doctors

says 4,528 doctors left for UK alone between 2015 and 2021

By Gabriel Ewepu

ABUJA-WITH less attention given to health care delivery services in the country over the years, a medical expert and Head, Healthcare Quality Improvement, Nisa Premier Hospitals, Abuja, Dr Victor Ede, yesterday, lamented and disclosed exodus of 33, 000 registered doctors amidst outbreak of the novel Coronavirus, COVID-19, pandemic in 2021.

Ede made this known while speaking on the sheer neglect of health professionals and their migration, which he described as brain drain.

He said the effect of brain drain in the nation’s health sector has negatively impacted quality health care delivery to Nigerians as a result of inadequate medical doctors and other health care professionals currently in the country.

According to him, the Medical and Dental Council of Nigeria, MDCN, says there are 74,543 registered doctors in Nigeria for the country’s population of about 200 million. This puts the doctor-patient ratio in the country at 1:3,500 as opposed to the recommended WHO standard ratio of one doctor to 600 patients.  

He also added that studies reckon that over 70 per cent of Africa’s healthcare practitioners are lost to migration where they currently make up one-fifth of physicians in developed countries.

He said: “Due to the emigration of healthcare practitioners, Nigeria has experienced a massive brain drain as skilled healthcare workers are moving to other countries to obtain better wages, improved standard of living and the opportunity to improve their skill set.

“Amidst the COVID-19 pandemic in 2021, 33,000 of the 75,000 MDCN registered doctors had left the country, leaving   42,000 to man all health institutions in the country.

 “Brain drain is the movement of highly skilled workers from a developing country to a developed country. As a phenomenon, brain drain has drained Africa of healthcare practitioners, who make up three per cent of the global workforce in a continent that is burdened with 25 per cent of global diseases.

“The emergence of brain drain in Nigeria has hindered the development of the medical infrastructure to the standards of other comparable developing countries, and is depleting Nigeria of its healthcare talents that could help build the health sector.”

Unraveling major causes of mass exodus of medical doctors and other health care professionals in Nigeria, he (Ede) pointed poor healthcare and facilities, whereby Nigerians have lost confidence and trust on the nation’s health sector.

“This is evident in the actions of those traveling out of the country for medical attention, the Nigerian leadership inclusive. This is one of the reasons why people emigrate to developed countries.

“The Nigerian health system has suffered several setbacks. It is vastly under-resourced in terms of personnel and medical infrastructure. While this is a widespread problem, conditions in rural areas are often far worse compared to urban ones.

“Nigeria’s poor health system has resulted in penurious outcomes, prompting stakeholders to call for immediate government intervention. Yet, the government’s health expenditure is still significantly lower than the WHO recommendation of 15% of the annual budget.

“Over the decades, the migration of medical doctors from Nigeria has increased. The NOI Poll in 2018 revealed that 88% of doctors in Nigeria were seeking employment abroad.

“Furthermore, between 2015 and 2021, about 4,528 Nigerian-trained doctors migrated to the United Kingdom. Even with the pandemic and existing health burdens in Nigeria, doctor’s migration has increased. This worrying trend exacerbates an already deteriorating health system”, he stated.

He also mentioned the protracted and precarious insecurity situation as one of the major causes, because doctors and other health care professionals have been victims of robbery attacks, kidnappings, insurgency, assassinations, and other crimes; The Boko Haram/ISWAP attacks in the North East and other parts of the country, kidnapping, ritual killings, banditry/terrorism in the North West, IPOB activities in the South East and killing by Fulani herdsmen in Central Nigeria also accelerate brain drain in the country.

He also said his colleagues prefer leaving the country due to unfavorable working conditions for countries they have conducive working environment, and that over the years this issue of doctors working in a good environment to prevent brain drain has been thrown into the wind.

“If one works in a good environment with requisite infrastructures, a clean and healthy environment, maintenance of working equipment, health of the workers and conducive working hours life would be good.

“However, most companies in Nigeria have not adequately addressed issues with the health and comfort of their workers. Most people work in hazardous areas which in turn affect their health and productivity. Health care workers want to be valued and desire to work in safe and healthy environments”, he said.

He added that another major impediment in the health sector is corruption.

“The level of crime and corruption in Nigeria is still very high and appears to be getting worse. From the Judiciary to ministries, the military, the police, public and private health systems, and governments at all levels, corruption remains an infectious plague and prevalent problem.

“The phenomenon of knowing someone that knows another to get something done is currently the accepted practice and this has systematically eroded the merit-based approach to work or getting things done” he said.

According to him, education is the soul of a nation, the key to its secured future. The poor state of   education in Nigeria has been attributed over time to a number of factors including underfunding, low-quality teaching personnel, poor infrastructure, sub-optimal curriculum and absence of dedicated practitioners. 

“Many teachers are not qualified to teach at various levels while incessant strike in the universities  all also contribute to the current low standard of education in Nigeria compared to developed nations.

“Above all, the absence of constant electricity hinders science education and creates a chaotic learning environment. Parents now prefer to have their children school abroad where educational standards are high and education systems are stable. Oftentimes, most of these children do not return to Nigeria after their education”, he added.

On addressing brain drain in the Nigerian health sector, he recommended that, “The Nigerian government should create conducive environment that will ensure employment opportunities and reduce poverty.

“The government ought to provide the needed infrastructure such as good roads and transport systems, affordable and functional education, water supply, security, stable energy in addition to a good healthcare system.

“But these are not enough to prevent the brain drain among medical doctors and other professionals.

“Other strategies are providing financial and other incentives to stay including institutional capacity-building that promotes career development, along with mentorship opportunities.

“We recommend a better system that preserves the individual freedom of Nigerian doctors, while accounting for the costs of subsidized medical education in the country. To retain Nigerian doctors and avoid subsidizing healthcare, multiple measures could be taken.

“For example, medical students could be offered a choice of state-subsidized training or market-rate education. Doctors who opt for subsidies would be required to work in Nigeria for a pre-defined period of time, post-qualification or repay the subsidies.

“Therefore, to make the compulsory work scheme more attractive, it can be combined with another option, which is to guarantee doctors’ employment and inflation-adjusted living salaries for a few years post-graduation on the condition that they stay in Nigeria. Apart from providing better remuneration, their work environment and career prospects should also be improved.

He also added that, “Nigeria should negotiate fair compensation with destination countries that persistently rely on foreign-trained doctors.

“Nigeria has limited tools to retain more doctors and upgrade its health system. The Federal Government’s healthcare budget for 2021 was a fraction of what it has lost to the migration of doctors to other developed countries.

“Nevertheless, the health sector ought to strive towards a future where Nigerian doctors benefit from more funds for training, salary and technical exposure, as a result of strategic partnerships with countries that require our doctors.”

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