By Chioma Obinna
Precisely on 12th May 2022, Nigeria joined the rest of the world to mark the International Nurses Day themed: “Nurses: A Voice to Lead–Invest in Nursing and Respect Rights to Secure Global Health”.
The Day is set aside to celebrate nurses and midwives all over the world as well as highlight the important works they do to save lives and keep their communities safe.
Sadly, this year, the World Health Organisation, WHO raised the alarm over the acute shortage of nurses in Africa saying nine million nurses and midwives are needed globally to achieve the 17 Sustainable Development Goals, SDGs.
In a message, the WHO Regional Director, Africa, Dr Matshidiso Moeti said Nigeria has the highest share of the headcount of nurses at 21 per cent, followed by South Africa with about 18 per cent. She warned that if left unaddressed, the severe shortage of nurses may pose a significant thret to progress toward Universal Health Coverage.
Good Health Weekly spoke to the Chairman Association of General Private Nursing Practitioners, AGPNP, Mr Clement Olaifa, who stated that Nigerian nurses are leaving in droves as no attention is being paid to the profession amid poor remuneration.
State of nursing practice
Nigerian nurses have been operating within the available resources and in a very hostile environment but nursing practice in Nigeria is not yet at the level it is expected to be. We have been trying our best to provide adequate quality healthcare services to the patients in Nigeria.
Nurses in Nigeria are the most populated in the health sector. We are trained to provide services regarding primary healthcare services and within this context, we’ve been trying our best. We have been also at the secondary level.
But the basic truth about all these is that the negative aspects of the existence of nursing in Nigeria go beyond the positive aspect. If you want to look at the private sector, nurses are allowed to operate in nursing homes and maternity homes but they have not been able to explore the total scope of their training.
In order to provide quality healthcare for the masses in Nigeria.
Deprivation in practice
There is still some deprivation in lots of areas, having said that we have also been allowed by the Lagos state ministry of health to do the little we can within the scope of our training but in Nigeria as a whole most of the time, in the public sector, the remuneration is still very poor.
Nursing is one of the most well-paid professionals in the health sector in the western world. However, it is still nothing to write home about in Nigeria. You can see a lot of brain drain now in Nigeria, job acquisition is on the high side.
Nigerian nurses are no more training to serve the people of the country because remuneration compared to what is supposed to be is very low. It is very low. Nurses were being given N5000 allowance for hazard allowance.
Unfortunately, when COVID came, a lot of nurses died. A lot of infectious diseases have been attacking us and people have been dying because of services they provide for the clients because most of the infectious diseases come to Nigeria like Ebola the other time, and Nurses were part of the victims.
The unfortunate thing is that the government has never done anything categorically to remember these nurses. Though our sisters in the medical profession sometimes will be shouting and they will answer them. If you want to weigh it, you will see that the attention to the nursing profession in Nigeria is not very good.
Like I told you, in terms of remuneration, it is poor, in terms of protection, it is poor. A lot of nurses have been kidnapped in the northern part of the country. Nothing has been done. It was friends and professionals colleagues who were contributing money to pay for their ransom and the government is not doing anything about them. These are some of the challenges the nurses are facing.
Nurses are now leaving in their droves. It is sad that Nigeria is training nurses for other countries. If you see nurses who are training in Nigeria presently, 80 to 90 per cent of them will tell you they are not training to serve the country and Nigeria’s maternal and mortality rate will still be on the high side. If you ask any nurse currently in training now, they’ll tell you they are training to work outside the country.
And the maternal mortality rate still continues to be on the high side of the country. The issue at hand now is the number of nurses to manage patients at the bedside is still not adequate. The number of nurses to manage a patient is still very poor and inadequate. You can see a nurse managing almost 20 patients in a hospital in Nigeria. It is expected that at least 1 to 6 patients.
“By WHO recommendation, it should be between 6 and 8 if I am not mistaken. Sometimes in Nigeria, a nurse will be handling multiple duties even the ones outside the scope of training. In some hospitals, you will see 1 to about 30 patients and you will now say a nurse is hostile? Sometimes they act as security personnel and persons to direct and admin person. In the western regions, all these are analysed.
Nigerian nurses are not allowed to practice in accordance with their training curriculum; they are still not allowed to practice to their very best and the quacks have overthrown all the communities, nurses are not available, and everybody has travelled.
I gathered some young nurses and trained them in 2019 at LUTH in Lagos here, and now I don’t think up to 80-70 per cent of those people are still in Nigeria. I met one of them; she told me that 70 per cent of them have left. Nigeria is now training nurses for other countries.
He said: “We need a better remuneration than what we have now. Outside allowances that you pay them, you must remunerate them. Nurses in the private sector need to bring more into the capacity for better provision of healthcare services to our people.
In Ethiopia, in Namibia, 2009 they saw that the rate of maternal mortality was about 500 per 100,000 deliveries, they were able to cut it by 50 per cent.
In Nigeria, it is still around 510 per 100,000 deliveries.
“We have been maintaining that for years and have not improved. In Ethiopia they look at the nurses and the Ethiopian government said in 2009; that there are not enough doctors in their country.
They gathered some nurses because they have the basic knowledge about the structure and the functions of the body they gathered them, retrained them and rebuilt their capacity and they were made to be performing Caesarean sections, CS. And at the end of the training between 2009 and 2015, they were made to be doing uncomplicated direct caesarian sections because they found out that the people in those countries are not having access to quality medical care.
And in the case of delivery, a lot of mothers have died as a result of little complications that could have been managed through surgical intervention. By 2015, they declared that their maternal mortality rate has reduced by 50 per cent. Nigeria has been battling with a high mortality rate for close to two decades.