By Oghenemaro Eruteyan

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Brain drain has over time become a trending phenomenon in Nigeria as Nigerian youths, workers and even healthcare professionals have continued to flee to more developed countries in search of greener pasture and better working conditions.

 Before the pandemic, the Nigerian health sector was faced with poor funding, poor remuneration, and poor working conditions. However, the emergence of the COVID-19 pandemic has further worsened those challenges and has created an atmosphere where Nigerian healthcare workers are further dissatisfied with their condition of service.

This has negatively affected healthcare delivery and medical education in Nigeria; hence, the need for urgent attention.

The reasons for mass exodus of Nigerian youths, workers, and healthcare professionals have been broadly classified into “push and pull” factors. The pull factors are the incentives and positive structures available in developed countries which assure better opportunities, whereas, the push factors are negative conditions in developing countries including escalating security challenges and harsh economic realities.

 The health sector has greatly been faced with the issue of shortage of professional doctors as a lot of them have moved overseas. The Nigerian hospitals now have fewer doctors to attend to patients, which implies a greater workload (pressure) for available ones.

Recently, there was a case of Dr Michael Umoh who died in the church after working for 72 hours at the health facility (Neurosurgery) in the Lagos University Teaching Hospital (LUTH). Reports have it that he had been engaged in numerous surgeries and other activities and as he got to church the following morning he slumped and died as a result of exhaustion.

 Migration wave on the other hand has infiltrated into the Nursing profession as unfortunately, the pandemic further strained the already fragile Nigerian healthcare system, resulting in serious negative impacts on its workforce.

Studies have further shown that over 5,000 nurses and midwives worldwide lost their lives during the 2020 COVID-19 pandemic, The National Association of Nigerian Nurses and Midwives (NANNM) reported that over 11,000 nurses migrated from Nigeria to developed countries thus, Nigeria witnessed shortage of nurses.

 The most protruding effect of professional nurses and midwives migration is evident in low quality of healthcare treatment given to patients, as certified and skilled nurses are no longer available giving way for quacks (auxiliary nurses) with less experience and professionalism in the field.

One of Nigerian’s late singers, Ilerioluwa Aloba, popularly known as Mohbad might have met his untimely death following an injection administered on him by an unqualified individual performing medical role as a nurse which was substantiated by the National Association of Nigerian Nurses and Midwives (NANNM).

The recent statistics on the migration of healthcare professionals from Nigeria to other countries is worrisome.  For instance, the UK immigration report in 2022 put the number of Nigerian healthcare professionals granted working visas in the UK in 2021 at 13,609. Also, between December 2021 and May 2022, a total of 727 Nigerian-trained medical doctors relocated to the UK. While the UK is one of the top destinations, Nigerian healthcare professionals emigrate to Canada, US, Saudi Arabia, Australia, and other developed countries.

Nurses and other healthcare practitioners have discussed the implications and possible solutions to the escalating and statistics factors responsible for this occurrence.

 Speaking with The Hope, Rhuno, a nurse at Eku Baptist Hospital, Delta state reiterated that in Nigeria, Nurses continue to migrate daily to countries beyond to seek for  greener pastures due to unfavourable economic, educational and governmental policies.

 Her words: “Nurses who have studied hard to be certificated with millions of naira are poorly paid.  They would rather opt to be employed in other parts of the world where their services and worth is appreciated”.

 She explained that this imply that, there would be a huge decrease in experienced healthcare professionals giving room for people with less educational background/training, which will result in low quality of care and treatment given to patients.

 She further suggested that the government should ensure that the standard of living is more favourable to nurses, invest in health technology, fix infrastructure, tackle insecurity, improve healthcare financing mechanisms.

 Another expert, Bose Olaoye, a nurse at Police Hospital, Akure also discussed the implications, causes and preferable solutions to brain drain.

 To her, the major effect is that the masses will suffer from poor healthcare services and as a result, cause delays in accessing proper healthcare services.

 She noted that unemployment, poor governmental policies, work overload, poor equipment, working conditions and high cost of living are the causes of brain drain.

She advised that the “Government should increase the wages/salaries for nurses to encourage them remain in the country, and they should also train more personnel and make it a necessity to recruit more nurses to cure palpable shortage and brain drain migration of nurses.”

The Deputy Director of Nursing Services at the Ministry of Health, Ondo state.

Mrs Ali has said that the outburst of brain drain migration in the nursing profession and the effect felt was after COVID. “Many nurses died as a result of COVID-19 and this opened way for nurses in Africa to migrate to USA and UK this is because the World Health Organisation (WHO) has a standard ratio of nurses to cater for patients”. She said. 

She opined that poor remuneration, poor working conditions, lack of modern equipment and self-actualisation are the reasons for nurses migrating.

She stated that the Ondo State Government, led by the Governor- Arakunrin Odunayo Oluwarotimi Akeredolu has approved a two-year programme where Community Nursing and Community Midwifery are specially trained to cater for the people in the community. This is one of the administrative efforts to bridge the gap of Brain drain.

Fagbemi, an Epidemiologist with the Ondo State Ministry of Health has said that brain drain is not a recent phenomenon but, it has escalated exponentially as healthcare professionals continue to emigrate. 

He added that the pull factors are; easier access to employment, good pay, technological and scientific advancement, organised economic tools, research and programmes/training. The push factors like poor working conditions(packages), poorly equipped health facilities in both hard and software resulting in patient deaths, poor working environment, shortage of human resources leading to increased workload are the two factors responsible for brain drain.

He noted that immigration in the health sector implies that there would be shortage of health workers, task shift, and increased, mortality rate.

Dr Faruk Abubakar, Registrar/Chief Executive Officer of the Nursing and Midwifery Council of Nigeria, has assured Nigerians that work is ongoing to curtail brain drain migration in the health sector while speaking at the 2023 Annual General Meeting/Scientific Conference of the National Association of Nigeria Nurses and Midwives (NANNM), Federal Capital Territory (FCT) chapter Abuja with the theme ‘Our Nurses, Our Future.’

 To stem this tide, there is a need for the government at all levels to prioritise this menace on the political agenda and work in conjunction with healthcare institutions, administrators, other leaders and stakeholders within the health sector to promote and improve welfare, working conditions, job security and satisfaction among healthcare workers as no other category of workers is so essential to the well-being of the people.

Eruteyan is a Corps member serving with The Hope