Nigeria stands at a pivotal juncture in its healthcare journey, grappling with numerous challenges that threaten the health and well-being of its citizens. Over the years, the nation’s healthcare system has been plagued by inadequate infrastructure, insufficient funding, and a troubling exodus of skilled professionals, all of which have hindered its progress.
The recent introduction of the “National Policy on Health Workforce Migration” marks a significant step in Nigeria’s healthcare reform efforts. This policy, alongside other complementary measures, aims to tackle critical workforce issues and rejuvenate the sector, heralding a new era of improved health outcomes and greater system efficiency.
One of the most pressing issues within Nigeria’s healthcare system is the stark disparity between healthcare facilities in urban and rural areas. While cities like Lagos and Abuja benefit from relatively better infrastructure, many rural regions remain underserved, with inadequate services and poorly maintained facilities. Primary Healthcare Centres (PHCs), designed to offer essential services at the grassroots level, often lack basic amenities and are frequently underfunded. According to the World Health Organisation (WHO), Nigeria’s healthcare facility density stands at about 0.4 per 1,000 people—far below global averages. This imbalance exacerbates health disparities, limiting access to quality care for rural populations.
The shortage of healthcare professionals compounds these infrastructure issues. With approximately 55,000 doctors serving over 200 million people, Nigeria’s doctor-to-patient ratio falls significantly short of the WHO recommendation of one doctor per 600 people. This shortage is further worsened by the migration of skilled professionals seeking better opportunities abroad. In the past five years, about 16,000 doctors have left the country, leaving the sector critically understaffed and straining already overstretched resources.
Funding remains another major obstacle. The government’s allocation for healthcare consistently falls below the recommended 15% of total expenditure, hovering between 5% and 6%. This financial shortfall results in a deficit of essential medical supplies, poor facility maintenance, and delayed salaries for healthcare workers. Corruption and mismanagement further exacerbate these issues, diverting resources away from critical needs and contributing to systemic inefficiencies.
The impact of these challenges is evident in Nigeria’s troubling health indicators, including high rates of infant and maternal mortality, with a maternal mortality ratio of 512 per 100,000 live births and a life expectancy of around 55 years—both figures well below global averages. The prevalence of diseases such as malaria, tuberculosis, and HIV/AIDS continues to challenge public health and overall quality of life.
In response to these pressing challenges, Nigeria has introduced the “National Policy on Health Workforce Migration,” designed to address the critical issues facing the nation’s health human resources. Coordinating Minister of Health and Social Welfare, Prof. Muhammad Pate, has articulated that this policy is not merely a reaction to the exodus of healthcare professionals but a comprehensive strategy to manage, harness, and reverse this trend. The policy aims to foster a thriving healthcare workforce that is well-supported, adequately rewarded, and effectively utilised.
Central to the policy is the establishment of the Nigeria Human Health Resource Programme. This framework will conduct regular reviews of working conditions, particularly for healthcare workers in rural and underserved areas. By enhancing working conditions and offering career development opportunities, the policy seeks to make the healthcare profession more attractive and reduce the impetus for migration. This approach aims to bolster workforce retention and ensure that healthcare professionals receive the recognition and rewards they deserve.
Another critical aspect of the policy is its emphasis on capacity building and continuous professional development. The policy outlines strategic partnerships and international training programs designed to equip healthcare professionals with advanced skills and knowledge. By investing in human capital, the policy intends to enhance the competencies of workers and increase the sector’s appeal.
The policy also recognizes the growing importance of digital health infrastructure, with provisions for implementing Electronic Medical Records (EMR), telehealth services, and a comprehensive Health Workforce Registry. These technological advancements are expected to streamline healthcare delivery, promote equitable distribution of health workers, and ensure high-quality care for Nigerians.
Addressing the brain drain, the policy seeks to facilitate the return and reintegration of health professionals from abroad. Simplified registration processes and attractive incentives are proposed to encourage these professionals to return and contribute their expertise to healthcare. Furthermore, reciprocal agreements with other nations will ensure that the exchange of health workers benefits Nigeria while balancing the interests of both parties.
Work-life balance and support for healthcare professionals are also prioritized in the policy. Provisions for routine health checks, mental well-being support, and reasonable working hours are designed to create a supportive work environment, reduce burnout, and enhance job satisfaction.
In tandem with the workforce policy, President Bola Tinubu has signed an Executive Order aimed at revitalizing the sector by boosting local production. This order eliminates tariffs, excise duties, and value-added tax (VAT) on imported pharmaceutical inputs, including Active Pharmaceutical Ingredients (APIs) and excipients. It will also increase local production of healthcare products such as pharmaceuticals, diagnostics, medical devices, biologicals, and medical textiles. By reducing production costs, the order seeks to make healthcare products more affordable and accessible.
The Executive Order is designed to stimulate local manufacturing of pharmaceuticals, diagnostics, and medical devices. By creating a favorable environment for local manufacturers, the order aims to decrease dependence on imported products, create jobs, and drive economic growth within the healthcare sector. Market-shaping mechanisms such as framework contracts and volume guarantees are introduced to support local manufacturers and ensure a stable market for domestically produced healthcare products.
Successful implementation of this Executive Order will require collaboration among various government ministries, including health, finance, and industry, trade, and investment. Agencies such as the Nigeria Customs Service (NCS), National Agency for Food and Drug Administration and Control (NAFDAC), Standards Organisation of Nigeria (SON), and Federal Inland Revenue Service (FIRS) will play crucial roles in ensuring effective execution.
The introduction of the National Policy on Health Workforce Migration and the Executive Order marks a transformative moment for Nigeria’s healthcare sector. These initiatives, which address workforce migration, invest in technology, reduce production costs, and improve professional well-being, have the potential to significantly enhance the quality and accessibility of healthcare in Nigeria.
However, the success of these reforms hinges on the active participation and collaboration of stakeholders. Government agencies must ensure effective implementation, oversee resource management, and address any challenges. Healthcare professionals should engage with the policy, providing feedback to refine and improve its effectiveness. Private sector entities, including pharmaceutical companies and healthcare providers, must contribute to boosting local manufacturing and improving healthcare delivery. Civil society organizations can advocate for reforms, raise awareness, and ensure that the needs of underserved populations are addressed.
As Nigeria embarks on this ambitious journey of healthcare reform, it is essential for all sectors to work together with dedication and innovation. By fostering a collaborative approach, Nigeria can overcome its challenges and build a healthcare system that reflects the nation’s potential and promise. The path forward requires a shared vision for a healthier future for Nigerians, driven by commitment, innovation, and collective effort.
