Reversing mass exodus of skilled health professionals
• FG to commence one- to- one replacement of exited healthcare workers in Federal Tertiary Hospitals • 3,122 of registered 58,736 doctors in Nigeria left country in 2023 • Lagos has largest number of doctors, 8,098, followed by FCT with 4,597, while Taraba has 269
THERE is growing concern over the alarming rate of migration mass exodus of skilled health professionals from Nigeria to the United Kingdom ( UK), United States of America ( USA), Saudi Arabia, Canada and other countries for greener pastures with the attendant negative impact on health care delivery in the country.
Official figures obtained by The Guardian from the Federal Ministry of Health and Social Welfare showed that, so far in 2023, about 3,122 doctors have travelled out of the country and have requested for letter of good standing from Medical and Dental Council of Nigeria ( MDCN), while a total of 2,134 doctors relocated to Europe in the period under review representing 68 per cent of doctors that have exited the system.
According to information made available to The Guardian from the Ministry, licences as at February 23, 2023 revealed that the total number of doctors in Nigeria is about 58,736 distributed across the federation with Lagos state having the largest number of 8,098 and Federal Capital Territory ( FCT) Abuja 4,597, while Taraba state has the least number of doctors with just 269.
Also, it is alleged that some doctors, nurses and pharmacists that have left the system and travelled abroad for greener pastures are still receiving salaries. It is believed that they connive with hospital administrators.
It has also been reported of 48 Nigeriatrained nurses and midwives who ‘ likely’ qualified fraudulently are still being allowed to treat patients while under investigation in the United Kingdom ( UK).
The Nursing and Midwifery Council ( NMC) recently confirmed that 48 Nigerian professionals are suspected of paying someone to sit a computer- based exam that tests medical knowledge and is needed to work in Britain. Also, no fewer than 18 nurses of Nigerian descent are currently facing charges in Texas, United States ( US), following allegations of fake educational qualifications.
In Nigeria, the Federal Government had in July revealed that some medical doctors who have left country in search of greener pastures still have their names on the nominal rolls of its hospitals
The situation has raised so many questions: Are there plans to replace the hundreds of health workers that are leaving the country? What are the implications of the gaps? What is the true situation? How can this be stopped/ solutions?
Reacting to the allegation by the Budget Office that some doctors who left the country are still receiving salaries after colluding with the management of teaching hospitals, President, Nigerian Association of Resident Doctors ( NARD), Dr. Dele Abdullahi, said: “Well, I do not have information to affirm or refute these claims, it has been stated by agencies of the government at different fora. I have to say I am disappointed that the government can indict themselves in this manner, to state that they have information that employees of government and their Ministries Departments and Agencies ( MDAS) are colluding to defraud the Federal Government and till date not one prosecution or example sounds abysmal to say the least.”
Abdullahi, however, chided the Federal Government for trying to use the allegation as the reason for her inefficiency to ensure adequate manpower in public hospitals, thereby denying the Nigerian populace their basic right to health is disturbing to know and pathetic.
He said the Association neither employs nor manages the human resources of the Government agencies. “Our grouse is with ensuring adequate welfare of our members and optimal care for every Nigerian citizen, so, we can’t help the government do their job and we won’t accept their inefficiency in managing the human resource they oversee as basis for not providing what they should,” the NARD President said.
Secretary, National Association of Nigerian Nurses and Midwives ( NANNM), Lagos Chapter, Mr. Toba Odumosu, told The Guardian: “The situation is getting dangerous. More people are leaving. We are experiencing acute shortage and it is affecting quality of care. We have to bear more burden. The situation is that more nurses want to go abroad. The response of government is not commensurate. We are calling for a state of emergency. We don’t know what the budget for next year will be. It is time we started looking at the recommended 15 per cent of the national yearly budget for health.
“The Lagos State Government is trying, they paid retention allowance in 2022 to encourage nurses to stay, but it is not enough. The government has to address the pull and push factors.”
Deputy Director of Pharmaceutical Services, Federal Medical Centre ( FMC), Asaba, Delta State, Dr. Kingsley Chiedu Amibor, said of a truth, many health care professionals such as pharmacists, medical doctors, nurses and others have left the shores of Nigeria in search of green pastures.
“It is surprising to hear that some workers who have travelled out of the country are still receiving salaries in their various places of work, in collusion with hospital administrators. Shocking because in my Centre where I practice, measures have been put in place to ensure that ghost worker syndrome does not exist.
“Every month, the hospital engages in staff verification exercise to ensure there are no ghost workers in the system. A date is set aside during which all staff, without exception, must compulsorily visit the administrative block with their identity cards, for staff verification. Even workers who are on annual leave are recalled for verification. Any staff who is not physically on ground during the exercise will not receive salary the following month.
“That way, the management is fully aware of staff movement and it becomes nearly impossible for staff who have relocated abroad, to continue to receive salaries from within the system. This is the position currently in my place of practice and I believe the practice should be the same in other federal health institutions,” Amibor said.
Adoption of One- to- One policy
Already, the government is adopting a policy on One- toOne replacement of exited health professionals in Federal Tertiary Hospitals.
Under the arrangement, the Office of the Permanent Secretary, Federal Ministry of Health and Office of the Head of Civil Service of the Federation is to facilitate the approval process for replacement of exited staff without going through all the bureaucratic process of employment.
The Director and Head Teaching Hospitals Division, Federal Ministry of Health and Social Welfare, Dr. Anuma Ogbonnaya, told The Guardian that considering the rate at which the health professionals are exiting service and at different times of the year, there is need for government to put in place a policy on seamless replacement of exited staff in order to maintain optimum health care for the citizens that may stand in need of medical services.
He observed that the extant policy and guidelines on recruitment of staff could not adequately address the peculiarity of the replacement of staff that are exiting in droves.
According to him, the Ministerial Committee considered the submission of the Committee of Chief Medical Directors ( CMDS/ Medical Directors ( MDS) on replacement of exited staff and agreed as follows: the replacement of exited staff will be done quarterly to ensure proper verification and capturing.