Doctor-patient ratio worsening over japa, NMA laments

The Nigerian Medical Association, on Wednesday, lamented the worsening doctor-patient ratio in the country fuelled by the continued exodus of doctors abroad – a trend now commonly known as japa.

Speaking at an interactive session with the media in Abuja on Wednesday, the NMA President, Prof Bala Audu, pointed out that Nigeria’s doctor-patient ratio had dwindled to about 1,000 per cent less than what the World Health Organisation recommended.

“The doctor-patient ratio is about 1,000 per cent less than what the World Health Organisation recommended. Recently, there was a medical school that graduated its medical students, and I  think they did a survey and asked the new graduates if they would stay or prefer to leave. Your guess is as good as mine. It’s something that is worsening, but it is something that we can mitigate.

“And I think that is the essence of such interactive forums, not to keep crying about our problems, but to profile solutions to these problems,”  Audu stated.

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.

Data from the Medical and Dental Consultants Association of Nigeria showed that about 1,056 consultants left the country to seek greener pastures between 2019 and 2023.

The Nigerian Association of Resident Doctors also revealed that over 900 of its members left for Europe between January and September 2023.

“The issues that will prevent doctors, and nurses from leaving this country include improving their well-being. It’s more than just their take-home package, their take-home package is important because they also need to have health care, they also need to educate their children, and so on. And if another person is providing a better opportunity, there is a tendency for them to take that option,” the NMA President said on Wednesday.

He stressed the need for an improved and friendly working environment for doctors to discourage emigration.

“There have been situations of attack on health care providers, especially by the people who take patients to hospitals, probably because one or other things are not available, and everybody is charged up and angry, and you get attacked. The facilities also need to be improved.

“Housing is also one of the requirements, especially for internship training. By regulation, for you to have quality training for House Officers, they must be housed within the hospital because they need to be available at all times. You hear very much about the Nigerian Association of Resident Doctors. The residency training implies that they should live within the hospital, which means there has to be provision of accommodation for them.

“We train these people with a lot of money. This country invests so much in training every doctor, nurse, dentist, and other healthcare provider, but how many of them do we take up after they graduate, despite the challenges we have in terms of the demand power for health? So if we don’t employ them early enough, somebody else will come and employ them and take them outside this country,” Audu said.

In May, the Coordinating Minister of Health and Social Welfare, Prof Muhammad Pate, said the enrollment quota in medical, nursing, and other health professional schools had been increased from 28,000 to 64,000  yearly.

Pate stated that the increase in the enrollment quota was one of the steps the government was taking to mitigate the Japa conundrum in the health sector.

The NMA President, however, noted that there was a need to improve the training facilities.

“If you are previously admitting 200 medical students each year, now you want to admit 400 medical students each year, then you have to double the accommodation, you have to double the facilities for their training if you are to maintain the quality of their training.

“So these are the areas that we are having discussions with the government to ensure that those areas are improved so that we continue to produce high-quality health professionals, not just for Nigeria but for the rest of the world,” he added.