Official statistics show that there is one doctor to every 6,400 patients in Nigeria. This falls far short of the World Health Organisation (WHO) standard of one doctor to every 600 patients and is a grave threat to the physical and mental wellbeing of the country’s populace.
Since the inception of the Medical and Dental Council of Nigeria (MDCN), there have been 65, 000 registered medical doctors but presently, only 25, 000 medical doctors are practicing in the country.
To meet the WHO benchmark, Nigeria needs to have 283,333 doctors, measuring by a 170 million population base. This means that the country needs 283,308 additional doctors at present.
One of the causes of the shortage of medical doctors in the country is the massive exodus of medical professionals in search of greener pastures abroad.
In addition, there is a disproportionate concentration of medical personnel in urban areas because they find remote areas unattractive, despite the huge disease burden such as malaria, tuberculosis, typhoid fever etc. in rural communities.
While poor geographical distribution of health care professionals also contributes to this dearth in manpower, the poor doctor-patient ratio of 1:6400 in Nigeria as against the World Health Organisation (WHO) standard of 1:600 remains a huge challenge, as medical schools in the country graduate between 2,500 and 4,000 new doctors annually.
In an interview with BusinessDay, Osahon Enabulele, National President, Nigerian Medical Association (NMA), identified factors driving this problem to include poor human resources planning and structures, unsatisfactory working conditions, poor remuneration, and few professional development opportunities.
While the working conditions make other countries more attractive to Nigerian medical professionals, Enabulele hinted that as a result of inadequate infrastructure and remuneration packages, a sizeable number of physicians, nurses and other medical professionals are lured away to developed countries in search of fulfillment and lucrative positions.
“Most of these doctors are presently working in the United States, Britain, South Africa, and other neighbouring African countries where medical personnel are treated better. Since the inception of the Medical and Dental Council of Nigeria (MDCN), there were 65, 000 registered medical doctors but presently, only 25, 000 Nigerian medical doctors in the country are practising.
Enabulele explained that out of the 27 fully accredited medical and dental schools and 4 partially accredited medical schools in Nigeria, about 3,000 doctors annually are churned out from these institutions annually.
“Over 100,000 applicants show interest in studying Medicine and Surgery annually but less than 5 percent are offered admission. Universities cannot admit more than a certain quota, based on Nigerian University Council (NUC) policy. This is due to lack of infrastructures in our universities. The onus lies on the Government to increase funding for education to put in place requisite facilities. This in turn would increase the number of applicants admitted to study medicine, increase the number of medical graduates and reduce the current Doctor-Patient ratio,” Enabulele added.
Drawing inference from countries like Cuba, where there is a ratio of 1 doctor to 125 people, Anthony Omolola, National President, Association of General and Private Medical Practitioners of Nigeria (AGPMPN) advised that reversing the current situation involves strengthening health worker motivation.
“Despite the fact that we have brain drain now, how can we effectively use the people within the country? Because we know that if there is a private partnership with government, with preventive medicine and primary care, the manpower crises will be reduced,” Omolola explained.
Dearth in manpower in the health sector is coming under the heels of WHO report which reveals that 59,000 women die annually from pregnancy and child birth. The report states that only 39 per cent of births are delivered by skilled health professionals and the risk of a woman dying from child birth is 1 in 18 in Nigeria, compared to 1 in 61 for all developing countries and 1 in 800 in developed countries. The 2011 Mo Ibrahim African Governance Index rating similarly ranked the Nigerian health service 51 out of 53 countries in Africa.
BusinessDay findings show that manpower shortage in health institutions in the country puts undue pressure and stress on the available staff. This shortage is more pronounced at the primary and secondary levels of healthcare and creates disruptive behaviour and disharmony amongst health care workers.
In addition, urban areas have become more attractive to health care professionals for their comparative social, cultural and professional advantages. These areas offer more opportunities for career and educational advancement, better employment prospects for health professionals and their families and easier access to private practice (an important factor in the country).
Health experts believe that significant consequences on the health of inhabitants of rural areas may worsen as unavailability of physicians and nurses within close proximity may lead to delays and postponing visits to health care facilities until the condition becomes unbearable .