Africa’s healthcare systems are at a turning point. The continent’s fast-growing population and rising disease burden have placed unprecedented pressure on already overstretched health systems. At the same time, the migration of skilled healthcare workers has accelerated, raising urgent questions about sustainability, equity, and long-term development.
Few professionals understand these dynamics better than Oluwaseun Badru, a Nigerian global health specialist whose work spans community health, health systems research, and program implementation across Africa and the United States. Through his involvement in HIV prevention, health workforce migration studies, and digital health interventions, Badru has contributed to conversations that sit at the intersection of public health, economics, and policy.
In this interview with BusinessDay, he discusses the structural forces behind Africa’s health workforce crisis, the opportunities for reform, and what must change to make Nigeria’s healthcare system more resilient.
Your research and field experience focus on the migration of African healthcare workers. Why does this issue remain so critical?
The urgency comes from what migration means for health systems at their core. When we talk about migration, we often focus on individual stories, a doctor leaving for the UK or a nurse relocating to Canada. But the deeper issue is structural. Every time a skilled professional leaves, we lose clinical expertise, institutional knowledge, and mentorship capacity. It’s a silent erosion of system resilience.
In the past decade, Africa has seen record numbers of healthcare workers migrate to Europe and North America. The challenge isn’t migration itself; it’s that we’re not managing it strategically. My work examines why professionals leave, how economic and governance realities shape those decisions, and what mechanisms could make migration more mutually beneficial for both individuals and the countries they leave behind.
From your perspective, what are the major push and pull factors driving Nigerian health professionals abroad?
There are both systemic and personal drivers. On the systemic side, we have weak health infrastructure, limited career progression, and salaries that don’t reflect the intensity of the work. Many professionals feel unsupported and undervalued. On the personal side, it’s about exposure and fulfillment. Professionals want access to continuous training, modern facilities, and the dignity that comes with practicing in an enabling environment.
It’s not always about higher pay but also about opportunity. A pharmacist or laboratory scientist in Lagos may simply want the tools and mentorship to reach their full potential. When those conditions aren’t available, migration becomes the only viable path for growth.
What kind of impact does this exodus have on Nigeria’s healthcare delivery system?
The impact is profound. The World Health Organization (WHO) estimates that Nigeria has fewer than 40,000 practising doctors for a population of over 200 million people, far below the recommended ratio. The same applies to nurses, midwives, laboratory personnel, and physiotherapists. When you lose skilled workers, you’re not just losing numbers; you’re losing quality, innovation, and continuity.
The consequences are visible in overstretched hospitals, increased waiting times, and burnout among the professionals who remain. Over time, these conditions discourage new entrants and perpetuate the cycle. Without intentional investment in retention and workforce planning, even the best policy reforms will fall short.
You’ve used the term “strategic migration management.” What does that look like in practice?
It means moving away from reactive policymaking. Migration is not something that can or should be stopped, but it can be managed. Other countries have found ways to turn migration into a development tool. The Philippines, for instance, has formal frameworks that allow healthcare professionals to work abroad while contributing to their home system through structured remittances, periodic service rotations, and skills transfer programs.
Nigeria can adopt similar models. That would mean building agreements between ministries of health, education, and labour, and creating partnerships that link diaspora professionals to local health institutions. Remote mentorship programs, telemedicine collaborations, and diaspora-led research initiatives are practical ways to bridge that gap.
Some argue that migration benefits sending countries through remittances and global exposure. What’s your take?
Migration has both costs and benefits. Remittances are a huge part of Nigeria’s economy, with over $20 billion remitted annually according to the World Bank’s 2022 Migration and Remittances Report. Many of those funds support families, education, and even healthcare infrastructure. But we can’t rely on individual contributions alone. The key is turning these personal efforts into structured national strategies — for instance, diaspora investment funds dedicated to healthcare, or tax incentives for diaspora professionals who collaborate with local institutions. Migration becomes an asset when it’s organized around long-term goals, not short-term fixes.
You’ve highlighted gender as an often-overlooked dimension of this issue. What have you observed?
Women form the backbone of Africa’s health systems, especially in nursing and midwifery but they face unique challenges, from limited career advancement to workplace discrimination and safety concerns. For many women, migration becomes a pathway to empowerment. The downside is that when they leave, we lose mentorship and leadership capacity at home.
Retention strategies must be gender-responsive. Equal pay, maternity protection, and leadership training for women in healthcare are not just fairness issues; they’re system-strengthening measures.
Having worked in both Nigeria and internationally, what lessons stand out for African policymakers?
The most critical lesson is the importance of data-driven planning. In countries like the U.S. and U.K., workforce migration data is tracked in real time. Policymakers know where shortages are emerging and can respond quickly. In Nigeria, data gaps make planning difficult. The second is continuous professional development. Regular training and fair evaluation systems build trust. The third is governance. When professionals see accountability, when they believe resources are used effectively they are more likely to stay. Governance is the foundation of retention.
How do you see technology shaping the future of Africa’s health workforce?
Digital health has tremendous potential. Remote consultations, mobile learning platforms, and telemedicine can connect professionals across borders. For instance, a young doctor in Nigeria can now collaborate with peers in Ghana or the U.S. without leaving their post. Technology also allows diaspora experts to contribute knowledge remotely.
But digital transformation must be inclusive. It can’t just serve urban hospitals. We need systems that reach rural areas where the health gaps are widest. When designed right, technology can make staying in the system as rewarding as leaving it.
Finally, what drives your personal commitment to this work?
I’ve seen both the strengths and weaknesses of Nigeria’s health system up close. I’ve worked with professionals who deliver exceptional care under difficult conditions. My commitment comes from wanting to make that system more sustainable, one that allows people to thrive, not just endure.
Ultimately, my goal is simple: to contribute to a health ecosystem where leaving isn’t the only path to success, and where talent can flourish right here in Africa.
