For decades, Nigeria’s health sector has been characterised by a disturbing degree of deterioration due to neglect by successive administrations. Indeed, the sector is now near a total collapse with very little hope of revival. Indeed, that President Muhammadu Buhari continues to be treated abroad for his health challenges is a further indictment of the nation’s health care system and a shame on those in office. So, that the Nigerian health sector requires attention is no longer news! What is now more disturbing is that more Nigerian doctors are even fleeing abroad, a situation that must be remedied if an already bad situation would not be made worse.
According to the World Health Organisation (WHO), for any country to be deemed to have enough doctors for its population, it should have one doctor for every 600 persons. This means that Nigeria needs about 300, 000 medical doctors. However, there are about 35,000 working in the country currently. Experts say that for good quality patient care that is not compromised by errors occasioned by fatigue and overworked medical doctors, Nigeria needs 303,333 medical doctors or at least 10,605 new doctors annually to join the workforce for the next 10 years. Obviously, the dearth of medical personnel is a major issue confronting the health sector and it is regrettable that a nation with the largest African population cannot boast of stable and quality healthcare for its citizens, as a result of lack of manpower and poor infrastructure.
The consequence of this crisis is grave because gigantic buildings do not translate to quality Health care services. Good personnel does! In essence, the lack of manpower is the bane of the health sector and this situation is unacceptable because further brain drain would paralyze clinical and other health services, with the attendant consequences of heightening mortality and morbidity in a country where life expectancy has fallen from 70 years to 47.
So, it is a shame that while the country is bemoaning the deficit of 265, 000 medical doctors, a new survey conducted by the Nigerian polling organisation, NOI Polls, in partnership with Nigeria Health Watch, has shown that about eight out of every 10, representing 88 per cent of medical doctors in Nigeria are currently seeking work opportunities abroad. The fleeing medical doctors cut across junior, middle and senior level in both public and private medical institutions. So, the brain drain that began since 1985, leaving the country with fewer practising physicians and specialists to about 180 million Nigerians is taking a turn for the worst.
What is responsible for this development?
The survey further provided some of the reasons for the looming brain drain in the health sector and they include poor salaries, high taxes and deduction from salaries and emoluments, low work satisfaction, poor infrastructure and huge knowledge gap. The reasons are not even debatable because many great doctors all over the world are Nigerians, showing that the country has the brain but cannot just retain them at home. A recent example is Dr. Oluyinka Olutoye, who had his medical degree from Obafemi Awolowo University, Ile-Ife in 1988, and in collaboration with his colleague successfully removed tumour from a baby in her mother’s womb. The duo removed the baby from her mother’s womb, operated on it, and returned it to the womb. The baby got healed and continued to grow until she was finally delivered at 36 weeks. This is just one of many medical feats by Nigerians. Dr. Olutoye is a Nigerian, who trained in Nigeria. And there are many like him. Perhaps, what made the difference largely is the enabling environment! Essentially, the unconducive operational environment is getting worse with the recession, and if nothing is done to reverse this trend, Nigeria’s health facilities already reputed as mere consulting clinics may even degenerate into something worse with no one to consult.
To the deficit in medical personnel and to even attract health technologies and experts in the diaspora back to Nigeria for a more effective and efficient health service delivery, the evidence-based issues identified should be dealt with using a participatory approach to improve the working conditions and enabling environment for professionals. Thus, the result from the survey should stimulate conversations and engagements among all the stakeholders in the country’s health sector. Furthermore, there is the need for better planning of the healthcare system, overseas training and private sector investment in health. These hopefully will trigger the much needed reforms to redesign and reposition the health sector. As such, the Nigerian Medical Association (NMA), Federal Ministry of Health (FMoH), civil society organisations (CSOs), development partners and organised private sector should see this survey result as a wakeup call and rise to the occasion for a more globally competitive health care system.