The development Research and Project Centre (dRPC) in collaboration with the National Institute for Policy and Strategic Studies (NIPSS) is holding a symposium to discuss recent brain drain in Nigeria’s health sector and its implications on health service delivery.
The high-level symposium themed “Nigeria’s health sector brain drain and its implications for sustainable child and family health service delivery and financing in the context of new national priorities” is taking place in Abuja.
The event will bring together policymakers and implementers alongside health professional associations and council executives, who are critical stakeholders in the health systems strengthening process.
The high-level symposium will focus on discussing current figures related to the health sector’s human capital loss to migration at National and sub-national levels.
The organisers said this is timely as the country’s health sector is facing financing and human resource gap.
It said the challenges in the sector is leading to continuous migration trend of health workers to other countries in search of better work conditions.
The symposium will also explore the implications of brain drain for new national health priorities for maternal and family planning services and identify strategies and mechanisms for sustainable financing as part of wider search for immediate solutions.
Stay on this page as PREMIUM TIMES provides live updates of the event scheduled to commence by 9:45 a.m.
9:45 a.m.- It’s a bright morning here at Fraser suites, Abuja. We are live at the one-day high-level symposium on Nigeria’s health sector brain drain and its implications for sustainable child and family health service delivery.
Although the event was scheduled to commence by 9:45 a.m., it will be starting some minutes late as few of the participants are yet to settle in.
All is set for the commencement of the event. The facilitator, Moji Makanjuola, takes the podium and the event commences with the National Anthem.
10:05 a.m: Ms Makanjuola welcomes everyone to today’s event. She said the deliberations should be productive and effective for the benefit of Nigeria. She invites the Director-General of NIPSS, Ayo Omotayo, to deliver the welcome remarks
Mr Omotayo takes the podium. He said NIPSS is established to find solutions to the country’s problems, noting that the institute has focused on the health sector in the past three years.
He said the theme of the event is timely as more and more persons are leaving the country to settle in developed countries.
He said all sectors in Nigeria have one problem or another, including health which is a critical sector in every country.
Mr Omotayo said the government must act now and fast. “When doctors leave the country, it means we are having existential problems.”
He said the statistics of doctors and nurses leaving the country is high, hence creating a huge gap in the health system.
Mr Omotayo said Nigeria’s population is increasing massively and so is the need for more health professionals. He said “the young Nigerians will tell you that Nigeria has done nothing to them – Is it fair to this generation?
He said the government is spending so much on educating doctors and nurses, hence it’s a major loss when they leave the country.
He explained that NIPSS will seat next to the government representative to discuss takeaways from today’s event. He ended his speech by encouraging everyone to pay attention to today’s message.
10:22 a.m: The facilitator, Ms Makanjuola, invites the chairman of the Nigerian Medical Association (NMA), Uche Rowland, to give the keynote presentation.
Mr Rowland takes the podium. He said the term brain drain refers to losing a major strength. He said official statistics show that as of 2019, Nigeria’s doctors-to-patient ratio is at one to 4,900.
He said this number has increased as the country continues to lose medical practitioners to developed countries. He explained that Nigeria is in dire need of health workers.
He said from 1963 to date, Nigeria produced only 93,000 doctors; which is inadequate to cater for the general population. “The real shock comes when you know majority of physicians we are training will not remain in the country,” he said.
He said research among health workers shows that the UK and the United States of America are the top two destinations for Nigerian medical doctors to seek work opportunities, with 93 per cent and 83 per cent.
He said Nigerian doctors are also migrating to Middle Eastern countries like Saudi Arabia, Qatar and Oman. “We are not just losing the consultants, we are losing fresh graduate doctors too,” he said.
Mr Rowland said currently, Nigeria has the highest number of doctors in the UK after India and Pakistan.
He said India contributes the largest number of foreign doctors to the UK health sector. He said, unlike Nigeria, as of 2018 India achieved the WHO-recommended doctor-to-population ratio of 1:1,000.
He noted that India produces 50,000 medical doctors per annum from more than 479 medical schools, with an annual capacity intake of 67,218 MBBS students at medical colleges regulated by the medical council of India.
He said in 2015, 233 Nigerian doctors moved to the UK; in 2016 the number increased to 279; in 2017 the figure was 475, in 2019, the figure rose to 852, in 2019 it jumped to 1,347; in 2020, the figure was 833 and in 2021 was put at 932.
He said the General Medical Council (GMC), the body responsible for licensing and maintaining the official register of medical practitioners in the UK, reportedly licensed 200 Nigerian-trained doctors in one month between August 31- September 30, this year.
He explained that the data further shows that an average of three Nigerian doctors per day were licensed within June and July this year to work in the UK. This is equivalent to 266 Nigerian doctors in the space of two months.
11:00 a.m: Ejiro Eyaru, a Nigerian doctor in the UK, gives his goodwill message virtually. Mr Eyaru said Nigeria’s challenges are peculiar and every country has its own challenges.
He said the Nigerian government can make more efforts in the health sector to prevent doctors from leaving the country.
He said based on analysis, at least 40 doctors leave Nigeria every week. He said the problems have been highlighted and identified but providing solutions is more important. He ends his speech.
11:05 a.m: The representative of the Population Association of Nigeria (PAN), Godwin Aidenagbon, takes the podium to give a goodwill message.
Mr Aidenagbon said the aim of PAN is to promote the advancement of demographic knowledge and control the population question in Nigeria’s developmental process through the promotion of scientific research on population issues.
He said the theme of today’s discourse falls within the strategic interests of PAN in a number of ways. He said brain drain across all sectors has a significant impact on population dynamics.
He said brain drain in the sector may have negative implications for the health of the population. He ends his speech and leaves the podium.
11:15 a.m: Oyewale Tomori, a virologist, takes the podium to give his goodwill message. Mr Tomori said brain drain is in every sector, not just health.
Mr Tomori said the government must invest more in the health sector to protect the health of the people.
He said his goodwill message today is “Let’s do what we can for this country.”
That’s the end of his remarks, he leaves the podium.
11:23 a.m: A representative of the office of the Vice President, Nicholas Audifferen. takes the podium to give a goodwill message. Mr Audifferen said the engagement with NIPSS on issues of policies regarding Universal Health Coverage has yielded positive results.
He said the health workforce has a critical role to play in ensuring Nigeria achieves UHC by 2030.
He said the presidential health reform committee will review and implement recommendations that will improve the country’s workforce. He ends his speech.
11:30 a.m: The minister of health, Osagie Ehanire, takes the podium to give the opening remarks. He is represented by Sydney Ibeanusi, an official at the ministry.
Mr Ehanire said the healthcare workforce plays a critical role in the development of a country. He noted that the majority of doctors are leaving Nigeria forgetting that every country has its own problem.
He said some persons that have left are willing to come back to the country but an enabling environment must be created
He explained that increased welfare for health workers will help in addressing issues of doctors’ migration. “We must have a way to reintegrate them and bring them back into the country,” he said.
He said “We need to look at the countries taking our best brains. We can tax countries that our doctors are relocating to.”
He said he looks forward to the recommendations from this event that will help in forming workable policies. He ends his speech.
11:43 a.m: It’s time for a group photo session and tea break. We will be back in 30 minutes, please stay with us.
12: 25 p.m.: The tea break is over and participants are all seated. Ms Makanjuola takes the podium to invite the first set of panellists. The panel facilitator is Kanyinsola Oyeyinka, coordinator, presidential health reform committee. The first panel will be deliberating on “Brain drain in the health sector-the facts and figures and implications for Nigeria meeting new health priorities.”
12:27 p.m: The first panellist is the Registrar of the Medical and Dental Council of Nigeria, Tajudeen Sanusi. He is represented by Henry Ogunleye. He said the impact of brain drain will affect Nigeria’s aim to achieve UHC.
12:28 p.m: Mr Sanusi said the doctors left in the country are overburdened with little or no pay. He said the issue of welfare and funding for the medical world must be addressed for the country to achieve UHC.
12:30 p.m: The next panellist is Ibrahim Ahmed, Registrar Pharmacy Council of Nigeria. Mr Ahmed said there is a need to look at the policy for human resources for health. “That way we can compare what we have today to see if it’s in line.”
12:32 p.m: He said the majority of pharmacists are leaving the country just like the doctors. He said over 783 pharmacists left Nigeria in 2021.
12:33 p.m: He explained that the government must move to halt more exodus of health practitioners. “We must go back to the basis to address this problem.”
12:35 p.m: He said there are concerns that the country no longer guarantees pharmacists well fare.
12:37 p.m: The next panellist is the Secretary General of the pharmacists society, Olumide Akintayo. Mr Akintayo said the country has less than 50 per cent of registered pharmacists practising in the country.
12:39 p.m: He said the government needs to come up with a concept call for pharmacists based on ante-natal care. He said this exists in many developed countries. “You can address maternal and child mortality problems through this initiative,” he said
12:40 p.m: Mr Audifferen, the representative of the VP office, is the next panellist. He said the challenge of being a Nigerian is the reason why many young Nigerians are leaving.
12:42 p.m: He said 70 per cent of the health problems are about financing. He said the government needs to start thinking about health as a business.
12:43 p.m: He said healthcare reforms involve everybody as the federal government alone cannot meet up with all the finance of the health sector.
12:45 p.m: The next panellist is the President, Association of Public Health Physicians of Nigeria, Alphonsus Isara. Mr Isara said brain drain is a problem of human development.
12:46 p.m: He said it is not impossible for Nigeria to achieve UHC but more effort is required. “The question is what approach are we using to achieve this milestone?”
12:48 p.m: He said the data are available and the problems are visible but the issue is addressing these challenges. He said the damage caused in Nigeria’s health sector cannot be revived in 30 years.
12:50 p.m: He said the country needs planning and strategy to achieve any change.
12:52 p.m: The panel facilitator, Ms Oyeyinka, asks the panellist to proffer solutions to the problem of brain drain. Mr Ahmed, Registrar of Pharmacy Council of Nigeria, said the government must look critically into the aspect of reform. He said the earlier the government acts, the better.
12:57 p.m: He also said there must be harmony between doctors, nurses, midwives, pharmacists and others. “Getting this right is critical to achieving health reforms,” he said.
12:59 p.m: Mr Akintayo takes the mic. He said money is needed to address the challenges of the health sector but “we don’t need finances from the government to achieve this.”
01:00 p.m: He said the country needs to innovate and be strategic with health investments.
01:03 p.m: Mr Audifferen said there are two ways to address the brain drain in the country. “You can be resistive or adaptive. If you want to be resistive, you have to address the problem of funding, staffing and harmony,” he said.
01:06 p.m: Mr Isara said the country needs to forget about pushback factors and focus on brain drain and how it can be addressed. This brings us to the end of the first-panel session.
01:12 p.m: The second and third panel session is merged and will commence now. The panel facilitator is Habib Sadauki, the president of the Society of Obstetrics and Gynaecology of Nigeria (SOGON).
The second panellists will deliberate on “Brain drain in the health sector – the facts and figures and implications for Nigeria meeting new maternal health priorities.”
The third panellists will discuss “sustainable financing options for health sector expenditure in infrastructure, systems strengthening and human capital development in the context of shrinking fiscal space-implications for CSO policy advocacy.”
01:17 p.m: The first speaker is the director of the daily trust foundation, Theophilus Abbah. He is represented by Ojoma Akor, the health editor for the organisation.
01:18 p.m: Mr Abbah said the brain drain situation is worsening but the degree varies. He said there is also a brain drain within the rural communities as medical practitioners are relocating to urban areas.
01:21 p.m: He said a visit to PHCs in the country will provide a clearer picture of the damage caused in the health sector. Mr Abbah said the statistics of health workers leaving the country have no doubt created a shortage of manpower.
01:24 p.m: He said the gap created is obvious in health service delivery.
01:26 p.m: The next speaker is the president of the National Association of Nigeria Nurses and Midwives (NANNM), Micheal Nnachi. Mr Nnachi said although many nurses are leaving the country, there is no exact figure of those that have left.
01:29 p.m: He said nurses are no doubt the worst hit of the damage caused in the health sector. He noted that nurses are the most marginalised and underappreciated health practitioners. “The nurses need to be recognised as other health workers are,” he said.
01:32 p.m: Mr Nnachi said UHC cannot be achieved without nurses. He appeals to the Nigerian government to prioritise the welfare of nurses.
01:36 p.m: The next speaker is the director of family health, FMOH, Salma Ibrahim. Ms Ibrahim said the Nigerian government is not relenting in its efforts to improve the health system.
01:38 p.m: She said medical practitioners seeking greener pastures in other countries will definitely come back to Nigeria. She, however, said the government must do something drastic to bring them back.
01:41 p.m: She said women and children are the worst affected by the exodus of doctors from the country. She said the government is doing all it can to improve allocations to the health sector.
01:43 p.m: “I’m happy to mention that the government is improving its health allocation despite the economic condition because the government recognised the importance of healthcare,” she said.
01:45 p.m: Ms Ibrahim said the country has learnt great lessons from the COVID-19 pandemic and is looking inwards to achieve sustainable financing of family planning.
01:47 p.m: The next speaker is the President of the National Association of Community Health Practitioners, Kabir Ahmed. He is represented by Aminu Hassan. Mr Ahmed said brain drain has affected both primary and secondary health institutions.
01:50 p.m: He said the country’s PHCs are abandoned at the mercy of community health assistants and environment workers. He explained that the lower level of the health sector caters for 70 per cent of health services.
01:53 p.m: He calls on the government to prioritise the health of the people.
01:55 p.m: The next speaker is Ekenem Isichei. Mr Isichei said the public should learn to hold politicians accountable. “We must ask politicians questions about their manifesto and plan for health.”
01:59 p.m: He said the country must get serious with advocacy and institutionalise accountability.
02:08 p.m: The next speaker is Gabriel Okeowo, a representative of BudgIT. Mr Okeowo said the issue of healthcare funding is paramount at all levels of government.
02:07 p.m: He said political will is also required for the country to achieve set goals.
02:12 p.m: The next speaker is the CEO of the private sector health alliance of Nigeria, Tinuola Akinbolagbe. Ms Akinbolagbe said there are various partnerships with the government to increase public healthcare access in the 774 LGAs.
02:15 p.m: She said there are new policies to ensure PHCs don’t rot again after revitalisation. “It’s important we invite the right stakeholder to listen to some of these important conversations and if we have them on board, they must have the political will to implement policies recommended.”
02:19 p.m: The panellists are having a recap of the session. They agreed that the government must work with the private sector and stakeholders if it’s to make a change in the health sector.
02:23 p.m: They also reached a consensus that without the revitalisation of the PHCs, the country cannot attain UHC. The panellists said PHCs are the bedrock of any developed country. They said a country is not fully developed until a strong health system is put in place.
02:25 p.m: In his recap, Mr Abbah, the director of Daily Trust Foundation, said the welfare of health workers must also be prioritised. He said without the health workers, the PHC system will crumble.
02:28 p.m: The panel session has ended and it’s time for questions and answers.
02:31 p.m: Participants are raising questions and making recommendations for the government on ways to improve health sector financing and curb doctor’s exodus.
02:35 p.m: Some participants said the government cannot achieve set goals without collaborating with the private sector.
02:37 p.m: “We need doctors in the country and to keep them here, we have to look for homegrown solutions in achieving this,” a participant said.
02:40 p.m: Mr Ibeanusi, the representative of the minister of health, takes the mic. He said the ministry is involving all relevant stakeholders and working assiduously to build a strong health system for the country.
02:43 p.m: He said the government is investing a lot in training these doctors and they are leaving the country. He said this is a major loss to the Nigerian government.
02:47 p.m: He said health education is heavily subsidised in Nigeria. “Let’s remove the subsidy so if the doctors are paying heavily, they are free to leave without any moral obligation to stay,” he said.
02:47 p.m: The panel facilitator, Mr Sadauki, takes the mic to announce the end of this session.
02:50 p.m: The lead facilitator, Ms Makanjuolatakes the mic to call for a photo session with the panellists.
02:55 p.m: The director general of NIPSS, Mr Omotayo, takes the podium to give the closing remarks. He said there are major takeaways from today’s event.
02:58 p.m: The takeaways are “We must accept there is serious brain drain in the health sector; we need to have harmony and good relationship between doctors, nurses, physicians, pharmacists and others.”
03:00 p.m: Mr Omotayo said other takeaways are “Increased funding for the health sector; training of health workers; we need to produce as many health workers as possible; we must control the outflow.”
03:01 p.m: He said the health sector must be seen as a business. He also said critical stakeholders must be allowed to sit at the table.
03:05 p.m: He also calls for improved remuneration of medical workers.
03:08 p.m: The facilitator, Ms Makanjuola, takes the mic to announce the end of today’s event.
Thank you for staying with us all through.
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