Why is Urgent Healthcare Education Investment Crucial for Nigeria?

Highlights

• Nigeria’s healthcare sector grapples with a scarcity of skilled personnel, contributing to elevated rates of maternal and child mortality

• The challenge intensifies as a brain-drain trend sees health professionals, including doctors and nurses, flocking to Western countries in large numbers

Nigeria holds a significant share of healthcare facilities in West Africa, yet the quantity alone fails to depict the actual scenario. Let’s delve into the statistics to unravel the challenges confronting Nigeria’s health systems.

Key Findings: The nation has 0.4 physicians or doctors per 1,000 people, translating to about 45,000 doctors for the entire population of 226 million. However, the Nigeria Medical Association (NMA) contends that the figure is deceptive, with actively licensed physicians numbering around 24,000. This results in a concerning ratio of 1:10,000 doctors to the population. In areas with predominantly rural populations, such as states in the south-east and north, the ratio becomes even more imbalanced, with a single doctor for 30,000 to 45,000 people.

Challenges in Accessing Healthcare: In rural regions, patients often face journeys of approximately 30 kilometers or several hours to access basic healthcare. Specialised medical facilities concentrated in urban areas exacerbate the situation for residents in sparsely populated regions, making it arduous to receive professional care.

The World Health Organisation (WHO) advocates for a team of 23 healthcare staff, including doctors, nurses, pharmacists, and support personnel, for every 10,000 people in developing countries. This ratio is designed to serve not only urban demographics but also vulnerable populations, encompassing maternal and children under five demographics, along with communities in remote locations. Dr. Uche Ojinmah, the NMA’s president, emphasises that the country requires an additional 363,000 doctors to align with WHO’s recommendations for providing essential care to such populations.

Maternal and Child Mortality Rate: Nigeria grapples with one of the world’s highest maternal and child mortality rates. According to the United Nations Economic Commission for Africa, one in seven maternal deaths worldwide occurs in Nigeria, along with one in eight children not reaching the age of five. Health experts attribute this alarming statistic to limited access to healthcare and a shortage of trained staff. Julitta Onabanjo, Director of the Technical Division at the United Nations Population Fund (UNFPA), emphasises the urgent need for skilled healthcare workers like midwives, coupled with affordable medicines, potable water, and nutrition to enhance survival rates.

Medical Migration: A critical concern is the escalating number of newly licensed doctors seeking opportunities abroad. The country faces a substantial brain drain in the healthcare sector, with nearly 5,600 or 4% of registered physicians leaving for the U.K. in 2022. The Medical and Dental Consultants Association of Nigeria (MDCAN) reveals that over 100 members migrate within 24 months of receiving a practice license. The NMA warns of potentially losing 50% of the trained workforce by 2025 if this trend persists. The mass departure of health professionals strains the country’s health systems, creating significant voids on the path to universal health coverage.

Shortage Impacting Specialised Care: The shortage not only affects basic healthcare but also specialised services provided by oncologists and psychiatrists. A study in the American Society of Clinical Oncology Journal indicates that the country has around 80 oncologists serving approximately 120,000 patients. The mental health sector faces a similar challenge, with only 300 psychiatrists for the entire population. This poses difficulties in addressing mental illnesses such as depression, contributing to a higher suicide rate. Nigeria currently grapples with a suicide rate of 17.3 per 100,000 deaths.

Measures to Combat Brain Drain: The severity of the brain drain has prompted the government to propose legislation restricting doctors from leaving the country after training. The bill suggests that certified physicians must practice in the country for five years to qualify for a full Nigerian medical license. Health experts argue that, at the current rate, it would take twenty years to recruit, train, and deploy the necessary 400,000 health workers needed to serve the country’s growing population. This also advocates for improved sector privatisation to enhance the availability of medical equipment. The government aims to establish a State University of Health and Medical Sciences in Lagos in 2024 to bolster the number of professionals and address the issue of medical migration.