The increasing migration trend among Nigerian medical professionals has seen alarming consequences for the region’s healthcare sector. Over 60% of registered Nigerian doctors have been found to practice abroad. This has resulted in a reported ratio of one doctor per 5,000 people in the country – a statistic deemed grossly inadequate. The country, like several in sub-Saharan Africa, does not meet the minimum acceptable 1-per-1000 doctor-to-population standard prescribed by the World Health Organization (WHO). This migration is not limited to doctors, however, with other health practitioners including nurses, pharmacists, and laboratory scientists also relocating in large numbers. With emigration rates continuing to climb, the crisis is anticipated to exacerbate over time.
Chike Nwangwu of NOIPolls observed that emigration rates are at an all-time high, claiming survey results showed “88 percent of doctors are considering work opportunities abroad.” This has had a tangible impact on the population, with the country’s health care system having been ranked 187th out of 190 countries by the WHO in 2018 and the average life expectancy in 2014 was 52.62 years. Most Nigerian public hospitals have no full-time specialists and are largely staffed by community health officers, retired nurses and doctors with limited clinical experience. Distribution of professionals across the region is also highly uneven and about half of doctors practice in the metropolitan hubs, namely Lagos and Abuja, while more rural and northern facilities are left woefully understaffed. As such, many middle class and wealthy Nigerians often resort to travelling abroad for medical attention. For example, Director of the Gynae Care Research and Cancer Foundation, Onwufor Uche, claimed that over 50 percent of Nigerians requesting visas to India “are going for medical care that is not available here in Nigeria.” Even Nigeria’s President, Muhammadu Buhari, goes to London for his health care needs.
Doctors have attributed the mass exodus to factors including poor working conditions and limited equipment, with only four percent of Nigeria’s budget being allocated to health, poor remuneration rates and disproportionately difficult tests in comparison to other nations. Despite these issues, such concerns have been downplayed, with health minister Isaac Adewole saying of doctors struggling to find placements, “It might sound selfish, but we can’t all be specialists.” This has been contrasted with the active encouragement of immigration of doctors and other advanced professionals by wealthier nations. Popular destinations for expats include the United States, Canada and United Kingdom.
Suggestions for resolving this crisis have included making the National Insurance Scheme (NHIS) compulsory for all citizens in order to provide greater funding towards improving working environments and infrastructure for medical professionals. Local training and education programs could also be made more robust and less expensive. The benefits of the introduction of public-private partnership into the healthcare sector have also been lauded as having the potential to increase overall efficiency and increase staff employment opportunities.
Organisations such as the WHO have established the status of health as a fundamental right and it is essential that this issue, as with any threat to human rights, be investigated and managed. The medical migration trend out of Nigeria and into wealthier nations has resulted in access to healthcare having been delineated along the lines of income, class and location and so poses a threat to global justice and equality. With human lives on the line, the need for the Nigerian government to prioritize and address the systematic issues in the country’s healthcare sector and stymie the emigration trend is apparent.