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Nigeria’s Healthcare System Struggles Amidst Dearth Of Doctors

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The nation’s health sector continues to struggle in the face of  scarcity of doctors  and utter neglect by relevant stakeholders, ODIRI UCHENUNU-IBEH writes.

All over the world, there is a strong correlation between health and economic growth. Most developed economies, from findings, have vibrant health sectors, with that sector contributing, in huge term, to their  respective countries’ Gross Domestic Product(GDP).

When the economy of a country improves, there will be more people able to conduct effective activities in the workforce.

While this is undoubtedly true, recent report from the World Bank revealed that 50 per cent of the economic growth differentials between developing and developed nations are attributed to poor health and low life expectancy.

According to critical observers in the health sector, the main reason for poor health is due to inadequate Human Resources.

For instance, the healthcare system in Nigeria, has, over the years, been faced with many challenges of which majority could be solved if there are adequate human capital at various public hospitals.

Investigation by LEADERSHIP revealed that Nigeria has about 72,000 medical doctors registered with the Medical and Dental Council of Nigeria (MDCN), with only approximately 35,000 practicing in Nigeria and recent survey shows 9 in 10 of these are looking to leave the country for greener pastures therefore compounding brain drain.

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In an exclusive interview with LEADERSHIP, a Consultant Obstetrician and Gynaecologist with Ahmadu Bello University Teaching Hospital, Zaria, Dr. Solomon Avidime, said, going by the country’s population of about 200 million, Nigeria  would need about 303,333 medical doctors now, and at least 10,605 new doctors annually to join the workforce.

Avidime noted that an estimated 2,000 to 3,000 medical doctors are produced from across the medical colleges through out Nigeria annually, and taking it from a period of five years, this amounts to about 10,000 to 15, 000 doctors that have been produced. ‘Whereas, the total number of doctors working in the country average 35,000 to 45,000,’ he added.

Stating that the World Health Organisation’s (WHO) recommendation is 1:600 doctors to community population, but that  in Nigeria, what is currently obtainable is a ratio of 1:4000, he added that, as at December 2017, from the MDCN register, a total of 7500 doctors are currently working in Lagos State, stressing that, the community population ratio of Lagos, which has the highest number of doctors, is about 1:3000.

The reason why the country has fewer doctors working currently, according to him, is as a result of the continuous migration of medical doctors to other countries for greener pastures.

Asked why doctors are leaving the country en masse, Avidime said, doctors are leaving in search of greener pastures and to work in an environment that provides an up to date technology, efficient health care system and of course better welfare.

“An estimated 2,000 doctors migrate annually from Nigeria to United Kingdom, Saudi Arabia, among others, and it is rather unfortunate that Nigeria will use her resources to train medical doctors that will now go and add value and improve the doctors population ratio of another country,” he pointed out.

Moreover, the President, Association of Resident Doctors at the Lagos State University Teaching Hospital (ARD-LASUTH), Dr. Balogun Fatai, said the hospital has one resident doctor serving as much as four consultants.

Fatai said this has led to frequent strikes by the association because doctors are chronically overworked and falling ill frequently.

According to Fatai, “It is pertinent to emphasize that resident doctors are the backbone of the workforce of any teaching hospital. As the name implies, they are supposed to be resident in the hospital and work 24 hours to ensure adequate care of patients.”

According to current national recommendation, he said, every consultant is to work with a minimum of six residents, noting that, the  reality on ground in LASUTH is really alarmingly disheartening, as the standard  for the hospital is 840 and  we have less than 200.

The issue, he stressed, bothers on perennial shortage of doctors which often results in unnecessary long waiting period and inefficient sub-optimal health service delivery. This perennial shortage, he pointed out, has gotten to its extreme due to non-replacement of exited resident doctors, house officers and irregular employment of resident doctors and house officers.

“The implication of this is having one resident serving as much as four consultants in some units. Our members have had to be on call everyday over several months, working. We now slump on ward rounds regularly,” he stressed.

The Immediate Past President, ARD-LASUTH, Dr. Ajibola Salami, said for the past two administrations, the association had been advocating for replacement of exited doctors, who had left the country for greener pastures or gotten  better offers in reputable hospitals.

Salami said: “Doctors have been overworked at LASUTH because there is shortage of manpower. Imagine only one doctor currently working at the chest unit of the hospital. He has nobody to replace him. One of our members collapsed while on duty, because he had worked for two straight weeks, with nobody to replace him. All we are pleading for, is for the management of LASUTH and the state government to employ new resident doctors and house officers.”

The Way Forward

Dr. Solomon Avidime, while speaking on the way forward, charged the federal government to make the health system work, by providing better welfare package for medical practitioners and improve medical training institution to meet international standard in terms of infrastructure and capacity building.

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