Improving Welfare of Health Workers in Nigeria

Isaac Adewole

Isaac Adewole

In commemoration of the International Workers Day which held on May 1, Martins Ifijeh writes on the need for the Nigerian government at all levels to give priority to the welfare of medical doctors, nurses and other health workers if they are serious about fixing the sector and reducing the burgeoning menace of brain drain on the economy

It is no longer news that at least seven in every 10 medical students in Nigeria only wish to benefit from the educational system and look for greener pastures in other countries, especially in United States, United Kingdom, Canada, United Arab Emirates, and even South Africa, where the profession is better appreciated.

Alarming Statistics
At least, about 70 per cent of Nigerian resident doctors and nurses are either on the verge of leaving the country or are writing various examinations to that effect. To them, there is no need spending the remaining decades of their career in a system that would not profit them and the sector they represent.

No wonder reports suggest an estimated 35,000 Nigerian doctors are practicing abroad out of the 72,000 medical doctors registered with the Medical and Dental Council of Nigeria (MDCN), with the United States and United Kingdom taking a major chunk of the percentage.
This exodus is not likely to stop anytime soon, as about 2000 medical doctors still leave the country every year, thereby depleting the remaining tens of thousands of their kind still in the country; a scenario that has in no small measure taken a huge toll on the health sector and by extension the health of the citizens.

Gaping Disparity in Pay
Figures released in February 2018 by the British government showed that over 5,000 Nigerian-trained doctors and nurses were currently working with the British National Health Service (NHS) in the United Kingdom, constituting 3.9 per cent of the 137,000 foreign staff of 202 nationalities working alongside British doctors and nurses.

A physician in Canada is paid $260,924 ($339,000 Canadian) for clinical services by the government’s ministry of health per year on average, according to a report from the Canadian Institute for Health Information published in September 2017. On average, a family physician is paid $211,717 ($275,000 Canadian) for clinical services and a surgical specialist is paid $354,915 ($461,000 Canadian)
These figures when compared to the abysmal poor renumeration of Nigerian doctors, which ranges between N150, 000 for entry level doctors and N500, 000 for consultants, show one of the major reasons why many doctors are leaving the country in droves.

NOI Polls
While the statistics is alarming enough, the situation could get worse, as a survey by the Nigerian Polling organisation, NOIPolls, in partnership with Nigeria Health Watch (NHW), revealed that about eight out of every 10, representing 80 per cent of medical doctors in Nigeria are currently seeking work opportunities abroad.

The poll findings cut across junior, mid and senior levels in both public and private medical institutions such as house officers, corps members, medical and senior medical officers, residents, registrars, consultants and medical directors.
According to the World Health Organisation (WHO), for any country to be deemed to have enough doctors for its population, it should have one doctor for every 600 persons.

However, there are about 35,000 working in the country currently, according to the Nigerian Medical Association (NMA). That means Nigeria needs more than 237,000 medical doctors to meet WHO standard doctor-patient ratio.
The implication is that only one doctor is available to treat 30, 000 Nigerians. In the North, it’s even worse as many states have one doctor to about 50, 000 patients. In some rural areas, patients have to travel more than 30 kilometres to get medical attention.

Priority for Health Workers
Speaking with THISDAY, a Public Health Physician, Dr. Rufus Ogbeifun, believes as the new government births next month, the president, governors and other stakeholders in the nation’s affair should quickly put series of steps in place to curb brain drain and ensure doctors no longer see it as lucrative practicing outside the country.

He said two things must be addressed for this to happen: “Renumeration of doctors, nurses, pharmacists, physiotherapists, and other health workers should be given priority as we mark Workers’ Day within few days. We all know what obtains elsewhere. The disparity in the pay is too wide. Gone are the days doctors are regarded as middle class Nigerians. They are now among the poor Nigerians because they work round the clock daily to feed their families, yet their pay cannot take them home.”

Addressing Poor Health Facilities
As part of measures to address brain drain, Ogbeifun said: “The second is for government and its partners to address the poor health facilities in the country. Assuming that Nigerian doctors have agreed to come home, what facilities are they going to meet on ground. Where are the cancer machines, where are the world class machines for the treatment and management of cardiovascular diseases?

“Where are the facilities for the management and treatment of kidney diseases? Where are the world class facilitie in our primary health centres, general hospitals and even the tertiary hospitals? How are our research institutes fairing? These two areas are priority. Once addressed, our people will no longer travel abroad. Even those abroad would love to come home and serve their country.

Charge to Government
He called on governments at all levels to bring into the system public private partnership, adding that this would enable the system work more effectively and give room for employment of more health workers, adding that in addition government should build more health facilities to absolve the thousands of jobless health workers in the country.

Harmony Among Health Workers
On disharmony in the healthcare system, he said there was no island in the health sector as every profession, including doctors, nurses, anatomists, among others have their own unique jobs which on the long run is for the advantage of the patient.
“The more united the workforce is, the better for the system. A security guard in the hospital is also a vital part of the workforce. That is why every profession must be treated with respect. Divisions of labour should be respected as well,” he said.

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