NIGERIA lost about 9,000 of its doctors to the United Kingdom, Canada and other countries between 2016 and 2018, the ICIR has found.

The loss left the country with only 4.7 per cent of its doctors as specialists, while the remaining doctors were general practitioners.

According to the World Health Organization, the number of doctors in Nigeria plummeted from 83,565 in 2016 to 74,543 in 2018.

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Doctors lost by the country within the period could have doubled, given the steady growth in the doctors’ population since 2003.

For instance, between 2005 and 2006, the number of doctors in Nigeria swelled from 39,210 to 49,612.

Similarly, between 2013 and 2016, the population grew from 65,759 to 83,565.

Nigeria’s population as of the time of filing this report was 212.8 million. It was 200.9 million in 2019.

According to the WHO, the doctors-to-patient ratio per 10,000 population in Nigeria was 3.81 in 2018.

The WHO reported that the number of doctors in Nigeria was 34,923 in 2003. The figure rose to 39.210 and 49,612 in 2005 and 2006, respectively.

Between 2007, 2008 and 2009, the country enjoyed a leap in its doctors’ population from 49,612 (in 2006) to 55,376 (2007) and to 58,363, respectively.

By 2013, the number of doctors in the nation had jumped to 65,759.

There were 74,543 doctors in Nigeria in 2018, while only 3,035 of them were specialists, otherwise known as consultants. 

The ICIR reports that Nigeria enjoyed a sustained increase in its doctors since 2003 until the growth ceased between 2016 and 2018. 

The depletion in the country’s doctors could result from factors namely: incessant strikes by the nation’s health workforce, poor and delayed payment of remuneration, the deplorable state of most public health facilities, tempting wages overseas, policy summersaults by successive governments, poor budgetary allocation to the health sector, inadequate and absence of complementary workforce in hospitals, and inconducive working environment, among others.

This newspaper had reported how the National Association of Resident Doctors of Nigeria (NARD) embarked on strike for two months between August 2 and October 4 over unmet demands by the government. The strike lasted for 63 days.

The doctors had embarked on a similar strike in April. The strike lasted for 10 days.

Nigerian officials, including President Muhammadu Buhari, prefer getting medical attention abroad to patronising the nation’s hospitals.

The ICIR reported in 2018 how the president beat the record of late former President Musa Yar’Adua after he spent 172 days of his first 1,096 days in office, receiving treatment abroad.

The Punch had, in September, reported how the United Kingdom licensed over 200 Nigerian-trained doctors between April and May this year. The newspaper had, in 2020, reported how the number of Nigerian-trained doctors had grown to nearly 8000 in the UK.

The ICIR had, also in August, reported how hundreds of Nigerian-trained doctors thronged the venue of a Saudi Arabia government-sponsored recruitment exercise in Abuja, where the employer needed only seven candidates.   

Doctors in South Africa, Egypt, Ethiopia, other countries

Meanwhile, South Africa has enjoyed a marginal growth in its doctors’ population since 2013, except in 2016 when it had a shortfall of about 150.

The number of doctors in the country rose from 39,847 in 2013 to 46,393 in 2019.

The doctor-patient-ratio per 10,000 population in the country was 7.9 against Nigeria’s 3.81 in 2018.

Egypt had 38,485 doctors in 2003. The figure nearly doubled in 2014, but growth has since been marginal. The country recorded a drop in its doctors’ growth between 2016 and 2017.

However, while there were only 3,035 specialists among Nigeria’s 74,543 doctors, Egypt had more specialists than its general practitioners. The country had 31,944 general practitioners and 42,974 specialists as of 2019.

Despite having the second-largest population in Africa, Ethiopia had 8,395 doctors as of 2019.

The figure was an increase from 1,936 in 2003.

Nevertheless, 2,528 of Ethiopia’s doctors were specialists in 2018, while the remaining 5,867 were general practitioners.

In Algeria, specialist doctors were more than general practitioners in 2018. Of the country’s 72,604 practitioners, 39,830 were specialists.

Ghana had 3,236 doctors in 2019, 1,055 of them were specialists.

The United Kingdom (Great Britain and Ireland) recorded 393,247 doctors in 2019. 145,367 of the figure were specialists.

In 2018, the US had 851,641 doctors, while India boasted of 1.268 million doctors in 2019.

Italy also had 485,190 doctors in 2019, and the world’s most populous nation, China, recorded 2.83 million in 2018.

Doctors exodus and Nigeria’s health systems

Doctors’ exodus from Nigeria continues to worsen the nation’s health indices.

According to the WHO, 20 per cent of global maternal deaths occur in Nigeria.

The 2013 National Demographic and Health Survey shows that infant and under-five mortality rates were 69 and 128 deaths per 1,000 live births, respectively. 

The deaths reduced to 67 deaths per 1,000 live births in 2018, while under-five mortality rose to 132 deaths per 1,000 live births.

The maternal mortality ratio was 576 maternal deaths per 100,000 live births in 2013. In the NDHS 2018 report, it was estimated at 512 maternal deaths per 100,000 live births.

Some communicable and non-communicable diseases in which Nigeria has a significant lead globally are HIV/AIDS, tuberculosis, cholera, typhoid, Lassa Fever, hypertension, cancer and diabetes.

Health financing has not improved under the Buhari administration, under whose government the doctors growth has stagnated and declined. 

In 2016, the Federal Government had a budget of N6.06 trillion, out of which it earmarked N550 billion to the health sector. The amount represented 4.1 per cent of the budget. The government allocated N221 billion naira and N28.6 billion as capital and recurrent expenditure, respectively, for the sector within the year.

In 2017, the total national budget was N7.4 trillion. The health sector got N304.1 billion, representing 4.0 per cent. Capital allocation for the year was N51.3 billion, while recurrent expenditure gulped N252.8 billion.

In 2018, there saw a further decline in the percentage of the health budget to the national budget. The total national budget was N9.1 trillion that year, from which the sector got  N356.4 billion. Recurrent expenditure was N269.9 billion, while the capital budget was N86.4 billion.

In 2020, the government reduced budget allocation to the Basic Health Care Provision Fund by more than 40 per cent, from N44.4 billion to N25.5 billion.

Out of this year’s budget of N13.6 trillion, recurrent and capital of N380 billion and N134 billion, respectively, were allocated to the health sector, totalling 514 billion.

Doctors free to go, govt said in 2019

The ICIR reported in 2019 how the Minister of Labour and Employment Chris Ngige boasted that doctors could flee the country as they wished. He said the nation had enough of them. 

“I’m not worried. We have a surplus (of doctors). If we have a surplus, we export.

“I was taught Biology and Chemistry by Indian teachers in my secondary school days. They are surplus in their country.

“We have a surplus in the medical profession in our country. I can tell you this. It is my area. We have excess. We have enough, more than enough, quote me,” Ngige, a medical doctor, said.

Marcus FATUNMOLE

Marcus bears the light, and he beams it everywhere. He's a good governance and decent society advocate. He's The ICIR Reporter of the Year 2022 and has been the organisation's News Editor since September 2023. Contact him via email @ mfatunmole@icirnigeria.org