ADDRESSING THE HEALTH SECTOR BRAIN DRAIN

There is need to ensure that health workers are well-provided for

While the issue of brain drain among medical professionals is not new, the recent surge has become increasingly troubling. This is most worrying for a country in dire need of skilled professionals to effectively manage the sensitive health sector. Increasingly, the country is losing medical consultants and specialists in anaesthesia, Intensive Care Unit (ICU), paediatrics surgery, family medicine (consultants), obstetrics and gynaecology, Ear, Nose and Throat (ENT), Emergency medicine, orthopaedic surgery, and more. This development has left an overwhelming pressure on the few doctors remaining in the country.

Survey after survey has revealed that most of the medical personnel in Nigeria are considering work opportunities abroad. Last week, the Coordinating Minister of Health and Social Welfare, Muhammad Pate revealed that over 16,000 Nigerian doctors have left the country in the last five to seven years for greener pastures in other countries. This trend, according to Pate—who also lamented that nurses and midwives are also leaving the country in droves—is not just about people leaving, it also represents a fiscal loss. For context, Nigeria had trained 90,000 medical doctors as of May 2018, according to a former Minister of Health, Isaac Adewole, but about 70 per cent of them have migrated to other countries where they feel their services are better valued.

The estimated cost of training one doctor exceeds $21,000, “a figure that reflects the magnitude of public financing walking out of our countries,” according to Pate. “It deeply affects our health systems—leaving many of our rural communities critically underserved,” Pate said to underscore the gravity of the situation while also highlighting efforts to redress the situation. “To retain and motivate health workers currently serving in Nigeria—thousands of whom work under difficult conditions; to establish ethical norms and explore bilateral frameworks for recruitment, aiming to correct global asymmetries; to expand training capacity…and to strengthen governance, improve regulatory coordination, and build real-time data systems.”

The reasons for the mass exodus of doctors, trained largely at public expense, are obvious. Like most other professionals, they are often treated with disdain. They work with inadequate and ageing infrastructure and are poorly remunerated. Besides, so many doctors and other medical personnel were lost during the Covid-19 pandemic because of inadequate equipment. Agreements with the government are hardly honoured hence in some states of the federation, doctors are owed salaries for months, thus prompting frequent industrial actions. Even worse, in the face of the prevailing insecurity across the country, many doctors have become easy victims of kidnap for ransom, with some losing their lives in the process.

This apparent neglect of the health sector is encouraging medical tourism among the middle-class and the wealthy. There are no adequate statistics but there is no doubt that Nigerians are spending a fortune outside the country on health. The British Broadcasting Corporation (BBC) said recently that Nigeria spends about $1billion annually on medical tourism, particularly to India. This is a lot of money that would have made a difference if ploughed to the health sector at home.

A few years ago, many were outraged when then Minister of Labour and Employment, Chris Ngige made light of the serious issue of the brain drain haemorrhage. Ngige, himself a medical doctor, asserted falsely that Nigeria had more than enough doctors to take care of its health needs. At that period, agencies of the United States, Canada, South Africa, United Arab Emirates, and many other countries were routinely conducting recruitment exercises in a country of one doctor to more than about 2600 patients, going by the latest statistics from Pate—still a far cry from the World Health Organisation (WHO) recommended ratio of one to 600.

We agree with Pate, but his action should speak louder than his words. To reverse the country’s worsening health sector, and retain the very best professionals at home, authorities in Abuja and the 36 states must improve the present work environment. Health professionals in Nigeria are among the least paid globally, a situation that spurs them to move to countries where they can get better incentives.

We need to address that challenge.