Stopping Nurses’ Migration Will Not Solve Nigeria’s Brain Drain

On February 7, 2024, the Nursing and Midwifery Council of Nigeria announced the revised guidelines and requirements for applicants requesting verification of certificate(s) to foreign nursing boards or councils. Among the eight itemized guidelines in the circular, eligible applicants must have at least two years of post-qualification experience from the date of issuance of a permanent practicing license. The new guidelines are a ploy to contain nurses within the country to prevent brain drain in the country’s health sector. The new regulations violate the human rights of health workers to work under just and favorable conditions anywhere of their choice. 

The government should focus on improving the healthcare sector rather than establish guidelines that prevent nurses from pursuing greener pastures elsewhere. Health workers should be adequately remunerated for their service and provided with a decent working environment. Additionally, quackery should be tackled in the healthcare system by relevant health organizations to allow more job opportunities for registered nurses and midwives.

According to the National Association of Nigerian Nurses and Midwives (NANNM), about 75,000 nurses and midwives have left the country in the last five years to seek greener pastures. NANNM admits that the primary factors responsible for the migration of its members are a lack of decent remuneration and a poor working environment. In Nigeria, nurses and midwives are underpaid for their care services. Despite the low wages, they are overworked in their service stations due to understaffing. The funds allocated to the health sector must be adequately utilized to ensure that health workers’ pay is increased. For better oversight and adequate utilization of funds, there should be a private-public partnership.

Putting up measures to prevent health workers from leaving their country to practice elsewhere infringes on their human rights.

The Ministry of Labor and Employment should ensure that health workers do not work beyond what their human capacity can handle. According to the World Health Organization (WHO), Nigeria has 20 nurses, midwives, and doctors per 10,000 population. The ratio is below the WHO’s recommendation that there should be 23 nurses, midwives, and doctors per 10,000 people. The ratio implies that most Nigerian hospitals are short-staffed, and a health worker can end up doing the work of at least two staff. To address this challenge, public and private hospital management boards must employ more health workers to offset the workload on the current health workers.

Furthermore, there is a need to eradicate quackery in the nursing and midwifery profession. Quackery has a negative implication on the quality of the healthcare system and contributes to the lack of proper welfare witnessed by nurses nationwide. In most private hospitals in the country, the common practice is to train quacks as an alternative to employing registered nurses to maximize profit. The Nigeria Medical Association and NANNM must collaborate with law enforcement agencies to curb quackery in hospitals. To enforce the fight against quackery in hospitals, especially private hospitals, quack health workers must be charged to court by NANNM and sentenced to prison. Stiffer penalties, like ten years imprisonment, must be implemented, contrary to the ₦2,000 fine or two years imprisonment stipulated in Section 21 of the Nursing and Midwifery Act. Similarly, the operational license of hospitals found culpable should be withdrawn by the ministry of health. With quacks out of the country’s healthcare system, more employment opportunities for registered nurses and midwives will be available.

Healthcare providers are entitled to work in any health institution they choose, regardless of where they are trained. Putting up measures to prevent health workers from leaving their country to practice elsewhere infringes on their human rights. To encourage health workers to practice in Nigeria, the government should improve their welfare by making the work environment more attractive and conducive while compensating them appropriately for their service. 

Immanuel Táiyéwò Fáwọlé is a writing fellow at African Liberty.

Photo by Francisco Venancio via Unsplash.