Nigeria has a long history of doctors’ migration that may delay the country’s effort at achieving health-related Sustainable Development Goals (SDGs).
This has been largely due to Africa most populous nation’s inability to organise and fund its health system in order to enable access to better healthcare, reduce brain drain and expand the Universal Health Coverage for Nigerians
Evidence-based reports show that Nigerian doctors migrate to the United Kingdom, America, Dubai South Africa, Saudi Arabia to render services that could have enhanced the healthcare system and the healthcare workforce.
Stakeholders are of the opinion that the current situation suggests that long-term solutions to shortages can only be found in addressing the problem from eliminating shortages through substantial investments in the sector, training and retaining Nigerian health workers in Diaspora, and not through policies that do not work towards solving this underlying problem, such as the ones that restrict migration.
“It would be great to fix the healthcare in Nigeria first make it attractive to reduce brain drain and doctor/nurses emigration to the US and Europe. These countries also have huge shortages of workers. At this time, we need a campaign to bring back our Nigerian diaspora doctors to Nigeria,” said Runcie Chidebe, executive director, Project PINK BLUE, Commonwealth Scholar, Transforming and Leading in Health Care, Birmingham City University.
Chidebe said that currently, Nigeria’s healthcare is not in the hands of Nigeria nor Nigerians; it is in the hands of donors. Importing workers can never be sustainable if you do not have a sustainable healthcare system.
The shortage of health workers afflicts many states in the country, even though findings by the Nigerian Polling organisation (NOIPolls) has shown that Nigeria needs 303, 000 doctors to meet the World Health Organisation’s (WHO) standard of doctor to patient ratio.
As of 2017 the country had 72,000 doctors registered with the medical and dental council of Nigerian, out of the 72,000, only about 35,000 are in Nigeria. This implies that this puts at risk rural patients who suffer because of an urban to rural doctor density ratio and Nigeria’s poor doctor-population ratio of 1:6000 as compared with the World Health Organisation standards of 1:1000.
However, this directly impacts the access and service delivery to citizens and by extension Nigeria’s economic growth and also halting the country’s ability to meet its health goals which is dependent largely on the knowledge, skills, motivation and deployment of the health workforce responsible for organising and delivering health services.
“Medical schools are confronted with a lot of challenges, mostly due to inadequate funding, whereas even the little which is available is not properly spent,” explained Francis Faduyile, president, Nigerian Medical Association, in an interview.
Faduyile also confirmed that when many of the specialists conclude their training, it is easier for them to sit for one or two foreign qualifying exams, and then leave the country for foreign destinations where he says “they do very well”.
Whereas, the same people, if they stayed back in Nigeria, could “roam the streets for up to five years looking for internship placement, if they chose to stay in the country.”
“These are challenges faced in terms of capacity to produce the right quality of medical personnel,” Faduyile said.
Similarly, analysts say a good economic condition will make most professionals return or stay back in the country.
X-raying the health workforce imbalance across the four tiers – imbalances in occupation/speciality, geographical representation, institutions and services, and demographics-BusinessDay can say that as the impact of these different types of imbalances on the health system varies, the need to monitor and assess each of these dimensions of workforce distribution in the country is exigent given the correlation between the size of the workforce and its implication for health-care coverage across the country.
Another important indicator is the number of graduates each year in the health professions per 100 000 population – by level and field of education. Data check to obtain the number of health professionals from the Nigerian University Commission was unsuccessful.
The number and type of newly trained health workers are relevant given the need to increase production among all cadres, including the need for more workers in rural and underserved areas.
Strengthening the performance of health systems depends on more than just increasing the numbers of health workers; actions for assessing and strengthening their recruitment, distribution, retention and productivity are also important.
These actions may include: adopting new approaches to pre-service and in-service training; strengthening workforce management; establishing or improving incentives for addressing distribution and retention challenges; or task-shifting (delegating tasks, where appropriate, to less specialised health workers).
Such strategic plans would normally include targets for monitoring health workforce metrics in both the short and the long-term and adaptation to any major health sector reforms (for example, decentralisation).
ANTHONIA OBOKOH
