The Nigerian Medical Guild has raised alarm over the mass emigration of Nigerian doctors abroad. The concern is that such high rate of Nigerian doctors’ relocation abroad has had an adverse effect on health care delivery in the country. It is feared that the poor health care delivery situation could get worse if the trend is not stopped.
We share the concern of the medical guild on the increasing number of doctors seeking greener pastures abroad and the need to discourage the trend. The case of doctors attracts particular attention because they are regarded as the leader group among professionals in the health care delivery system, as nurses constitute another unique professional group also involved in mass migration abroad.
It is estimated that about 50 percent of Nigerian doctors practice abroad. Figures vary from 40,000 to 50,000 as the number of Nigerian doctors in the Diaspora. An official of the Medical and Dental Council of Nigeria (MDCN), the agency that regulates the medical profession, indicates that it has registered about 80,000 doctors and dentists in Nigeria, including those trained abroad.
An official of the Nigeria Medical Association (NMA), Dr. Olumuyiwa Odusote, is quoted as stating that about 40,000 out of 75,000 registered Nigerian medical doctors are practicing outside the country.
To underscore the gravity of the situation, he pointed out that 100 doctors resigned from UCH (University College Hospital) in 2017 while 800 doctors resigned from hospitals owned by the Lagos State Government. Statistics by the British government released in February 2018 indicate that about 5,405 Nigerian trained doctors and nurses are working with the British National Health Service (NHS) in the UK.
According to Prof. Akin Osibogun, former Chief Medical Director, Lagos University Teaching Hospital, Nigeria produces 3,000 medical doctors yearly but needs to train more and provide incentives to retain them. But reports indicate that about 70 percent of young Nigerian doctors are making plans to leave the country and taking examinations to this effect, with 660 reported to have written the British Council administered Professional Linguistic Assessments Board (PLAB) to qualify to practice in the UK with 1,000 others waiting in line to write the exam.
The cumulative effect is a doctor/patient ratio of 1 doctor to 4,000 patients in Nigeria as against WHO recommended 1 doctor to 600 patients. Also, WHO health performance rating for 2017 placed Nigeria in 187th position out 191 countries.
However, while we recognise the deleterious effect of doctors’ emigration to several countries, it is primarily a symptom of the general rot in the nation’s health care delivery system arising from lack of according the health sector deserved priority by successive governments in the country.
Stakeholder groups in the health sector have attributed the exodus of doctors and other health professionals to the deplorable working environment, the lack of necessary equipment and poor welfare package.
Unhealthy rivalry among the health professional groups, leading to series of disruptive strikes, has also been identified as a frustrating factor for doctors, whose headship of the health team, is being ceaselessly and needlessly contested in recent times compounding a worsening work environment. Government insensitivity to the country’s poor health care delivery system is manifested in low budgetary allocation to the sector.
While a Summit of the African Union in Abuja recommended 15 percent budgetary allocation to the health sector, Nigeria has never attained 6 percent allocation. For instance between 2010 and 2018, the allocations had fluctuated between 3.7 percent in 2010 and 5.8 percent in 2015, dropping to 4.1 percent for 2016 and 2017 and taking a dip to 3.9 percent in the 2018 budget proposal. Nigeria’s 4.1 percent allocation to the health sector in 2016 is against 18 percent by Rwanda, 17.8 percent by Botswana, 17.1 percent by Malawi and 15.8 percent by Burkina Faso.
A major source of frustration for doctors is lack of adequate equipment in hospitals. We note that, sadly, this bleak situation is not likely to improve considering that 80 percent of budgetary allocation to the health sector is expended on recurrent expenditure and only 20 percent to equip the hospitals. That the Presidential Villa clinic in Abuja draws lamentation of Mrs. Aisha Buhari for its lack basic equipment and drugs highlights the widespread rot in the health sector and lack of concern at the highest level of authority.
As a first step to stem the tide of doctors’ emigration, the federal government must meet the 15 percent allocation to the health sector as prescribed by the AU Summit in the Abuja Declaration of 2001. We consider it a shame that the Nigerian government, which hosted that Summit, has failed, woefully, to implement the Abuja Declaration which had been implemented by less endowed African nations.
We recommend a paradigm shift in addressing doctors’ emigration from brain drain to brain gain by harnessing their experience and encouraging a mentoring/partnership programme between Nigerian doctors in the Diaspora and those at home, given the absurd situation of jobless/under employed young doctors.
That Nigerian-trained health professionals are sought after abroad should, at another level, be a source of pride. A government-private sector collaboration to create synergy between Nigerian doctors abroad and the nation’s health system as well as health professionals will turn the doctors’ brain drain into brain gain.
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