to meet health its 190 million people. The burden of health worker remains heavy in many African countries.

Recently, Nigeria was identified as the leading African source of foreign born practising in other countries. Last year BusinessDay reported on how Nigeria’s best doctors are leaving the country even as medical schools deteriorate. Meanwhile, the number of Nigerian trained medical doctors working in the United Kingdom is about 5,340.

An average of 12 doctors who had their primary medical education in Nigeria are said to register for practice in the UK every week, and when Nigerian trained medical personnel in other places such as the US, Canada, and some oil rich gulf countries are added, the total number of Nigerian doctors practicing abroad could be in excess of 20,000.

These challenges have contributed to inequitable distribution of the existing health workforce with lower levels of care in rural areas, with the northern parts of the country particularly lacking. In addition to challenges related to internal human resources for health mobility and inequities.

The unfriendly work environment has implied health workers in Nigeria continually find every possible way to exit the country, leaving behind a health system which many in the mildest of descriptions, say is simply not working; not for the patients and not for the medical practitioners.

However, some factors responsible for this development in Nigeria include inadequate infrastructure, poor human resources planning and management practices and structures; unsatisfactory working conditions characterised by heavy workloads.

Other factors are lack of professional autonomy, poor supervision and support, long working hours, unsafe workplaces, inadequate career structures poor working conditions and poor compensation packages have contributed to the emigration from the country of a sizeable number of surgeons, physicians, nurses and other medical professionals.

Development experts have long recognised health as an important moral and social goal. Health is also a key component of a sound development strategy, along with education, economic growth and good governance. As a form of human capital, health is essential to a productive society.

The sustained trend in “brain drain” from the health system in Nigeria has in particular contributed to acute shortages of specialised and experienced health professionals in the country. “Nigeria will never climb out of poverty unless its devastating health challenges are tackled,” experts say.

Doctors complain of “brain drain”, and take opportunities for professional increase in countries with better medical infrastructure. Yet, scores of Nigerian doctors presently overseas are willing to return to Nigeria, provided appropriate employment opportunities are available. Unfortunately, not only are such opportunities very scarce, there is growing unemployment among registered doctors in Nigeria.

Nigeria’s health indicators are very poor and are only slowly improving. The country has some of the world’s highest infant and maternal mortality rates—women have a 1 in 29 lifetime risk of dying in childbirth and only 38 percent of births are attended by skilled health workers.

Nigeria has a 3.2 percent adult HIV prevalence rate and HIV/AIDS is the second leading cause of death. Women have an average of 6 children and the contraception prevalence rate is 14 percent.

Industry experts informed BusinessDay that the country requires an additional 200,000 beds to meet the healthcare needs of the growing populations. A bed costs a minimum of N50, 000 and up N500, 000 depending on the special needs it is required. Using the lowest cost, Nigeria requires at least N10 billion to meet up the barest minimum in number of beds required for the country’s hospitals.