By Victor Okeke
Nigeria, like many other countries, is grappling with a pressing issue that poses a significant threat to the delivery of quality healthcare: a depleting health workforce. The shortage of skilled healthcare professionals has reached a critical level, adversely impacting the country’s ability to provide essential medical services to its population. Urgent measures are needed to address this crisis and secure a healthier future for all Nigerians.
The current situation is alarming. The World Health Organization (WHO) recommends a minimum threshold of 4.45 healthcare workers (doctors, nurses, and midwives) per 1,000 people to achieve adequate health coverage. In Nigeria, however, this ratio stands at a staggering 0.77 healthcare workers per 1,000 people, which is significantly below the recommended level. This severe shortage undermines the effectiveness of the healthcare system, leading to increased morbidity and mortality rates, particularly among vulnerable populations.
Several factors contribute to the depletion of the health workforce in Nigeria. Firstly, there is a significant brain drain phenomenon, where trained healthcare professionals seek better opportunities abroad due to factors such as inadequate remuneration, limited career advancement prospects, and challenging working conditions. This brain drain deprives Nigeria of valuable expertise and leaves healthcare facilities struggling to meet the needs of their patients.A study done in South Africa showed that the main reasons health professionals migrated were corruption, personal and family safety, poor infrastructure, and their children’s future. To address this issue, the retention of health-care workers should be prioritised in the national planning process. Incentive packages, better work environments, team training, and opportunities for career advancement can improve job satisfaction and develop positive work attitudes.
Furthermore, the country’s medical education system faces numerous challenges. Insufficient funding, outdated curricula, and limited teaching facilities hinder the production of an adequate number of well-trained healthcare professionals. Additionally, the lack of effective retention strategies, such as providing incentives and improving working conditions, further exacerbates the problem.
To address this critical issue, a multi-faceted approach is required. The Nigerian government must prioritize healthcare workforce planning, allocating adequate resources to recruit, train, and retain healthcare professionals. Investment in medical education is crucial, with a focus on modernizing curricula, strengthening teaching facilities, and providing scholarships and grants to encourage more students to pursue careers in healthcare.
Improving the working conditions and remuneration of healthcare professionals is paramount. Competitive salaries, career development opportunities, and a supportive work environment will incentivize Nigerian healthcare workers to remain in the country, fostering a sustainable healthcare workforce. Partnerships with international organizations, such as the WHO and other countries, can also play a significant role. Collaborative initiatives, including knowledge exchange programs, capacity-building projects, and twinning arrangements between Nigerian and foreign healthcare institutions, can help bridge the skills gap and promote the transfer of expertise. Moreover, leveraging technology and telemedicine can enhance healthcare delivery in remote areas with limited access to healthcare professionals. Training community health workers and empowering them to provide primary healthcare services can also alleviate the burden on the limited number of skilled professionals.
Addressing the depleting health workforce in Nigeria requires a long-term commitment and concerted efforts from the government, healthcare organizations, educational institutions, and international partners. Adequate funding, effective policies, and sustainable strategies are vital components of a comprehensive plan to attract, retain, and support healthcare professionals.
Harnessing technology can also benefit health-care systems by facilitating patient education, providing seamless access to medical records, and reducing the workload of health-care professionals. Improving community health workers’ programmes will help to enhance service delivery. Creating a balance of duties so that professionals’ activities match their qualifications can improve working conditions in health systems. A global survey from the Organisation for Economic Co-operation and Development found that 79% of nurses and 76% of doctors were carrying out processes for which they were overqualified. Restructuring service delivery processes to minimise tasks and optimise disease management and service delivery is integral to addressing this issue. The mobilisation of preventive health-care approaches in health systems can also work in the long term to reduce the workload of health-care professionals, reduce emergency rates, and prevent complications.
By investing in the healthcare workforce, Nigeria can ensure that its citizens receive quality medical care, reduce the burden of diseases, and make significant progress towards achieving universal health coverage. The time for action is now, and through collaborative efforts, Nigeria can overcome the challenges it faces and build a robust and resilient healthcare system that meets the needs of its people.
Okeke writes from the Centre for Social Justice (CSJ) Nigeria