The ability of Nigeria to meet its health goals is dependant largely on the knowledge, skills, motivation and deployment of the health workforce responsible for organising and delivering health services.
While several studies show a direct correlation between the numbers of health workforce and population health outcomes, Nigeria is faced with the dearth of human resources needed to deliver essential health interventions for several reasons, including migration of health workers to other developed climes such as the United States of America, United Kingdom, Canada, Saudi Arabia and many other nations across the globe including poor mix of skills and demographic imbalances.
In recent times, Nigerians is expressing serious concerns over looming human resource dearth in Nigeria’s healthcare system. This directly impacts the access and service delivery to citizens and by extension Nigeria’s economic growth. Below is a breakdown of the health workforce in Nigeria.
According to data sourced from global decision-making data in the world Knoema, it was revealed that in 2010, the density of nursing and midwifery personnel for Nigeria was 1.6 numbers per thousand populations with the number likely to have dwindled due to rising population and birth rate in the country.
Efforts to get the oofficial statistics of the number of doctors practising in Nigeria and those who have left from the Medical Dental Council of Nigeria, (MDCN), the agency which regulates the profession in Nigeria, were not successful at the time of filing the report.
The World Health Organisation (WHO) recommended core indicator on the nnumber of health workers per 10000 populations which stipulates the size of the current workforce that is meant to meet a given threshold that should allow the most basic levels of health-care coverage to be achieved across the country leaves much to be desired in Nigeria as evident in the data above.
While the number of health workers available should be relative to the total population since it represents a critical starting point for understanding the health system resources situation in the country, the comparable data currently available on the health workforce pertaining to physicians, nurses and midwives including other categories of service providers (dentists, pharmacists, community health workers); management and support workers (health service managers, health economists, health information technicians and others) is one that falls below global standards. This is a critical indicator given the country’s quest to meet its health-related Sustainable Development Goals by 2020.
“A total of $1 billion is lost annually to medical tourism in Nigeria. If you want to solve this problem you have to tackle the root cause of brain drain,” Clare Omatseye, the president, Healthcare Federation of Nigeria, (HFN).
Omatseye said, there is need for new strategies in reversing the brain drain as well as patient drain, an enabling framework and policies by the government that would encourage private sector participation in healthcare sector.
Similarly, Analysts say a good economic condition will make most professionals to return or stay back in the country.
“The increasing frequency of doctors leaving in droves is no longer news in the health sector, it been bedevilled over the years in the country. Preference should be placed on our health sector so that necessary provisions will be made to enhance our health systems,”
“If federal governments, institutions corporate and create a platform for success in the sector and opportunity, then the country will increasingly get more talent wanting to stay back to serve the people well,” say Analysts.
A cursory look at the distribution of health workers in Nigeria– by occupation/specialization, region, place of work and sex shows an imbalance (or misdistribution) in the supply, deployment and composition of human resources for health, leading to inequities in the effective provision of health services.
X-raying the health workforce imbalance across the four tiers – imbalances in occupation/specialty, geographical representation, institutions and services, and demographics-BusinessDay can reveal that as the impact of these different types of imbalances on the health system varies, the need to monitor and assess each of these dimensions of workforce distribution in the country is exigent given the correlation between the size of the workforce and its implication for health-care coverage across the country.
Another important indicator the agency is the Annual number of graduates of health professions educational institutions per 100 000 population – by level and field of education. Data check to obtain the number of health professions from Nigerian University Commission was unsuccessful too.
The number and type of newly trained health workers is relevant given the need to increase production among all cadres, including the need for more workers in rural and underserved areas.
Strengthening the performance of health systems depends on more than just increasing the numbers of health workers; actions for assessing and strengthening their recruitment, distribution, retention and productivity are also important.
These aactions may include: adopting new approaches to pre-service and in-service training; strengthening workforce management; establishing or improving incentives for addressing distribution and retention challenges; or task-shifting (delegating tasks, where appropriate, to less specialized health workers).
Such strategic plans would normally include targets for monitoring health workforce metrics in both the short and the long-term and adaptation to any major health sector reforms.
Given the diversity of potential information sources, monitoring and evaluation of human resources for health would require robust collaboration between the ministry of health and other sectors that can be reliable sources of information, including the National Bureau of Statistics, Mministry of Eeducation, ministry of finance, ministry of labour, health professional regulatory and licensing bodies, associations of private providers, and individual health-care facilities and health training institutions
Nigeria can apply these strategic plans of monitoring health workers metrics in both the short- and the long-term and adaptation to any major health sector reforms. Not only is the need for increasing the number of health workers, but a need for action in assessing and strengthening recruitment, distribution, retention and productivity is also pivotal to changing the current worrisome narrative of Nigeria’s health workforce.
New aapproach to pre-service and in-service training; strengthening workforce management; establishing or improving incentives for addressing distribution and retention challenges, or task-shifting are needed in Nigeria’s health care system.
ANTHONIA OBOKOH
