According to a report by the UK Home Office, in the year ending June 2022, Nigerians made up 15,772 of the ‘worker’ visas granted; a 303 per cent increase when compared to the 3,918 worker visas granted in 2019. India, which ranked first, received 102,981 work visa grants. The Philippines ranked third with 12,826; Zimbabwe fourth with 8,378 and the United States fifth with 7,748.
While many Nigerian skilled workers are migrating in search of greener pastures, the ‘hot cake’ are our health workers who are in demand in Europe, United States and the Gulf States among others. It is with that that we should be most concerned about.
According to the World Health Organisation (WHO) Nigeria’s health outcome indicators are still unacceptably high. Maternal mortality ratio is 814 per 100 000. Mortality rate for infants and children under five years is 70 and 104 per 1000 live births respectively. A significant disparity in health status exists across states and geopolitical zones as well as across rural and urban divide, education and social status.
Communicable diseases still constitute a major public health problem: Malaria accounts for 27% of global burden; TB prevalence is at 323 per 100 000; HIV/AIDS prevalence is estimated at 3.2%. Malnutrition is common with stunting rate at 43.6%. Guinea worm transmission was interrupted in 2013, and the last Wild Polio Virus was reported in September 2016 and the threat posed by the virus persists. Non communicable diseases (NCDs) burden including hypertension, diabetes, and neurological disorders are on the rise.
As a country with high health outcome indicators, including doctor-to-population ratio of about 1: 4000-5000, which falls far short of the WHO recommended doctor-to-population ratio of 1:1000, it is unconscionable that our leaders are doing nothing while the best medical brains are leaving the country in droves in search of greener pastures abroad.
Indeed, while Nigerian hospitals continue to suffer from insufficient doctors and other health personnel, over 13,000 healthcare workers left the country for the UK in the past year. A new report by the UK government showed that the 13,609 Nigerian healthcare workers granted working visas within the period are second only to the 42,966 from India. According to the UK immigration report, Nigeria is second only to Indians in the number of visas granted for the ‘Skilled Worker – Health & Care’ with 14 per cent (13,609) of the total. India has the highest in this category with 45 per cent (42,966) of the total while The Philippines is third with 11 per cent (11,021).
However, while India has doctor/population ratio of 1: 854 which is one doctor to 854 population which is better than WHO recommended ratio of 1: 1000, and thus could afford to have many of their doctors abroad the same cannot be said of Nigeria that has 1: 4000-5000. And if India with a population of 1.3billion could have population/doctor ratio better than WHO standard surely Nigeria with a lesser population of mere 200million can achieve the same feat.
Nigerian Medical Association (NMA) has also stated that Nigeria currently has only 24,000 licenced medical doctors available in the country, less than 10 per cent of the number needed to meet a WHO recommendation. The president of the NMA, Uche Rowland, disclosed this recently while speaking at a symposium to discuss ‘the brain drains in Nigeria’s health sector and its implications on health service delivery’ in Abuja.
Mr Rowland said a large number of Nigerian doctors emigrated to seek greener pastures in developed countries, noting that 5,600 of them have migrated to the United Kingdom (UK) in the last eight years.
A country requires a mix of 23 doctors, nurses, and midwives per 10,000 population to deliver essential health services, according to the World Health Organisation (WHO). Today, only one doctor is available to treat 30,000 patients in some Southern states, while in the North, it is one doctor to 45,000 patients. In some rural areas, patients have to travel more than 30 kilometres from their abodes to get medical attention where available thus making access to healthcare a rarity.
In January, the Medical and Dental Consultants Association of Nigeria (MDCAN) lamented the exit of more than 100 of its members who left the country in 2021. The president of the association, Victor Makanjuola, while speaking at a briefing in Abuja said the medical officials resigned from 17 tertiary health institutions across the country. Mr Makanjuola said the mass exodus of medical and dental consultants to more developed countries have brought significant disruptions to Nigeria’s health care ecosystem.
A 2017 survey by the Nigerian Polling organisation (NOIPolls) in partnership with Nigeria Health Watch, revealed that about 88 per cent of medical doctors in Nigeria were seeking work opportunities abroad at the time.
Similarly, the Director of Clinical Services and Training, Babcock University Teaching Hospital (BUTH), Ilishan-Remo, Ogun State, Dr Titus Oyedele, has reportedly expressed concern over the issue of brain drain in Nigeria, saying already about 50 of its doctors and 90 of its nurses have resigned to seek greener pastures abroad.
Oyedele, disclosed this while taking journalists on a tour of the institution’s facilities, and blamed the issue of brain drain on leadership failure and having people in position who do not believe in the system. He said retaining the best hands in the hospital has been challenging as it has to pay so much just to get competent and qualified personnel.
According to him, “At times, we have to source for highly skilled personnel even at a very high cost. For instance, in a system, you can have 10 people and many institutions struggling to get them. It has become the highest bidder, but the university has been trying its best to ensure that no matter what it costs, we have to ensure that the system is running.”
There is no doubt that brain drain has worsened the already depleted healthcare resources in Nigeria and widens the gap in health inequities in the country. Healthcare workers generally migrate from developing countries to more developed countries, leaving a scarcity of health workers where the need is greatest. The big question is what can be done to halt the brain drain that is hurting our health sector and our economy?
The National Assembly should make law to ban medical tourism for public officials. Under the law, from President to local government councilors should access their health needs at home which would force these officials to provide the best medical facilities in the country and pay the medical personnel like their counterparts abroad and thus halt brain drains. Medical practitioners should also protect patients’ information to encourage more public officials to seek medical care in the country and thus encourage the elite to patronize medical facilities at home and invest in it.
Doctors and other health workers trained in state and federal government universities and institutions should work for at least 10 years in Nigeria before they should be allowed to go abroad to practice. Afterall medical training in Nigeria is one of the cheapest in the world because it is subsidized by the government using tax payers’ money. The country should benefit from their training before they could transfer their services abroad.
One other way to reduce the migration of Nigerian doctors to the UK, USA, and Gulf countries among others is to improve the working conditions and salaries for doctors in Nigeria. This will include the provision of better equipment and resources for hospitals and clinics, as well as increasing the salaries and benefits for doctors and other health workers. Additionally, the government could invest in programmes to support the professional development of doctors and provide opportunities for continuing education and training. This will surely help to retain talented doctors in Nigeria and make the profession more appealing to those who are considering leaving the country.
May Nigeria Rebound
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