Nigeria is sure to witness an impending doomsday sooner than later if the Federal government fails to take definite and decisive steps to arrest the current parlous state of the nation’s medical system.
Association of Medical Doctors (ARD), which dropped the warning, cited how Nigeria currently boasts of just 55,000 doctors to serve a population of more than 220 million people, warning that with the current paucity in its healthcare system, an impending doomsday was only a matter of time.
The doctors, who raised the alarm at the Ordinary General Meeting and Scientific Conference of the association, held at the Federal Neuropsychiatric Hospital (FNPH), Yaba, Lagos, the doctors, among whom were mental health experts, also said the present situation was worsening access to psychiatric care and leaving millions of vulnerable Nigerians untreated.
Citing no fewer than 16,000 Nigerian doctors, who have emigrated in the last five years, had worsened an already dire manpower shortage in the country’s health sector, they warned that the sustained exodus of healthcare workers under the “Japa” syndrome had severely depleted the country’s mental health workforce, widened treatment gaps, increased the cost of care and placed enormous pressure on the few specialists remaining in the system.
Vanguard quoted Omoti Ernest, President of Nigerian Medical Association (NMA), as saying that recent data showed that the Medical and Dental Council of Nigeria (MDCN), had registered over 130,000 doctors but noted only about 55,000 are actively practicing within Nigeria.
Stressing that with a population exceeding 220 million, this translated to roughly one doctor for every 3,600 to 4,000 people, he added: “This ratio is far below the World Health Organisation’s recommended threshold of one doctor to about 600 people, highlighting the significant shortage of medical personnel and the strain on healthcare delivery.
“Many Nigerian-trained doctors have emigrated or are no longer engaged in active clinical practice, contributing to the country’s healthcare workforce shortage. The emigration of skilled professionals in search of better opportunities abroad has had a significant impact on Nigeria’s hospitals and healthcare workforce.
“Thousands of doctors and other healthcare professionals have left the country in recent years, leading to severe staff shortages, increased workload for those who remain with many suffering from burnout, longer waiting times for patients, and declining quality of care in many public hospitals.
“Rural and under-served communities have been particularly affected, as they already struggle with limited access to healthcare services. ’The reasons behind this migration include poor remuneration, inadequate working conditions, insecurity, limited opportunities for career advancement, and insufficient investment in healthcare infrastructure, among others.
“Many professionals are attracted by better pay, improved facilities, and more stable environments in countries such as the United Kingdom, Canada, and the United States.”
‘What can be done’
To address the trend, he said the Federal Government should prioritise salaries and welfare packages for healthcare workers, invest more in modern medical equipment and hospital infrastructure, expand residency and specialist training opportunities, and create clear career progression pathways.
“Strengthening security, ensuring timely payment of wages, and providing incentives for professionals to work in under-served areas will also help retain talent. ’In addition, partnerships with the private sector and diaspora engagement programmes could encourage Nigerian healthcare professionals abroad to contribute their expertise and support development of the country’s healthcare system.”
Yesir Kareem, a Consultant Psychiatrist at the Neuropsychiatric Hospital, Aro, also lamented how Nigeria’s doctor-to-patient ratio had fallen to about one doctor for more than 10,000 patients, far below the World Health Organisation’s recommended ratio of one doctor to 600 people.
The consequences, he argued were particularly devastating for mental healthcare, he said, adding: Only about 55,000 doctors remain to serve a population of over 220 million Nigerians. More than 40 million Nigerians suffer from mental health disorders, yet about 85 per cent of them do not have access to mental healthcare services,” Kareem said.
He noted that Nigeria’s shortage of psychiatrists and other mental health specialists has reached alarming levels, warning that untreated mental illnesses contribute to family breakdowns, substance abuse, unemployment, delayed diagnosis and premature deaths.
“The economic consequences are equally devastating, with billions of dollars lost annually due to untreated mental health conditions. Over 94,000 doctors and nurses have left Nigeria since the Japa syndrome started some years ago due to poor remuneration and delayed salaries, competitive salaries in destination countries, overwhelming patient loads (1:10,000+), better work-life balance and conditions, and inadequate medical equipment & facilities.
He listed access to modern medical technology, limited career advancement opportunities, professional development and training, unsafe working conditions and long hours, unstable political and economic environment and insecurity and socioeconomic instability as factors encouraging migration of doctors from the country.
Vanguard, also quoted Veronica Nyamali, President of the Association of Psychiatrists in Nigeria (APN) as saying that the manpower shortage was a crisis that had forced consultants to abandon higher-level responsibilities, such as research and specialist care, in order to fill gaps left by departing doctors.
She said: “There are gaps everywhere. Work that should be done by four psychiatrists is now being handled by one or two people. Consultants are increasingly forced to work at lower levels because the doctors they are supposed to supervise are no longer there.
“Those we train are leaving. Junior registrars, senior registrars, many complete their examinations and return abroad. The result is that we have shortages at every level of care. Nigeria has less than 150 psychiatrists. The dwindling number of specialists is making mental healthcare increasingly expensive and inaccessible, especially for patients in rural communities where psychiatrists are virtually non-existent.
“When specialists become scarce, services become more expensive. Access becomes difficult because patients must travel long distances to find care. This is contrary to the principle of universal health coverage, where mental health services should be available, affordable and accessible to everyone.