Brain Drain Hits Health Sector

Chief Medical Directors (CMDs) of University Teaching Hospitals and Federal Medical Centres (FMCs) in Nigeria have warned that if nothing is done urgently, the nation’s hospitals will be empty of doctors in the next two years. This newspaper sent a similar warning in its September 17, 2022 editorial. We hope someone is listening.

Recently, the N a t i o n a l Association of G o v e r n m e n t General Medical and Dental Practitioners (NAGGMDP) said over 2,000 doctors had left Nigeria for Europe, Saudi Arabia, and Canada as of June this year. The president of the association, Dr. Noel Dokun, said this in Abuja during the National Executive Council meeting of the association.

He said the doctors left for countries where their services were better appreciated, especially Britain. Similarly, the Nigeria Association of Resident Doctors said that six out of 10 doctors in the country plan to leave for greener pastures. This is just as it disclosed that there are only 12,297 resident doctors in the country’s Federal and state tertiary health institutions.

In the considered opinion of this newspaper, it is regrettable that in recent years, Nigerian doctors have been leaving the country in droves in search of professional fulfillment due, mainly, to poor conditions of service at home and a lack of appreciation for the sacrifices they make while working in an environment of inadequate facilities.

In a country of an estimated 200 million people and with the number of doctors as quoted above, the Minister of Health, Dr. Osagie Ehanire, comments that there are actually enough doctors in the nation leave a bitter taste in the mouth.

The minister was quoted as saying, “We have heard complaints of doctors who are now leaving the system, but there are actually enough doctors in the system because we are producing up to 2,000 or 3,000 doctors every year in the country, and the number leaving is less than 1,000.”

We recall similar statements by a former minister of health who admonished doctors to take to farming if the medical field is not meeting their aspirations. The minister of Labour echoed the same sentiments.

However, the facts on ground indicate that the country is grossly lacking enough medical doctors. Experts say the country needs at least 283,333 doctors to meet global standards. According to statistics on doctors in Nigeria, the country has about 72,000 medical doctors registered with the Medical and Dental Council of Nigeria, and approximately 35,000 practice in Nigeria.

In a country with a huge population of over 200 million, the 35,000 translates to one doctor per 5,000 people. This figure is a far cry from the World Health Organisation (WHO) recommendation of one doctor to 600 patients. Comparatively, the ratio of doctor-patient in India (1:2083) and the United States (1:500) paints a clear picture of where the nation stands on providing health care services for the people.

The WHO’s data capture countries’ ratio of available doctors per 10,000 people in each nation. Mauritius (27 doctors in 2020), Tunisia (13 in 2017), Cape Verde (8 in 2018), South Africa and Egypt (7 each in 2019), and Gabon (6 in 2018) have more doctors to attend to their populations than Nigeria.

The Executive Director of a cancer advocacy group, Project PINK BLUE, Runcie Chidebe disclosed last year that Nigeria will have a shortage of 50,120 doctors and 137,859 nurses by 2030 due to mass migration of health workers to foreign countries.

The nation’s statistics, therefore, are, to say the least worrisome. And the current mass exodus of doctors from the country has exacerbated the already bad situation.

Experts have attributed the poor working conditions in the country to the mass exodus of doctors. Instructively, the annual healthcare threshold per person in the United States of America is $10,000, while in Nigeria it is just $6. Also, experts have lamented that medical examinations are getting more expensive in Nigeria. In this light, the current trend of senior doctors and consultants leaving the country is saddening.

Unfortunately, it is doubtful if the nation’s policymakers have reflected on this ugly development. Their utterances have not suggested that concern.

According to NARD, about N576 billion ($1.2 billion) is lost to medical tourism yearly in Nigeria, an amount that could have been invested in developing the country’s health care system and the country as a whole. This is about N100 billion less than the N632.7 billion allocated to the health sector in the 2021 budget.

In April 2001, heads of state and government for African Union countries came together at a summit to address the challenges posed by HIV/AIDS, tuberculosis, malaria, and other diseases plaguing the region. They pledged to dedicate 15 percent of the budget to health.

However, 20 years later, Nigeria has fallen short of the 15 percent pledge to health. Regrettably, the average budget allocation to the health sector was about 4.7 percent across two decades. Needless to say, this has to change. From the foregoing, we call on the federal and state governments to significantly increase their budgetary allocations to the health sector.