President Bola Tinubu, on Monday, approved the National Policy on Health Workforce Migration to address the continued exodus of Nigerian doctors abroad.

The policy, announced by the Coordinating Minister of Health and Social Welfare, Prof Muhammad Pate, on his X handle on Tuesday, aims to woo an estimated 12,400 Nigerian-trained doctors practising abroad

According to Pate, who also appeared on Channels TV on Tuesday evening, 67 per cent of Nigerian-trained doctors are practising in the United Kingdom alone.

“The recruitment countries, that recruit our professionals, should they not have some responsibilities to help us expand the training? Because the strain of health workers’ migration is continuous; it’s not going to stop tomorrow.

“the UK will need Nigerian doctors; 67 per cent of our doctors go to the United Kingdom and 25 per cent of the NHIS workforce is Nigerian.

“Nigerians are very vibrant, very entrepreneurial, and very capable wherever they are. If Nigerians hold back from the UK, for instance, the NHS will struggle to provide the services that many Nigerians are going there to get,” the minister said.

Pate said the policy signed by the President was more than just a response to the ongoing exodus of healthcare professionals but a comprehensive strategy to manage, harness, and reverse health workers’ migration.

While health workers believed the policy might be positive, they demanded the details and implementation plan.

Announcing the policy on Tuesday, the health minister said, ”This afternoon, HE President Bola Ahmed Tinubu, GCFR @officialABAT, in-council, approved a landmark policy set to transform healthcare human resource management in Nigeria.

“The National Policy on Health Workforce Migration addresses the critical challenges facing Nigeria’s health human resources. As the AU Champion for Human Resources for Health and Community Health Delivery Partnership, Mr President’s commitment to a resilient and robust healthcare system is powerfully reflected in this forward-looking policy.

“This policy is more than just a response to the ongoing exodus of healthcare professionals; it’s a comprehensive strategy to manage, harness, and reverse health worker migration. It envisions a thriving workforce that is well-supported, adequately rewarded, and optimally utilised to meet the healthcare needs of all Nigerians.”

Many Nigerian healthcare workers leave the country for greener pastures, leaving their colleagues to contend with additional workload and extended call hours.

The push factors, according to them, are inadequate equipment, worsening insecurity, poor working conditions, and poor salary structure.

The minister noted that central to this vision was the Nigeria Human Health Resource Programme, which sets a framework for regular reviews of working conditions, ensuring that health workers, especially in rural and underserved areas, receive the recognition and rewards they deserve.

“By fostering an environment conducive to professional growth and stability, the policy aims to retain top talent within Nigeria.

“In an increasingly digital world, integrating advanced health technologies is essential. The policy’s focus on digital health infrastructure—including electronic medical records, telehealth, and a comprehensive health workforce registry—marks a significant step towards a more efficient, data-driven health system. These innovations will streamline healthcare delivery and enhance the equitable distribution of health workers, ensuring access to quality care for all Nigerians.

“Capacity building is at the heart of this policy. It recognises the importance of continuous professional development, with strategic partnerships and opportunities for international training to equip our healthcare professionals with cutting-edge skills. This investment in human capital underscores our commitment to retaining and empowering our healthcare workforce,” he stated.

He added that the policy addressed the return and reintegration of Nigerian health professionals from the Diaspora.

The minister said by establishing streamlined registration processes and providing attractive incentives, the policy would not only encourage the return of talented professionals but also actively reintegrate them into the health system.

“This approach leverages the expertise of our Diaspora to bridge gaps within the health sector. Also, the policy champions reciprocal agreements with other nations to ensure that the exchange of health workers benefits Nigeria. These bilateral and multilateral agreements are designed to protect national interests while respecting the rights and aspirations of our healthcare professionals. We call on recipient countries to implement a 1:1 match—training one worker to replace every publicly trained Nigerian worker they receive.

“Recognising the importance of work-life balance, the policy includes provisions for routine health checks, mental well-being support, and reasonable working hours, especially for younger doctors. These measures aim to create a supportive work environment, reducing burnout and enhancing job satisfaction.

“The governance of this policy will be overseen by the National Human Resources for Health Programme within @Fmohnigeria, in collaboration with state governments. This ensures responsible implementation and alignment with broader sector-wide health objectives.

“With this decisive action, the National Policy on Health Workforce Migration is set to secure the future of Nigeria’s healthcare system. Under Mr President’s leadership, this policy will further catalyse the transformation of our health sector, ensuring access to quality healthcare for all Nigerians.

“As we embark on this journey, all stakeholders are invited to contribute to building a healthcare system that reflects our nation’s potential and promise,” Pate said.

Explaining the policy further, the Senior Adviser, Media and External Relations, Tashikalmah Hallah, said the government was negotiating with countries where Nigerian healthcare workers migrate to to help Nigeria improve health training facilities.

“We are talking to those countries that our health workers are going to, to see if they can now help Nigeria to improve provisions of some of the facilities that will enable Nigeria to train more health workers.

“The Federal Government has expanded our admission quota and improved on these medical institutions, so they are now encouraging all these countries where our health workers go, to assist us in maintaining these health institutions.”

Hallah said the implementation of the policy takes effect immediately.

“It’s a policy, it was adopted by the Federal Executive Council yesterday (Monday). So, it is immediate, and it has been approved. So, it’s a Nigerian government policy. This is a policy binding on healthcare workers.

He emphasised that the FG has established a policy allowing healthcare workers to travel abroad for training and then return to apply their new knowledge.

“Currently, there is a request by Qatar for 10 medical doctors to go there to study, especially in oncology. So, immediately after the training, they are coming back to the country,” he said.

Guarded optimism
The President of the Medical and Dental Consultants Association of Nigeria, Prof Muhammad Muhammad, said the policy looks more theoretical than real.

Muhammad also called for the details of the policy for a better understanding.

“The issue is that we need to see the detail, it’s not just the English that matters. People bring a lot of policies on the ground, very well drafted and crafted, but execution is usually a problem. It might be difficult to say we are fully in support or otherwise if we have not seen the document.

“I have planned to check on the Ministry of Health, maybe tomorrow (today), to see if we can get the document and look at it. They mentioned certain things that we have been advocating – the welfare of doctors, improvement of the work environment, and retraining, but how they are going to do it needs to be spelled out in the document.

“We were not consulted before drafting the document, so we don’t have an insight into what is in the document. If they are going to put it to work, what they have written might be beneficial to the system and to also the healthcare workers, but the problem is that there may be a lot of other things that we don’t know yet. For example, when they say they are going to stop the migration, in what way? Is it by preventing doctors from moving, or how are they going to do it?”

The MDCAN President noted that the public needs to know if the policy will improve or worsen the rights of healthcare workers.

He said the 1:1 match—training of healthcare workers to replace every publicly trained Nigerian worker might mean that, “They want any country that is hiring a healthcare worker, in addition to paying the healthcare worker, will also pay Nigeria for the cost of training that doctor. Let’s say Saudi Arabia or UK or Canada are going to employ a doctor that is trained in the public institution, they will expect that that country will pay Nigeria the same amount that was spent to train that doctor in Nigeria.”

The Secretary of the National Association of Nigeria Nurses and Midwives, Lagos State Council, Toba Odumosu, acknowledged that the policy appeared promising but emphasised the importance of gaining a clearer understanding of its details.

He also expressed support for the 1:1 training match for healthcare workers, noting that this approach is successfully implemented in other countries as well.

“For everybody that migrates to particular countries, you have a bilateral agreement for active recruitment of our health workers, then you find a way to sponsor the training of another healthcare worker in Nigeria. So the burden of training is not just on the Nigerian government, but the people who also benefit. That’s essentially what so many countries have done. In some cases, they have bilateral agreements that would mean that you actually go there for a certain number of years, and then you also find an agreement to come back to your country for a particular number of years before you are now free to migrate back. So, it’s sort of like a controlled migration system.

“But, we need the details of the policy to understand how this works because we still need to allocate more funds in the health sector, and meet the 2001 Abuja health declaration,” he noted.

As of December 3, 2023, the number of Nigerian-trained doctors licensed to practice in the UK was now 12,198, according to data from the General Medical Council in the UK.

Also, no fewer than 281 Nigerian doctors are working in other African countries, according to the data obtained from the Medical and Dental Council of Nigeria in 2023.

The MDCN data showed that 153 Nigerian doctors are practicing in Sudan; followed by South Africa with 41 doctors; Egypt 17; Ghana 17; Uganda 13; Gambia – seven.

Others are Lesotho -six; Cameroon – four; Namibia -four; Algeria -two; Ethiopia -two; Kenya -two; Liberia -two; Benin -one; Botswana -one; Equatorial Guinea -one; Niger -one; Rwanda -one; Sierra Leone -one; Seychelles -one; South Sudan -one; Tanzania -one; Togo -one; and Zambia -one.

So far, a total of 13,656 Nigerian-trained nurses and midwives are practicing in the United Kingdom.

This is according to the latest report on the number of nursing and midwifery professionals on the Nursing and Midwifery Council register as of March 31, 2024.

The report also showed that Nigeria is one of the top non-UK countries of education as of March 2024, and the number of Nigerian nurses and midwives practicing in the UK increased by 28.3 per cent in one year.

Other top non-UK countries of education as of March 2024, compared to last year are India (62,413), Philippines (49,092), Romania (7,378), and Ghana (5,536).

PUNCH