Highlighting the Challenges Faced by Nigerian Doctors and Proposing Solutions on Independence Day.
Prof Afekhide Ernest Omoti
Consultant Ophthalmologist,
Chairman, Eye Health Committee, Nigerian Medical Association
Past Chairman, Nigerian Medical Association, Edo State.
As we celebrate 65 years of independence, let us reflect on the progress we have made, the struggles we have endured, and the aspirations that continue to guide our path forward. As we celebrate the freedom that defines us, let us take a moment to reflect not just on how far we have come, but on where we are headed as a nation. Independence is not only a celebration of sovereignty it is a call to responsibility. It is a reminder that the strength of a nation lies in the well-being of its people. As we honour our nation’s achievements, we must also confront the realities that challenge us especially within our healthcare system. At the very heart of this system are our doctors: resilient, dedicated, and often unsung heroes.
One of the most critical challenges that continue to shape our nation’s future is the state of our healthcare system. Today, I want to highlight the invaluable role that medical doctors play in the health and well-being of every Nigerian. They are the frontline heroes, the unsung warriors, tirelessly working to save lives, cure ailments, and restore hope. Yet, despite their immense contribution, they face immense difficulties that undermine their ability to perform optimally and, in many cases, put their own lives, health and liberty at risk.
Challenges Faced by Doctors working in Nigeria
1. Poor funding of the health sector: Nigeria’s healthcare system remains chronically underfunded, with a large proportion of hospitals lacking basic medical equipment and supplies. The Abuja Declaration on Health financing adopted in 2001 by the African Union (AU) member states, committed them to allocate at least 15% of their annual budgets to the healthcare sector. Often the budgetary allocation to health is less than 5% in Nigeria with the 2025 budget being 5.18% which is a far cry from the minimum of 15% recommended. Doctors, despite their training and dedication, often have to work in suboptimal conditions, where life-saving tools like ventilators, diagnostic machines, and essential drugs are unavailable. Doctors work in facilities that, too often, do not match the standards of care they strive to uphold. If not for the ingenuity and dedication of the Nigerian doctors and other health workers, the situation would have been calamitous.
2. Poor Remuneration: Doctors in Nigeria receive salaries that do not reflect their worth. This discouragement pushes our brightest minds to seek better opportunities abroad. It is no secret that doctors in Nigeria often work long hours, sacrificing personal time and energy to serve their communities and nation. However, their compensation does not match the work they put in or the scale of their responsibility. Nigerian doctors are among the lowest paid in the world. Some doctors are given call duty that make them work continuously for 72 hours without break over a weekend, and no off duty after that. There are roasters from hospitals which show doctors being on duty for the 24 hours every day for the entire month largely due to the Japa syndrome. The Government places a maximum payment on the units of call duty that will be paid for, but when the roasters are drawn, there is no limit to the maximum call duty a doctor is expected to take. In many cases, delayed salaries and insufficient benefits have led to low morale and frustration among medical professionals. Even doctors in private hospitals are burdened by multiple taxation and heavy electricity bills among others. There are also challenges with universal applicability of wages whenever they are approved with some states and local government areas failing to adjust their wages.
3. Brain Drain: There is no profession more badly affected by the Japa syndrome than the medical profession. The statistics of medical doctors leaving the country is alarming and if not stemmed will soon lead to total collapse of the health sector. Nigerian doctors are forced to seek better opportunities abroad due to very low salaries, poor working conditions, and limited career development opportunities among others. This brain drain has led to a shortage of medical doctors in the country, markedly increasing the workload of the few left behind and further exacerbating the already dire healthcare crisis.
4. Violence and Security Concerns: The threat of violence, especially in conflict zones or areas affected by civil unrest, puts doctors and medical staff in constant danger especially when you consider that they have to work odd hours. Doctors are frequently at risk of being caught in the crossfire of societal turmoil. This risk is particularly heightened during emergency responses and the delivery of care in remote regions. Interestingly, even in areas of the country that are relatively safe, doctors are frequently victims of violence by relatives of patients following their death. Matters are made worse by some Nigerian police officers who criminalise death in hospitals with doctors being arrested for murder following death of patients.
5. Inadequate Training and Professional Development: Although, Nigerian doctors are ranked among the best in the world, the lack of continuous education and professional development opportunities significantly impacts the quality of healthcare delivery. Many doctors struggle to keep up with the rapid advancements in medical science due to limited resources for research and specialized training, and those that do, achieve this by self-help effort.
6. Overwhelming Workload: There are now too few hands to meet the needs of the rapidly growing population of Nigeria, medical doctors are overworked, leading to burnout, and risking the quality of care that the patients receive. This unfortunately is not taken into consideration by relatives, law enforcement agencies, the courts, and even the regulatory bodies. The medical doctor is expected to be super human. He loses on all sides making the work environment very hostile.
Proposed Solutions to Address These Challenges
Today is not just a time for reflection, it is a call to action.
1. Increased Investment in Healthcare: The government must prioritize healthcare funding, implement the 15% budgetary allocation to health prescribed by the Abuja Declaration, and ensure that medical facilities are adequately equipped. Budgetary allocations to the healthcare sector should be distributed in a way that ensures every hospital, from rural clinics to urban centers, has access to the necessary tools to provide quality care. We must invest in both infrastructure and personnel to build a healthcare system that can serve all Nigerians, regardless of where they live, urban and rural alike. A healthy nation requires healthy environments for healing.
2. Comprehensive Strategy to Address Brain Drain: it is obvious that to stem the flow of doctors leaving the country, we must create a conducive environment for them to thrive at home. This includes offering competitive salaries, career development opportunities, security, and improved working conditions. Nigeria needs to implement policies that ensure Nigerian doctors can access modern medical training and resources, making them feel valued and supported in their mission to provide quality health solutions to their patients.
3. Enhance Remuneration and Benefits: Doctors need to be compensated, not just with words of praise, but with the salaries, benefits, and protections they rightly deserve. Doctors deserve fair pay for their labour. Currently, negotiations are ongoing with the government. This should be concluded quickly to ensure inclusion in the 2026 budget. Tax relief, especially for professional allowances and those in private practice should be implemented. The government must address the issue of delayed salaries, ensure competitive remuneration packages, restrict multiple taxation, and improve the overall welfare of medical personnel. Incentives like insurance, housing, vehicle, and retirement benefits would help retain doctors in Nigeria.
4. Provide Security for Doctors: No doctor should fear for their life while delivering healthcare. The government must invest in providing a secure working environment for healthcare professionals, especially in conflict zones and elsewhere. Emergency services must be better protected, and doctors in danger zones should be given adequate security to perform their duties without fear of harm. Hospitals also need better security to protect doctors from harm. Law enforcement agencies should exercise restraint in dealing with health issues.
5. Public Private Partnerships: Government alone cannot solve all the challenges faced by Nigeria’s healthcare system. There is a need for increased collaboration between the public and private sectors to bridge the gap in healthcare delivery. Private investments in medical research, hospital infrastructure, and training programs can complement government efforts in strengthening our healthcare system. The Public Private Partnership model should be encouraged.
6. Promotion of Health Education and Research: In partnership with global health organizations and universities, as well as the Nigerian Doctors organisations in the diaspora, the Nigerian government should invest in medical research, develop health education programs, and establish international partnerships to keep Nigerian doctors at the cutting edge of medical practice. Encouraging young medical professionals to specialize in emerging fields will elevate the quality of care we provide and contribute to the development of a more advanced healthcare system.
7. Community Engagement: Good health is a shared responsibility. We should encourage civic participation, public health education, and support for healthcare initiatives in our communities.
A Call to building a better healthcare system
As we mark this Independence Day, let us renew our collective commitment to building a healthcare system that leaves no one behind. We need a healthcare system where top politicians and the rich will be proud to patronise. Let us build a system where doctors are empowered, patients are respected, and every Nigerian, no matter where they live, has access to quality care. Let us build a Nigeria where the next generation of doctors will choose to stay in Nigeria, not out of duty, but out of pride in what we have built together. Together, we can build a Nigeria where our doctors thrive, and our healthcare system is one of the best in the world.
Happy 65th Independence Day, Nigeria.
May our future be as bright as our hope.
