The federal government has adopted a strategy to retain healthcare professionals by offering credit facilities and tax holidays to investors as part of a broader plan to enhance local medical practice, a policy document seen by BusinessDay shows.
Through its new national policy on health workforce migration, the government aims to create a supportive environment by enhancing infrastructural capacity and improving conditions of workers.
This initiative seeks to reduce health workers’ desire for opportunities abroad and encourage Nigerian professionals in the diaspora to return home.
To mitigate the negative impact of health workforce migration in the country, the policy employs a multi-pronged approach, utilising various tools, including incentives, security measures, capacity development initiatives, education and training programmes, health diplomacy efforts, research projects, governance leadership strategies, and robust monitoring and evaluation systems.
According to the policy document, a special incentive programme for all health workforce serving in rural and underserved areas will be developed by federal and state governments.
Federal and state health ministries, in collaboration with their finance counterparts, will create accessible special credit facilities and offer tax holidays to encourage health workers and other investors to establish functional private healthcare centres, the document says.
Government and relevant ministries, departments and agencies (MDAs) will create modalities for special mortgage facilities for healthcare workers to own houses, cars, and other essential assets.
Read also: Nigeria develops policy to reverse health workers’ exodus
The federal and state ministries of health, in collaboration with the offices of the head of the civil service as well as the National Salaries, Income and Wages Commission will ensure periodic review of healthcare workers’ salaries, benefits, pensions, and allowances.
Governments at both levels will also ensure the provision of adequate equipment and supplies that will make working conditions encouraging.
Muhammad Ali Pate, Nigeria’s minister of health and social welfare, said the policy strikes a balance between the need for professionals to seek where they can advance and improve themselves and the need of the health system to deliver quality services to Nigerians, during an interview on Channels TV on Tuesday.
“We don’t expect it to disappear overnight, but how can we as a government balance these two competing priorities? Half of 17,000 doctors trained in the last five years have left. This policy aims to retain them while making it easier for those who have gone to return and overtime for our health system to provide less push for them to leave despite the pull from the advanced countries that are using them as economic migrants to some extent,” Pate explained.
“How do you provide non-monetary incentives as well as monetary incentives to allow folks who are health workers serve in the rural areas more? Whether it is credit for cars, mortgage or other mechanisms that will make their lives comfortable we need to provide. We will also be dealing with the allowances and packages of service. This is something that we will work with the Service and Wages Commission and other relevant parties to see that there is improvement.”
The policy document further says that the capacity development of human resources for health will be approached on three levels: individual, organisational, and societal levels.
The idea is that strengthening local training institutions and providing opportunities for professional development and career advancement, in partnership with destination countries, can incentivise healthcare workers.
Chris Isokpunwu, director, Department of Health Planning, Research and Statistics, Federal Ministry of Health and Social Welfare, said the policy is a collaborative effort of health professionals, researchers, policymakers, and stakeholders who shared insights and expertise during consultations, workshops, and discussions.
What is at stake?
Healthcare workforce migration has worsened the shortage of healthcare professionals, leading to a number of negative consequences.
Patients experience longer wait times, reduced access to specialised care, and a decline in overall care quality due to overburdened staff.
Nigeria faces a ratio of 1.83 health workers per 1,000, according to the policy document.
Read also: Nigeria targets runaway health workers with system revamp, incentives in new policy
The World Health Organization recommends a health worker density of 4.45 per 1,000 population.
This shortfall has positioned the country as the largest exporter of healthcare professionals in Africa and among the 37 nations facing a critical shortage of healthcare workers.
Yet, its tide of migration appears to be waxing strong.
The year, 2022, was a record high for medical doctors’ emigration from Nigeria, with over 3,000 physicians requesting letters of good standing from the Medical and Dental Council of Nigeria (MDCN), the policy document shows.
The United Kingdom was the primary destination for 68 percent of Nigerian medical and dental professionals who migrated through the MDCN in 2022.
Other popular destinations included: Canada (10 percent), the United States (7 percent), the United Arab Emirates (five percent) Australia and Ireland (three percent each), Saudi Arabia, and the Maldives (one percent each).
These figures only account for healthcare professionals who notified the MDCN of their departure.
There was a significant increase in the number of nurses and midwives seeking verification to emigrate from the Nursing and Midwifery Council Of Nigeria (NMCN). Of those requiring letters of good standing, 52 percent chose the United Kingdom as their destination, while 36 percent selected the United States. The remaining 12 percent emigrated to other countries.
Year 2021 and 2022 alone accounted for 89 percent of the total migration of medical laboratory professionals through the Medical Laboratory Science Council of Nigeria (MLSCN).
Meanwhile, in 2022, Canada was the destination for 72 percent of Nigerian pharmacists who emigrated through the Professional Council of Nigeria (PCN). Notably, the overall number of pharmacists migrating through PCN during this period did not fluctuate significantly compared to other healthcare professionals.
In 2022, a significant surge in physiotherapists’ emigration was evident as 1,020 physiotherapists sought letters of good standing from the Medical Rehabilitation Therapists Board of Nigeria (MRTBN) to facilitate their departure.
This number surpasses the total number of physiotherapy emigrants processed by the MRTBN in the previous four years (2018-2021). Among the numerous countries requiring letters of good standing, the United Kingdom emerged as the primary destination for 91 percent of physiotherapists leaving Nigeria through the MRTBN.
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