The Health Sector Needs Emergency Actions, Not Just Policy

Cheetahs Policy institute

Cheetahs Policy institute

Share:

Over the last five years, Nigeria has lost approximately 16,000 doctors due to the phenomenon popularly known as “Japa Syndrome,” where skilled professionals leave the country for better opportunities abroad. This exodus has worsened the already critical shortage of healthcare professionals in Nigeria, resulting in a massive Human capital flight in the medical field. Doctors, alongside other professionals, have been migrating since 2019, and the trend has now escalated into a national crisis.

Prof. Ali Pate, the Minister of Health and Social Welfare, stated that Nigeria currently has 300,000 health professionals, including around 90,000 registered doctors. Out of these, only 55,000 are licensed and available to serve a population exceeding 200 million. These numbers are far below the World Health Organization’s (WHO) recommendations for doctor-to-patient ratios, which is 1:600 to meet the Sustainable Development Goals (SDGs) on health and well-being. In 2021, Nigeria’s doctor-to-patient ratio was a dismal 1:2500, highlighting the burden placed on doctors who are physically and mentally exhausted due to overwhelming patient numbers.

One of the primary reasons behind the mass emigration of doctors is the lack of adequate health facilities. In many Nigerian hospitals, basic infrastructure such as reliable power supply is absent, leading to a slower rate of medical operations and an inability to effectively utilize equipment dependent on a steady power source. This puts patient lives at risk and limits the capacity of doctors to provide quality care.

In addition to inadequate facilities, the inadequate remuneration of Nigerian doctors is another major factor driving the human capital flight. According to some report especially by Dataphyte, doctors in Nigeria earn an average of $2,000 annually, or $200 per month—an amount professionals in other countries can earn in one month. This pay disparity is driving many health workers to seek better opportunities abroad.

The lack of investment in the health sector is at the root of these challenges. Nigeria, along with other African Union (AU) countries, agreed in 2001 to allocate 15% of its annual budget to healthcare. Countries like Rwanda and South Africa have successfully implemented this agreement, significantly improving their healthcare systems. Nigeria, however, has allocated only around 4% of its annual budget to the health sector, contributing to the ongoing crisis.

In 2024, the Federal Government allocated 4.64% of its total budget—about N1.34 trillion—to the Ministry of Health. Despite a marginal increase in percentage terms from previous years, the naira’s depreciation against the dollar has reduced the actual value of this allocation. A detailed analysis by ICIR reveals that, when adjusted for inflation and currency devaluation, Nigeria’s 2024 health budget is worth even less than in 2022. Had Nigeria adhered to the AU’s 15% health budget agreement, the 2024 allocation would be closer to N4.3 trillion, which would help address urgent issues such as improving medical infrastructure, ensuring reliable power supply, and paying healthcare professionals competitive salaries.

The Nigerian government has enacted a policy to reduce emigration and reverse the migration of health workers, aiming to improve working conditions through better shift management overseen by the Nigeria Human Health Resource Program. This program includes capacity-building opportunities and a push for bilateral agreements to lure back Nigerian healthcare professionals from the diaspora.

While these policies are steps in the right direction, they fall short of addressing the immediate crisis. Emergency action is required, not just policy. The mass exodus of health workers is a state of emergency, and the Federal Government must prioritize quick, decisive action to ensure healthcare workers remain in Nigeria.

Insecurity is another major issue affecting Nigeria’s healthcare system. In August 2024, doctors protested the kidnapping of a fellow doctor who had been held for almost a year. While the government has enacted policies, there are doubts about its capacity to protect healthcare professionals. Urgent interventions, including paying ransoms or deploying force to rescue abducted health workers, are necessary to restore confidence and ensure the safety of those still serving in Nigeria.

The Nigerian government must recognize that policy alone is insufficient to resolve the crisis in the healthcare sector. Immediate supplementary budget allocations are essential to fund the purchase of sophisticated medical equipment, ensure 24/7 power supply, increase healthcare worker salaries, and provide attractive incentives to retain skilled professionals. Without these actions, Nigeria risks worsening the already critical shortage of doctors, leading to an even more precarious public health situation.

Policy must translate into action. Investing in Nigeria’s healthcare sector now is the only way to stem the tide of professionals leaving the country and to build a sustainable, resilient health system capable of serving the needs of over 200 million citizens.

Lawal Sofiyyat Bolanle

Lawal Sofiyyat Bolanle

Lawal Sofiyyat Bolanle is a freelance journalist with interest in education and healthcare sectors' policies.