Addressing brain drain in Nigeria’s health sector

Nigeria experiences a significant brain drain in diverse sectors, especially in healthcare.

The brain drain of health workers is ”the movement of health personnel in search of a better standard of living and life quality, higher salaries, access to advanced technology and more stable political conditions in different places worldwide.’’

Brain drain is a challenge triggered by various economic, societal, and global factors.

Some people say that the underinvestment in healthcare and poor remuneration of healthcare workers also play significant roles in the exodus of many healthcare professionals to developed countries.

According to the Nigeria Medical Association (NMA), the shortage of healthcare professionals in Nigeria was common in the mid-1980s when the Structural Adjustment Programme (SAP) reduced the purchasing power of many Nigerians.

The development led to a brain drain, as highly skilled older colleagues relocated abroad.

Not much has been done to effectively arrest the trend, which seems to be becoming worse.

It has continued to the extent that even younger health workers are now involved.

Some people say that the trend has become more frightening due to the economic downturn, reduced government revenues and healthcare budgets, increased unemployment, and poverty, which have put pressure on demand for healthcare services.

The health sector in Nigeria suffers from many challenges including insufficient and inconsistent funding, heavy reliance on out-of-pocket payments, and poor condition of healthcare facilities, particularly in rural areas.

The Medical Guild, an association of doctors employed by the Lagos State Government, highlights the gravity of the brain drain, saying it remains an inadequately recognised crisis.

It notes that an average of two to three doctors resign from the state’s primary and secondary facilities every month without commensurate replacement.

According to the guild, this leads to overwork, chronic fatigue, burnout, and strained family relationships for the remaining doctors, with many grappling with chronic medical conditions from stress and overwork.

It also notes that economic starvation and stagflation are biting harder on doctors too.

Similarly, the Association of Psychiatrists in Nigeria (APN) laments that no fewer than 100 psychiatric doctors left Nigeria to work abroad between January 2023 and July 2024.

According to the association, it is estimated that for every five psychiatric doctors trained in Nigeria, three of them leave the country to work abroad.

Presently in Nigeria, it is estimated that the sector has one doctor to about 10,000 patients as opposed to the World Health Organisation (WHO) recommendation of one doctor to 600 people.

More worrisome is the question of who replaces the existing medical practitioners and the ageing healthcare workforce.

The Pathfinder’s Country Director in Nigeria, Amina Dorayi, told the News Agency of Nigeria (NAN) that the country’s healthcare system desperately needed repairs.

She added that there were strategies the government could implement to discourage brain drain.

Ms Dorayi also suggests ways to motivate healthcare professionals to work in Nigeria’s public health sector.

She attributes the medical brain drain in Nigeria to be majorly a result of the failure of health system leadership.

“The medical brain drain in Nigeria could be attributed to the failure of health system leadership that stems from poor insight and neglect of the problem.

“Nigeria’s healthcare professionals have been migrating in droves to the United Kingdom, United States, Canada, Australia and other developed nations,’’ she said.

To stem the tide, Ms Dorayi says the government at all levels must prioritise the menace of brain drain on the political agenda.

She said, “Governments must work in conjunction with healthcare institution administrators, other leaders, and stakeholders within the health sector.

“This will promote improved welfare, working conditions, job security, and satisfaction among healthcare workers, as no other category of workers is so essential to the well-being of the people.

“To discourage brain drain and motivate healthcare professionals to work in Nigeria’s public health sector, the government must take concrete steps.

“First, we need to improve the working conditions of health professionals, which means enhancing infrastructure, equipment, and resources in public healthcare facilities to create a conducive work environment.

”Competitive remuneration is also crucial, offering salaries and benefits that are comparable to international standards.’’

Ms Dorayi says career development opportunities, including training and mentorship, should also be provided to help healthcare professionals grow professionally.

According to her, the federal government’s recent student loan initiative is a laudable step and should be implemented to give people from disadvantaged backgrounds an opportunity to study medical courses.

She said that ensuring healthcare professionals’ safety and security, particularly in high-risk areas, is vital.

In addition, she says the government needs to recognise and reward their contributions and achievements to boost morale and motivation.

“I also think that engaging with Nigerian healthcare professionals’ community abroad can encourage knowledge transfer, collaboration, and potential return to contribute to the country’s health sector,’’ she said.

Ms Dorayi said that Nigeria must be ready to arrest the issues of brain drain in the country.

There is no doubt that the health sector in Nigeria faces an exodus of skilled professionals.

Factors that drive the trend include the incentives and available structures that offer better opportunities for healthcare workers in developed countries.

Also, the emigration of healthcare professionals has been encouraged by security challenges and harsh economic conditions, including inflation.

These and more require the political will to take care of capacity and funding in the health sector.

The government can also address those social issues that encourage Nigeria’s health professionals and their families to seek solace and a better life abroad.