9,000 doctors left in Nigeria, for an estimated 200 million people – Nigeria’s Healthcare Crisis Deepens

9,000 medical doctors are left with the Nigerian Association of Resident Doctors (NARD) due to the surging migration pressure on Nigeria’s healthcare system, Emeka Orji, NARD president, has said.

Orji made the revelation in the wake of an indefinite strike by the association over unmet demands for improved working conditions.

The body has continued to record a declining membership rate from an average of 16,000 a few years ago as doctors pursue prospects of better remuneration, up-skilling opportunities, and improved standards of living in developed countries, according to Orji.

“We have been engaging the government since January without avail. The doctors remaining here are overworked and poorly cared for,” Orji said responding to why the strike action is the most preferred means to communicate doctors’ displeasure.

The shortage of doctors has left the country with a dire scarcity of healthcare professionals. With only one doctor for every 10,000 patients, this is far below the World Health Organization’s (WHO) recommended ratio of one doctor to 600 people.

This is taking a devastating toll on the health of Nigerians, who are often forced to wait long periods of time to see a doctor, and who may not be able to access the care they need at the appropriate time.

Analysts often tag the loss of doctors as a situation of the poor subsidising the rich. Nigeria, home to over 82 million poor with health expenditure per person of $71 seems to be offsetting the cost of healthcare for countries such as the United States, a country capable of $10,921 in health spending per individual.

The United Kingdom and Saudi Arabia spends about $4,312 and $1, 316 on each citizen, yet Nigeria keeps losing the health workers it needs to the more advanced healthcare facilities and working provisions provided by the likes of the duo.

Instead of a robust health workforce, equipped to drive up doctors to patient ratio, raise life expectancy, and flatten maternal and child mortality rates, the country keeps grappling with a lean structure that continues to bleed from the government’s neglect.

According to the World Bank, there were 24,000 physicians (per 1000 people) in Nigeria in 2019. This means that there is one doctor for every 8,000 people in Nigeria.

In 2017, the Nigerian Medical Association (NMA) estimated that there were only 39,912 doctors practicing in Nigeria. The number has likely decreased further since then.

In a communique issued at the end of its national executive council meeting in July, NARD accused the government of failing to release the circular on one-for-one replacement of clinical staff despite the untoward hardship the current spate of brain drain has caused Nigerian doctors and other clinical staff.

It stated that the payment of the 2023 Medical Residency Training Fund (MRTF) has been delayed despite several engagements with the government. Also, the salary arrears of 2014, 2015, and 2016 owed its members have not been paid. And the hazard allowance arrears and the arrears of the consequential adjustment of the minimum wage are pending among other issues.

The six items on NARD’s list of demands include a call for the immediate fix of these issues. It also wants immediate implementation of full CONMESS, domestication of MRTA/payment of MRTF, and review of the hazard allowance by all state governments to be addressed. It is also seeking immediate reversal of the downgrading of the Membership certificate by the Medical and Dental Council of Nigeria (MDCN).

The government has taken some steps to address the shortage of doctors, such as increasing the number of medical schools and offering scholarships to students who want to study medicine. However, these measures have not been enough to solve the problem.

Both in the public and private healthcare sectors, the shortage of doctors is a serious problem that stakeholders say the government must address.

Kay Adesola, national president of the Association of Nigerian Private and Medical Practitioners (ANPMP) and a veteran medical doctor said it has become an endemic problem that has come to stay and is getting worse daily.

The rate of death among medical workers especially doctors has become historically high in the last couple of months due to the high burnout rate.

He also noted that the economic hardship has also aided the problem and translated to poor quality of care for patients.

“The government just declared an emergency on food production. We need one in the health sector. We need to look at the works done at the twilight of the last government by the Presidential Health Reform Committee headed by Professor Yemi Osinbajo,” he said.