In the first two years of President Bola Tinubu’s administration, health workers across hospitals have left Nigeria in record numbers despite policies initiated to curb workforce emigration, popularly known as japa.
After assuming office in May 2023, Tinubu’s administration shone its light on health workforce emigration, rolling out a number of ambitious policies to not only reduce japa but also encourage Nigerian professionals in the diaspora to return home.
But data shows that these policies are failing to keep health workers at home, with a growing number of them pursuing overseas ambitions.
Read also: Bill Gates meets Tinubu over healthcare reforms
Incentives
The federal government’s policies to keep health workers at home include the ban on leave of absence for health professionals, particularly doctors seeking to work abroad. The government also increased the quota of admission into medical schools in Nigeria by 100 percent so as to produce more health professionals.
The Federal Ministry of Health and Social Welfare further unveiled a national policy on health workforce migration, which promised a range of incentives. These included special credit facilities, tax holidays to encourage health workers and investors to establish functional private healthcare centres; mortgage facilities for healthcare workers to own houses, cars, and other essential assets; periodic review of healthcare workers’ salaries, benefits, pensions, and allowances; and provision of adequate equipment and supplies to improve working conditions.
In February 2025, Tinubu approved an increase in the retirement age for doctors and other healthcare workers from 60 to 65 years, and consultants to 70 years.
Japa hasn’t ceased
In spite of these, emigration has not slowed. Data from the Federal Ministry of Health and Social Welfare show that the number of doctors leaving the nation reached a record 10-year high of 3,974 in 2024, from 688 in 2015.
The figure rose steadily over the years, nearly tripling to 1,824 by 2019. It dropped to 1,242 in 2020, likely due to COVID-19 travel restrictions, before surging to 2,900 in 2022. After a brief decline to 1,447 in 2023, emigration spiked again in 2024.
According to the data, 18,949 doctors have left in 20 years, with 2024 recording the highest annual figure to date.
Also, the number of Nigerian-trained nurses joining the United Kingdom (UK)’s permanent nursing register surged to a nine-year high of 14,815 as of September 2024, compared to 2,823 in 2016, according to the latest report from the Nurses and Midwifery Council (NMC) UK. The number had increased by 39.3 percent from 10,639 as of September 2023.
Read also: Federal Executive Council approves $1.07bn for healthcare reforms
This is despite states such as Katsina and Kwara reporting a lack of doctors to recruit. The recent ‘State of Health of the Nation’ report published by the Ministry of Health shows that 12 states, including Abia, Adamawa, Bauchi, Benue, Cross River, Ekiti, Gombe, Jigawa, Kebbi, Kogi, Kwara and Niger, have fewer than 200 doctors.
These statistics further highlight the extent of the japa phenomenon amid government policies.
BusinessDay gathered that most of these policies are largely unimplemented. Additionally, health workers say the government is not addressing the core factor – remuneration.
Health experts are worried
Speaking to BusinessDay, Tope Zenith, president of the Nigerian Association of Resident Doctors (NARD), lamented the lack of tangible outcomes from government policies.
“It’s just unfortunate that we have not been able to see the dividends of these policies. As it is, they are just policies on paper. But the reality is that we’ve not been able to get anything tangible from the government,” he said.
Zenith confirmed ongoing talks between the ministries of health and housing regarding mortgage housing schemes for doctors. He, however, warned that the core issue of remuneration remains largely unaddressed, with the government not making any move.
He said the government is yet to pay outstanding arrears, noting that there has not been a consequential adjustment of the minimum wage increase on salaries.
“We have a collective bargaining agreement as far back as 2009, which the government has yet to implement. That means that since then till now, there is no significant improvement in what the doctors are collecting as salaries.”
He said doctors are still ‘very eager to leave’ the country, while urging the government to prioritise competitive remuneration and welfare packages in addition to other incentives.
The Nigerian Association of Resident Doctors (NARD), in a recent statement, also disclosed that the ban on leave of absence has been counterproductive and has even worsened brain drain.
Promises not kept
An official in the Ministry of Health and Social Welfare, who is also a medical doctor, confirmed that the incentives promised to healthcare workers by the current administration haven’t translated into action.
No, improvement won’t be instantaneous
When contacted, Tashikalmah Hallah, a senior adviser to Mohammed Pate, health minister, said the expected improvement would not be instantaneous and can’t happen overnight.
When asked to provide an update on the progress of implementation, he said he has no information yet and referred the reporter to Alaba Balogun, director of press, who was yet to do so as of press time.
Hallah, however, noted that the policy to double the admission quota is already being implemented.
Experts raise eyebrows
Prosper Okonkwo, chief executive officer, APIN Public Health Initiatives and lecturer at Bingham University in Abuja, questioned the effectiveness of Tinubu’s policy in curbing brain drain.
“When you ask 150 graduating medical students how many of them want to remain in the next two years, you’ll get only two or three hands,” he said, while harping on the need to improve the working conditions of health workers.
Read also: Tackling Africa’s public health workforce crisis
Need for improved welfare
Philip Ekpe, former chairman of the Nigerian Medical Association (NMA), the Federal Capital Territory (FCT) chapter, stressed the need for improved welfare and remuneration.
He recommended the implementation of mandatory health insurance to inject more funds into the sector, allowing for better pay and improved infrastructure comparable to what doctors receive abroad.
