Nigerian healthcare workers have expressed doubts on the Federal Government’s newly introduced incentive policy aimed at curbing the growing trend of professionals leaving the country, commonly referred to as ‘Japa.’
The ‘National policy on health workforce migration’ introduced last month and promises incentives for improved working environments seems to have done little to boost the confidence or assuage the concerns of healthcare workers who expressed their doubts around the implementation and effectiveness of the plan in addressing the underlying issues that spur them to leave the country.
Dele Abdullahi, president of the National Association of Resident Doctors said in an interview with BusinessDay said the plan does not adequately address their concerns, adding that health professionals are unconvinced about the government’s commitment to their welfare.
“We are not confident in the policy or government’s commitment to improving our welfare. Many doctors are still eager to leave the country.”, Abdullahi said.
The President stated that underlying issues driving doctors’ exodus were not adequately addressed, stressing that it is not just about remuneration—but there needs to be substantial investment in healthcare infrastructure to further improve the working environment which according to him is “toxic”.
Abdullahi emphasized that while welfare improvements important, providing modern equipment, and ensuring the overall development of healthcare facilities are key.
“The policy cannot stem japa, most healthcare facilities do not have the facility for doctors to work with. This administration is over one year now, even the demands they met on ground, they are yet to make any major inroads into it”, he said.
He also mentioned that the persisting economic challenges in the country, including inflation and rising costs of living, which drive Nigerian health workers towards migration remains a concern and a driving factor.
He questioned how many doctors who have left the country would be willing to return to such an environment, calling the policy a “political statement” rather than a practical solution.
He noted that doctors still have a long list of unmet demands and is unsure about government commitment to implementing the policy. He said the migration of healthcare governments will persistent unless the government shows significant commitment by matching words with action soon enough.
He also expressed disappointment that even the N70,000 minimum wage committee recently formed by the government does not have a single doctor as a member, even though doctors have a special salary structure known as Consolidated Medical Salary Structure (CONMESS).
“We still have a long list of demands that wr are clamoring for. It’s not about renumeration, but creating an environment for doctors to thrive, the environment is toxic, and the current economic reality is not favorable.”
He also criticized the broad nature of the policy, arguing that it lacks specific, actionable steps.
The policy which aims to strategically address the fundamental problems of the shortage of skilled healthcare professionals in Nigeria, particularly in rural and underserved areas, focuses on incentives such as mortgage facilities, periodic review of healthcare workers’ salaries, benefits, pensions, and allowances.
The policy also focuses on Health Workers Safety; Capacity Development; Strengthening Health Workforce Education and Training; Health Diplomacy, Ethical Recruitment, and Equality; Research, Innovation, and Strategy.
According to the policy, Nigeria suffers from severe shortages of health workers, stemming from long-lasting issues on the production of skilled professionals and on the difficulty to deal existing professionals in rural and underserved area Nigeria has 0.363 medical doctors per 1,000 people, far below the World Health Organization threshold of 4.45 healthcare workers per 1000 people for adequate health coverage. The country was the highest workforce-exporting country in Africa, with the UK, US, Canada, Australia, and Saudi Arabia as key destinations between 2021 and 2022.
Sandra Obi, a medical graduate from the University of Abuja said she would jump at any opportunity to leave the country for better working conditions.
Though she commnded the move which said was long overdue, and expressed skepticisShescommendedntation. She is worried that the implementation may drag further due to systemic challenges that generally face implementation of policies including finance, and the lack of continuity in governance according to her.
“Doctors have been clamoring for better salaries and working conditions for years. Now that many are leaving, the government is only starting to understand the consequences. But will putting it on paper make any difference?” she questioned.
Samuel Ode, an Abuja-based medical doctor applauded federal government for the initiative of unveiling the policy, but expressed concern over the implementation. He said state governments, in particular, might struggle to domesticate and enforce the policy, while also noting that governments at all levels have not done well in implementing good policies.
“We have many doctors at the state level, so it’s not just a federal level. Look at the minimum wage law for instance, how many states are complying? They always complain they don’t have money. So what is the assurance that will commit to the welfare of medical Profesional?” He queried.
Aisha Aliyu, a nurse at the Federal Medical Centre, Keffi said she is not convinced by the policy and is still searching for opportunities.
“They have been saying this for long and nothing is happening. We are not paid what we ought to be paid. Our salary is not enough, yet the government is stopping us from going abroad. Our salaries cannot do anything, especially with the hike in transportation and cost of living. We have not seen anything on the new minimum wage.
In the hospital where I work, so many nurses are eager to go, those abroad are 100% more better than us here, they have the equipment to work with If I see the opportunity, I will leave without hesitating”, she said.
The exodus of Nigerian healthcare workers was further highlighted when the Nursing and Midwifery Council of Nigeria (NMCN) reopened its verification portal, allowing nurses and midwives to process their licenses for international migration.
This move sparked jubilation on social media, with many healthcare professionals expressing eagerness to pursue opportunities abroad.
Data from the Federal Ministry of Health shows that there was a huge jump in the number of Nurses requesting verification to migrate
from NMCN, with 52% of nurses and midwives who needed a letter of good standing to move chose the United Kingdom as their new home, while 36% chose the United States of America.
The council in February deactivated the verification portal leaving several Nigerian nurses and midwives working abroad frustrated, especially those whose licence expired.
But nurses are excited about the reopening of the verification portal though they are not happy with some conditions attached including two years post-graduation and required letter of good standing. They said this may affect on their abroad dreams.
“I think we’re still stuck in the previous issue. How will these hospitals allow you to start the process of leaving them “, Abdulyasari Faruq wrote on X.
“Dear Nurses, now that the verification portal is open, please don’t forget to resign at your former place of Work before you leave the country so they can employ those left in the country.
The change begins with us”, @Ruth iyanda wrote on X. Meanwhile, Faruk Abubakar, Registrar of NMCN, speaking with BusinessDay acknowledged that the success of the national policy hinges on political will.
He said the council is also making efforts to increase the number of qualified nurses in the country. He informed that the council has so far registered 29,000 in 2024 and projects to register 40,000 nurses by the end of the year.
