About 500 senior Nigerian medical doctors attending Saudi Arabia interviews in Abuja Nigeria
Brain drain also called human capital flight can be defined as the net loss of academic and technological labour force through the migration of human capital to more favourable, developed, economic or professional environments. They are different types of brain drain.
Nigerian medical brain drain
Brain drain (human capital flight) in Nigeria is the flight of middle-class and highly skilled Nigerians which has been occurring in waves since the late 1980s. This trend has further deteriorated in recent times with a rapid surge in the emigration of all cadres of medical doctors in Nigeria to more advanced nations of the world.
The total number of registered doctors in Nigeria according to the Medical and Dental Council of Nigeria is about 74,543 for the country’s population of about 200 million. This puts the doctor-patient ratio in the country at 1:3,500. This is by far below the World Health Organisation’s recommendation of 1 doctor:600 patient.
A significant number of the doctors registered with the Medical and Dental Council of Nigeria are presently not even practising in Nigeria, further impacting negatively on the above-stated doctor-patient ratio.
Nigerian doctors working in foreign countries
Nigerian medical brain drain has lead to the progressive increase in the number of qualified Nigerian medical doctors working in other countries.
About 8,737 Nigerian trained doctors are currently practising in the United Kingdom, consequently, Nigeria is one of the highest exporters of medical expertise to the UK.
In the United States, the number of Nigeran trained doctors practising in the USA is more than 4000.
In Trinidad and Tobago, there are about 344 Nigerian doctors registered with their medical board, 235 out of these doctors were trained in Nigerian universities.
Other popular destinations for Nigeria-trained doctors include Canada, Qatar, Saudi Arabia and Australia.
Recently over 500 doctors turned up in Abuja for a recruitment exercise by the Saudi health ministry organised to pick the best skilled and knowledgable Nigerian doctors for work in Saudi Arabia.
Causes of medical brain drain in Nigeria
They are different causes of brain drain in Nigeria however brain drain of doctors in Nigeria can be attributed to a whole lot of issues
1. Poor remuneration.
2. Poor working conditions.
3. Poor funding of the health sector, leading to frequent strikes.
4. Lack of social amenities.
5. Political instability.
6. Improved quality of life
Poor remuneration
This is one of the major contributing factors associated with the brain drain of doctors in Nigeria. There is generally a poor salary structure for most civil and public servants in Nigeria. The present minimum wage in Nigerian is N30,000 ($60) per month and the constant devaluation of Naira has not helped issues as the value of the money people receive as salaries continue to depreciate.
The Nigerian doctor is not spared from the dwindling economic situation. The present hazard allowance of all cadres of medical doctors in Nigeria and other health professionals is a paltry sum of N5000.
Aside from the poor pay packages, the actual payment of salaries is often irregular in some parts of the country. In some states of Nigeria, medical doctors are owned between 6 and 19 months salaries. Delayed salaries were reported in Abia state, Plateau State and Kogi State among others.
Even with the ongoing covid 19 pandemics and the attendant loss of life of health care professionals who contracted the virus while attending to covid 19 patients, the Nigerian Government has not been able to review the current hazard allowance of doctors and other health personnel.
In addition to the issue of poor wages, the Nigerian government has no functional health insurance for its medical personnel.
Considering the poor remuneration of the Nigerian doctors, one should not be surprised that these health professionals are seeking better employment opportunities in other countries.
Poor working condition
The working condition in Nigeria is generally poor with most federal and state-owned hospitals in dilapidated states. Their hospital wards, consulting rooms, offices and patient waiting area are in very poor conditions.
In addition to the above, the government and hospital managements are unable to provide a steady power supply to these hospitals, meaning that patients are attended to in very unconducive environments and when patients are admitted they are even exposed to more hardship throughout their stay in the hospital.
Doctors and other medical personnel will prefer working in better working conditions abroad, also the patients who have the means will prefer to patronize foreign-based hospitals where they can get the best service delivery.
Poor funding of the Nigerian health sector
This is also one of the main reasons that result in the brain drain of doctors in Nigeria. The Nigerian health sector is very poorly funded, with less than 5% of the Nigeria annual budget allocated to health.
The direct consequences of poor funding of the health sector are the poor hospital infrastructures, obsolete equipment, frequent industrial disharmony and understaffing of the hospitals.
Obsolete hospital equipment reduces the ability of the doctors to carry out their job effectively with poor job satisfaction, also because of understaffing of the hospital and ongoing brain drain in Nigeria the doctors are overworked and stressed out without any commensurate compensation.
The residency programme for medical doctors in specialist training is meant to be a sponsored programme, however, in Nigeria, this is not so, as these doctors largely sponsor themselves through the programme with their meagre salary with little or no sponsorship from the state and federal government.
Currently, the Nigerian Association of Resident doctors have been on strike for about two months over issues concerning poor policies and the welfare of their members. The government response to their demand was to stop their salary and taking the Nigerian Association of Residents Doctors to the National industrial court.
The difficulties associated with poor funding of the Nigerian health sector worsens the brain drain of doctors in Nigeria because these doctors end up migrating to other developed countries in search of better job satisfaction, a good working environment and carrier progression.
Lack of social amenities
In most parts of Nigeria, basic amenities such as clean water supply, electricity, good schools and good roads are still largely not available. This is further complicated by the high rate of insecurity in Nigeria with the recurrent incidence of armed robbery, kidnappings and murder.
These factors make Nigeria very unsafe and unconducive for all citizens which will lead to brain drain in Nigeria, as the citizens will migrate to other countries once the opportunity presents.
Political instability
Political instability is another cause of brain drain in Nigeria. The Nigerian political system is one of the most expensive to maintain as Nigerian politicians go home with very mega salaries and allowance to the detriment of the masses.
A situation where a senator in Nigeria earns about 35 million Naira per month minus other accrued allowances and politicians enrich themselves maximally unchecked at the detriment of the masses, leaves most Nigerians with no option than to seek a better quality of life in other countries. This further increases the rate of Nigerian medical brain drain.
Improved quality of life
The summary of the reasons while highly educated Nigerians are migrating to other climes in search of better remuneration and other things is simply to improve their standard of living and quality of life.
The decay in the system affects all Nigerians, even the medical personnel also suffer from the unattended issues of the health sector, consequently, they too migrate to countries where medical service and other services are optimal.
Effects of Nigerian medical brain drain
The rate of Nigerian medical brain drain is rapidly increasing. However, Nigeria has one of the worst health indices in the world and has the second-highest population of people living with HIV.
Nigeria also has the largest number of deaths from malaria and is still one of the countries with a high maternal mortality rate.
Effects of brain drain of doctors in Nigeria include
1. Decrease in the number of medical doctors.
2. Increase in death rate.
3. Loss of income.
4. Poor economic development.
Decrease in the number of medical doctors
The direct mathematical effect of Nigerian medical brain drain is the net decrease in the number of qualified medical doctors in the country. This will result in reduced medical manpower in the health institutions, increased patient waiting time, increased patient load per doctor and reduced efficiency of medical service delivery.
Increase in the death rate
This is an expected end result of the brain drain of doctors in Nigeria. The progressive export of Nigerian medical expertise to other developed nations will result in a continuous decline of the health indices in Nigeria. This will mean an increase in gross mortality rates in Nigeria.
Loss of income
Nigerian medical brain drain will naturally result in the loss of tax paid by the migrating Nigerian trained medical doctors. Also, the ability of the hospitals to generate income from the delivery of medical services will be grossly reduced.
The Nigerian government subsidization of undergraduate and postgraduate medical training is quite poor, however, there is a net loss of funds used to train these professionals when they migrate to other countries after their undergraduate or postgraduate training.
The loss of spending power of the emigrating Nigerian doctors also leads to loss of income. As money earned by these professionals are spent in other countries.
A significant amount of money is also lost to medical tourism because the rich and middle-class Nigerians have lost faith in the dilapidated Nigerian health sector, consequently, there is a huge sum of money spent by Nigerians seeking international health services.
The President of Nigeria General (retd.) Muhammadu Buhari and other wealthy Nigerian politicians frequently seek medical care outside the country.
Poor economic development
The educated, skilled and talented individuals in a country are one of the most significant contributors to growth and development. However, when these categories of people migrate to other countries, the country of origin is left with only the untalented, unskilled and unintelligent people. This will negatively impact economic development.
Aside from the paucity of medical practitioners caused by brain drain in Nigeria, other sectors in Nigeria are also affected. A typical example is the immigration of a talented Nigerian youth Ignatius Asabor who makes special drones using local materials. He was flown to Finland by a Finnish company and employed by the same company.
Solutions to Nigerian medical brain drain
To reverse the brain drain of Nigerian doctors the following things when done might potentially help.
1. Improved remunerations
2. Improved funding of the health sector
3. Improved subsidization and funding of the residency training programme
3. Provision of basic amenities
4. Favourable and reasonable government policies
Conclusion
From the above discussion, it is clear that the brain drain of doctors in Nigeria is rapidly accelerating. The effect will lead to a progressive decline in Nigerian health indices. The Nigerian government has not taken any sustained active effort to reverse the brain drain of Nigerian doctors.
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