THE row and protests over the verification of nurses’ certificates by the regulatory body is a symptom of the deep troubles afflicting Nigeria’s health system. Claiming that a new rule by the Nursing and Midwifery Council of Nigeria to delay the vetting of their documents by 24 months is an attempt to abort their emigration to greener pastures, the nurses have been protesting virtually and physically over the past two weeks. Although Nigeria is short of medical practitioners, including nurses, the nurses should not bear the brunt of the collective failings of Nigeria’s health system alone.
Recently, the NMCN stipulated that nurses seeking application and verification from international nursing boards must have garnered two years post-qualification experience after the issuance of the permanent practice licence. With many nurses desirous of escaping the toxic system at home, this instigated protests by the National Association of Nurses and Midwives members in Lagos and Abuja soon after.
Without stating it, the intention of the circular might be to stem the tide of emigration and retain the services of nurses for a longer period without placing ample priority on their welfare, and remuneration. The law is draconian. At best, it can only reprieve Nigeria temporarily but cannot salvage the decayed system that has stymied general medical practice in the country. The Minister of Health, Ali Pate, a seasoned public health professional, must intervene.
Also, the Ministry of Health must tinker with strategies that will incentivise nurses and midwives to work in federal, state, and local government hospitals. The current system discourages nurses, provokes resentment, and pushes them to search for rewarding careers abroad.
Undoubtedly, the Nigerian health system is dire, and the mass exodus of its personnel is symptomatic of the years of decay, lack of investment by governments, and bad human capital management. As far back as 1983, ex-Head of State, Sani Abacha, had described the hospitals as “mere consulting clinics.” They have not improved today.
Doctors, nurses, and other medical personnel complain bitterly about poor wages and shabby work conditions. Some states owe backlog of salaries. The outcome is that many are relocating abroad. The NMCN Registrar, Faruk Abubakar, said that over 15,000 nurses and midwives left the country in 2023 to seek greener pastures. Abubakar stated that nurses earn N135,000 monthly on the average.
This is compounded by the debilitating economic policies of the petrol subsidy removal and merger of the naira rates by the Bola Tinubu administration, which has plunged Nigerians, including medical professionals, into gnawing hardship.
Meanwhile, personnel-to-patient ratio has exponentially increased, leading to unmitigated work stress, while infrastructure is mainly absent. Against the backdrop of the World Health Organisation’s doctor-patient ratio (1:500), Nigeria has a 1:10,000 ratio, and 1:1,160 for nurses, as against global standard of 1:5.
Alarmingly, the cost of drugs is out of the reach of the common man while the elite, including presidents and public officials, take refuge in medical tourism. The Central Bank of Nigeria Governor, Olayemi Cardoso, said that Nigerians spent $11.01 billion on medical tourism between 2010 and 2020.
The immediate past president, Muhammadu Buhari, was notorious for embarking on medical trips to the United Kingdom. The late President Umaru Yar’Adua treated himself in German and Saudi Arabia hospitals. Unfortunately, Tinubu is reportedly going for treatment in France.
Therefore, the mass exodus of nurses is not due to a lack of patriotism, it is simply in tandem with free market forces; labour will migrate to the countries where the best remuneration and welfare are prioritised.
Government should not stop nurses and other medical personnel from enhancing their careers through overseas practice, it should rather create an enabling environment for them to thrive at home.
