Not too long ago, President Bola Tinubu accredited a Nationwide Coverage on Well being Workforce Migration to handle the exodus overseas of expert Nigerian healthcare professionals.
As introduced by the Coordinating Minister of Well being and Social Welfare, Muhammad Pate, the 56-page doc presents the nationwide plan to handle the dynamics of well being employees’ migration, guaranteeing that it doesn’t compromise the wants of the nation’s healthcare system.
Mr Pate described the coverage as a serious a part of Nigeria’s efforts to handle the present well being disaster whereas selling collaboration with crucial stakeholders at nationwide and worldwide ranges.
Ranked among the many 37 nations with crucial well being workforce shortages within the 2023 WHO Well being Workforce Assist and Safeguards record, Nigeria has been battling the rising exodus of its skilled professionals.
Nevertheless, via this coverage, the federal government seeks to handle the basic issues of well being workforce scarcity in Nigeria, significantly in rural and underserved areas.
The coverage outlines new initiatives reminiscent of bilateral agreements and memorandums of understanding (MoU) between the Nigerian authorities and key overseas locations of Nigerian well being employees.
It stipulates the institution of coaching, alternatives for profession growth, incentives and a conducive work surroundings.
Article Web page with Monetary Assist Promotion
Additionally, the coverage introduces the creation of a digital registry for migrants within the system, cross-border data-collection on Nigerian well being employees, moral recruitments, analysis, innovation and equitable distribution of healthcare suppliers throughout the nation.
This evaluation supplies a breakdown of those rising initiatives, and what impacts they could have on the sector and the nation.
Developments of migration amongst Nigeria well being employees
Nigeria’s well being minister lately revealed that about 67 per cent of Nigerian medical doctors migrating overseas apply in the UK and the nation now has solely 55,000 licensed medical doctors to serve its rising inhabitants of over 200 million.
With 0.363 medical medical doctors per 1,000 folks, far beneath the WHO suggestion of 4.45 per 1,000 inhabitants, Nigeria has continued to lose much more and the uneven distribution within the ratio of medical doctors to inhabitants is worsening.
The doctor-to-population ratio in Abuja is 4.7 per 10,000 inhabitants and in Lagos, 4.6 per 10,000 inhabitants.
Between 2008 and 2021, 36,467 Nigerian medical doctors migrated to the UK, a gentle improve from 1,798 in 2008 to 4,880 in 2021.
A bigger development was noticed for nurses. Between 2002 and 2021, 60,729 Nigerian nurses migrated to the UK. There was a constant improve from 1,393 nurses that migrated in 2002, to five,543 in 2021.
Highlighting the development of migration amongst Nigerian well being employees within the coverage, knowledge introduced reveals that 2022 represents the height of migration of medical medical doctors as over 3,000 medical doctors requested letters of fine standing from the Medical and Dental Council of Nigeria (MDCN).
The UK is the vacation spot for 68 per cent of Nigeria’s medical and dental professionals who migrated out of Nigeria via MDCN.
Different locations are Canada (10 per cent), USA (seven per cent), UAE (5 per cent), Australia (three per cent), Eire (three per cent), Saudi Arabia (one per cent) and Maldives (one per cent)
Proposed MoU
One of many new measures being adopted within the coverage is the institution of a Memorandum of Understanding (MoU) with the USA, UK, Australia, and different key vacation spot nations of Nigerian well being employees to align with the WHO International Code of Observe on the Worldwide Recruitment of Well being Personnel.
The coverage stipulates that there ought to be a longtime bilateral or multilateral settlement between Nigeria and overseas businesses attempting to recruit well being employees within the nation.
These agreements would be the foundation on which a overseas recruitment company can interact a physician, nurse, and each different member of the healthcare workforce.
The brand new growth implies that the federal government is focusing on a extra structured and managed course of for migration and the recruitment of healthcare employees by different nations, “guaranteeing that it’s carried out in a way that aligns with the nation’s pursuits.”
Whereas it states that the federal government doesn’t intend to ban healthcare employees from leaving randomly, the method might restrict the movement of well being employees to different nations, because it seeks to make sure that it occurs underneath agreed phrases relatively than haphazardly.
In response, the Nationwide President of the Nigeria Medical Affiliation (NMA), Bala Audu, mentioned the MoU thought is an effective initiative to handle the migration of well being employees, if correctly applied.
Mr Audu instructed PREMIUM TIMES that vacation spot nations are anticipated to make sure commitments earlier than taking Nigerian-trained well being employees to serve their well being wants.
“From my understanding of the bilateral settlement, it isn’t dangerous. It’s for nations who come to our nation to draw our expert medical doctors to have commitments they make.
“The best way it seems, you need to give one thing again in return when you come to take our professionals,” he mentioned.
There have been efforts by the Nigerian authorities previously to manage well being employees migration however the circumstances have been rejected.
Final 12 months, the Home of Representatives proposed a invoice to mandate Nigeria-trained well being employees to practise in Nigeria for at least 5 years earlier than they’re granted full licenses or journey overseas.
The invoice, which handed a second studying, generated heated debates as medical doctors threatened to down instruments, vowing to withstand any guise to “enslave” Nigerian medical medical doctors.
Incentives for well being employees
That is the primary thematic space of the coverage which mandates the supply of “particular incentives” for well being employees within the nation, particularly for individuals who select to serve in rural and disadvantaged elements of the nation.
It affirmed that the federal government ought to create easy accessibility to particular credit score services, tax holidays and modalities for particular mortgage services for healthcare employees to simply personal homes, automobiles, and different important belongings.
The coverage stipulates a periodic evaluate of healthcare employees’ salaries, advantages, pensions and allowances, and the supply of enough gear and provides.
It additionally mandates well being businesses to spend money on digital well being infrastructure (telehealth) within the Nigerian well being system and the event of a “return-to-practice” programme with particular incentives for well being employees who wish to return to Nigeria.
Through the years, well being professionals in Nigeria have complained of low wages and non-payment of their hazard allowances, amongst others, which has led to industrial actions on quite a few events.
In his remarks on the incentives, the NMA President mentioned Nigeria’s effort in direction of curbing mind drain “relies upon largely on how successfully the incentives are applied.”
“On our personal aspect, as leaders within the healthcare business, we will probably be reviewing the coverage and if there are extra areas we imagine will enhance the retention of well being employees and different suppliers, we can even dialogue with the federal government to extend the world of incentive which they could haven’t been included within the present coverage,” he mentioned.
Additionally chatting with PREMIUM TIMES, the Vice President of the Nationwide Affiliation of Resident Medical doctors (NARD), Kefas Wida, mentioned remuneration is the main purpose well being employees are migrating and that for Nigeria to retain its workforce, “it must adequately handle the modalities for incentives highlighted within the coverage.”
Mr Wida famous that with out implementation, the federal government can not cease anybody from migrating, “even when they make the method tough and tedious with too many bureaucratic processes.”
“Persons are on the lookout for higher remuneration. Something we’re doing that’s in need of addressing points round this, we’re beating across the bush. This coverage is an effective one and it’s a step in the suitable course. However we should handle the primary crux of the workforce migration, significantly by enough remuneration,” he mentioned.
On well being employees’ security, safety
As Nigeria grapples with armed conflicts reminiscent of terrorism and banditry, many well being employees have been attacked, kidnapped, killed or displaced from their properties.
Not too long ago, the Nigerian Affiliation of Residents Medical doctors (NARD) threatened to down instruments if the federal government did not safe the discharge of Ganiyat Popoola, a resident physician on the Nationwide Eye Centre in Kaduna kidnapped in December 2023.
The Safeguarding Well being in Battle Coalition (SHCC) recognized 19 incidents of violence towards well being employees in Nigeria in 2023, and 43 incidents in 2022, in comparison with 56 in 2021, through which 37 well being employees had been kidnapped, seven others had been killed, and well being provides had been looted from pharmacies and well being centres.
SHCC reported that between 2016 and 2020, there have been 4,094 reported assaults and threats towards healthcare in battle areas internationally. Throughout this era, not less than 1,524 well being employees had been injured, 681 had been killed, and 401 had been kidnapped.
Nevertheless, the federal government, via this coverage, seeks to reinforce and make sure the security of well being employees serving in any respect ranges of the Nigerian healthcare system.
The coverage mandates the supply of enough safety in well being services for the safety of the well being workforce throughout the board.
Job for returnees, knowledge assortment
Not like the present regulation that stops returnees from reclaiming their earlier positions by banning go away of absence for well being professionals transferring overseas, the brand new migration coverage permits employees to be rehired in the event that they return to the nation inside a set interval.
Additionally, the brand new coverage mandates that the prevailing Public Service Guidelines assure the suitable of return for well being employees beforehand employed by the federal government.
This coverage permits for rehiring returning well being employees, however inside a specified timeframe. Because of this if employees miss this window, they could face difficulties regaining employment, inflicting job insecurity.
The federal government, via the coverage, additionally calls for routine cross-border knowledge sharing relating to the licensing and efficiency of employees migrating to overseas nations which it says ought to be carried out “on a quarterly foundation.”
The coverage recommends that: “The Federal Ministry of Well being should usually report on the traits, patterns, and impression of well being workforce migration in Nigeria.
“The report will disclose vacancies, remittances from migrant well being employees, and the circumstances of Nigerian well being employees of their vacation spot nations.”
Whereas this portends to be useful to the nation and likewise migrating healthcare suppliers, routine knowledge sharing and reporting may add layers of forms, probably complicating the method for well being employees in search of emigrate or return.
The Nigerian authorities will reintroduce the one-year overseas coaching programme, in line with the brand new coverage.
Capability growth, coaching programmes
Not like India and the Philippines, Nigeria lacks a managed migration system and a strong system to coach healthcare employees to satisfy home and world calls for.
Figuring out this deficit, the Nigerian authorities, via this coverage, seeks to enhance coaching and recruitment programmes for well being employees to handle the scenario and contribute to progress in direction of the Sustainable Growth Targets (SDGs) particularly on well being.
The coverage mandates rising the capability of well being establishments and strengthening the well being workforce for “each native and worldwide wants.”
It additionally stipulates that the federal government should be certain that current well being employees obtain post-graduate diploma coaching and the institution of extra well being coaching establishments to supply extra healthcare professionals of “enough high quality and amount.”
Presently, there are 400 nursing coaching establishments, 139 accredited Medical Laboratory Science (MLS) coaching establishments and 37 totally accredited medical colleges.
Monitoring, implementation
Monitoring and analysis is one other thematic space highlighted within the coverage to institute an evidence-based well being workforce migration data system.
This mandates the inclusion of well being workforce migration knowledge in all related nationwide surveys, together with the Nigeria Demographic and Well being Survey (NDHS) and facilitates cross-border knowledge sharing on well being workforce migration.
Total, the federal, state and native governments are anticipated to develop acceptable methods, plans and tips to facilitate the implementation of the coverage, whereas noting that civil society organisations will monitor the implementation and supply suggestions to the federal government on the successes, challenges and options.
In the meantime, Mr Audu famous in his remark that the NMA plans to satisfy with the federal government to debate the coverage and implementation modalities.
“I imagine we’re going to sit with people who have common this coverage, to barter in such a manner that the conclusion will appease those that selected to stay in Nigeria and doubtless appeal to whoever has left to come back again.
“Implementation is sacrosanct for the coverage to have its desired impression,” he instructed PREMIUM TIMES.
Assist PREMIUM TIMES’ journalism of integrity and credibility
At Premium Occasions, we firmly imagine within the significance of high-quality journalism. Recognizing that not everybody can afford pricey information subscriptions, we’re devoted to delivering meticulously researched, fact-checked information that continues to be freely accessible to all.
Whether or not you flip to Premium Occasions for every day updates, in-depth investigations into urgent nationwide points, or entertaining trending tales, we worth your readership.
It’s important to acknowledge that information manufacturing incurs bills, and we take satisfaction in by no means inserting our tales behind a prohibitive paywall.
Would you contemplate supporting us with a modest contribution on a month-to-month foundation to assist keep our dedication to free, accessible information?
Make Contribution
TEXT AD: Name Willie – +2348098788999
