The effect of mass migration of healthcare workers is biting harder and nudging towards an emergency situation even as top private hospitals that have pooled huge investment into operations struggle to retain skilled staff, according to BusinessDay finding.
Hospitals continue to face rejections despite offerings of a work setting that matches global standards, a pay level that doubles local average, or is at par with some foreign offers.
Vast and short experienced health workers are constantly migrating out of Nigeria even if it means little or no raise in their income. Hospitals are left to run with a constant cycle of fresh graduates who are often looking to enrich their credentials with the experience before leaving.
A center manager at one of the private hospitals championing the reversal of medical tourism in Lagos informs BusinessDay that the management is considering bringing in equally skilled expatriates as a means to protect service delivery.
Her hospital, for instance, lost close to 30 skilled workers between December and January, all leaving for destinations such as the UK, Canada, and the US, among others.
Those who are yet to leave are actively processing their way out, taking different examinations.
“Unfortunately, in the hospital now, we are losing very skilled people and those that are available are applying to leave. I have a consultant close to 50 who earns up to N2 million monthly. He’s leaving also and I can’t stop him. He wants a better life for his family. A lady in patient service left for the US last week. It’s so bad,” she says, asking not to be mentioned.
The drought of health professionals is also hitting hard at another big private hospital with multi-specialties in one of Lagos major highbrow setups. BusinessDay understands that if the desertion continues at the current pace, the hospital’s prospects of delivering world-class services could be dampened too early. It could even land in a double whammy where it struggles to keep both professionals and high-end patients from going abroad.
“Those you see applying for the jobs we have now are fresh out of school, and those that want to work in the health sector for one or two months to enrich their CV because it is very hard for them to get employed without work experience. We are at that point where it is either we pay our local people more money or we start importing Indians, as they are the closest to our economy,” the center manager states.
According to the World Health Organisation (WHO), Nigeria has a ratio of 16.1 nurses to 10,000 people and one doctor to 5,000 patients, rather than one to 600.
The trend shows top private hospitals are no longer protected from the skill drought that has been challenging many government-run facilities for decades. The Federal Government had on several occasions acknowledged the shortage of healthcare experts without substantial actions to tackle the crisis. Rather, health workers are owed several months of salary and due allowances unpaid.
A real tsunami
Despite that shortage and a ban on recruitment, 1,334 Nigerian trained nurses joined the UK workforce between March and September 2021, marking an all-time high, the Nursing and Midwifery Council (NMC) of the United Kingdom data indicate.
Population growth-based projections on Nigeria from 2016 to 2030 suggest that there would be a shortage of up to 140,000 nurses and midwives in 2030, compared to 2016.
The International Council of Nurses (ICN) on Monday said about 13 million nurses would be required over the next 10 years to fix the worsening nursing shortage from mass poaching from countries, including Nigeria.
The body, representing over 27 million nurses worldwide, says it anticipates a migration tsunami as wealthier countries find a quick fix to the pandemic fallout by pooling qualified hands out of poorer countries, deepening inequalities in access to healthcare further.
Attractive remuneration packages, advanced working conditions, and immigration policies targeted at easing healthcare workers’ emigration have effects as baits and major drivers of brain drain in lower-middle-income countries, the ICN report shows.
Read also: Emigration: The old-new rage
Such a scale of nurses’ exodus in emigrating countries such as Nigeria has seen the nursing workforce grow leaner.
The report notes that global inequalities in the availability of nursing personnel are largely income-driven, with a density of 9.1 nurses per 10,000 population in low-income countries compared with 107.7 per 10,000 population in high-income economies, a tenfold variation in nurse availability.
Nigeria falls among the countries accounting for the largest shortages, and population growth is expected to further push up demand for nurses, irrespective of the current workforce profile.
More than 550,000 foreign-trained nurses were working across 36 OECD member countries in 2019, which was a marked increase on the 460,000 recorded in 2011, according to an OECD analysis.
The share of foreign-trained nurses has increased particularly in Belgium, France, Germany, and Switzerland, with a steady growth also occurring in Australia, New Zealand, Canada and the US.
The US reports the highest number of registered international nurses, estimated at almost 197,000; the second was the UK with over 100,000 foreign-trained nurses, then Germany with 71,000, and Australia with 53,000.
Howard Catton, CEO, ICN, who co-authored the report, says the findings underlined the severity of the shortages.
While the situation was known hitherto as a persistent historical underfunding of nursing around the world, the latest information about nurse vacancies, their rates of intention to leave, and staff sickness rates is a compelling reason to now recognise the issue as a global crisis.
“We already had a shortage of 6 million nurses at the start of the pandemic, but with the immense and relentless pressure of responding to COVID and the Omicron variant, and an avalanche of resignations and retirements anticipated, the world will need to recruit and retain up to 13 million nurses over the next decade,” Catton states.
Action agenda
The report says a long-term plan is needed to stem the tide of those leaving nursing because of the additional stresses resulting from COVID-19 and to create a new generation of nurses to grow the profession to meet the increased future demands of an aging global population.
The ICN is calling for urgent coordination of policies both at national and international levels to mitigate the effects of these shortages.
At the country level, it suggests that policy priorities are focused on ensuring adequate domestic training capacity and improving the retention of domestically trained nurses.
There also has to be increased commitment to supporting early access to full vaccination programmes for all nurses as well as all other interventions to improve sustainability risk that could be undermined without it.
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