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Tag: brain drain

  • Initiative to reverse brain drain launched

    Initiative to reverse brain drain launched

    An initiative, the Return2Naija  has been launched to  empower Nigerian migrants to reintegrate, rebuild, and reimagine their homeland.

    The programme is stop Nigeria’s brightest minds from seeking opportunities abroad, resulting in a significant brain drain that threatens the nation’s innovative potential and self-reliance.

    Nigeria Student Ambassador and founder of the Initiative, John Aikeremiokha, said the initiative  has already garnered significant attention and support at the highest levels.

     “It was first launched at the Presidential Villa in Abuja, with First Lady in attendance, a powerful demonstration of commitment at the national level. Later, to strengthen its global impact, the project was relaunched at the United Nations Headquarters.

    This international endorsement underscores the initiative’s potential to address complex challenges such as organized crime while fostering the reintegration of migrant talent,” he said.

    He said the key objectives of the initiative include, reversing brain drain, encouraging Nigerian students abroad to return and contribute to the nation’s development.

     “On grassroots development, with dedicated funding, communities can gain resources to improve education, infrastructure, and economic opportunities. By repatriating talent, we can reduce our reliance on foreign expertise and build stronger, homegrown solutions to Nigeria’s challenges,” he added.

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    The initiative is aligned with the United Nations Office on Drugs and Crime (UNODC), highlighting the importance of collaborative efforts in addressing brain drain and promoting national development.

    By promoting reintegration and grassroots development, the Return2Naija Initiative seeks to restore homegrown brilliance and empower Nigeria’s future.

    “I am proud to lead this transformative initiative. Our journey begins with a historic road trip from London to Nigeria, a symbolic yet concrete commitment to our cause. Along the way, I will engage over 700 local government chairmen across Nigeria’s 36 states.

    The aim is to secure their pledge to allocate 5% of their annual project budget toward grassroots development so that returning students are supported in applying and amplifying their expertise where it matters most: in Nigeria,” he said.

  • CMDs: brain drain worsening health sector challenges

    CMDs: brain drain worsening health sector challenges

    Chief Medical Directors (CMDs) of teaching hospitals have raised the alarm over the growing brain drain in the health sector.

    They lamented the exodus of medical professionals who leave the country in droves in search of better opportunities abroad.

    They expressed this concern during a budget defence session before the House of Representatives Committee on Healthcare Institutions, chaired by Patrick Umoh.

    But, Coordinating Minister of Health and Social Welfare, Ali Pate assured that the government was actively addressing the exodus of doctors and other health practitioners through short and long-term strategies. 

    Pate mentioned the permission granted to CMDs to recruit health personnel to fill the gaps as one of the measures.

    Heads of federal medical centres and university teaching hospitals defended their 2024 budget performances and presented their 2025 proposals.

    The CMDs lamented that despite the Federal Government’s investments in health infrastructure, tertiary hospitals are at risk of becoming empty due to the exodus of doctors, nurses, and other skilled healthcare workers caused by poor remuneration and lack of incentives.

    Among those who attended the session were the CMDs of the University of Uyo Teaching Hospital (UUTH), Prof. Emem Bassey; Lagos University Teaching Hospital (LUTH), Prof. Wasiu Adeyemo; and University College Hospital (UCH), Ibadan, Prof. Jesse Abiodun, among others.

    Prof. Bassey said UUTH returned N1,056,034,392.80 to the Federal Government in 2024 due to staff shortages.

    The amount, originally allocated for salaries, could not be utilised because of unfilled vacancies resulting from staff resignations.

    “For 2024, our total capital appropriation was N20,617,154,692.56, broken down into personnel costs of N12,874,350,949.56, overhead of N240,186,681.00 (about N20 million monthly), and capital expenses of N7,502,617,062.00.

    “Personnel releases totalled N11,818,316,556.72, leaving a balance of N1,056,034,392.80, which was mopped up by December 31 due to unfulfilled recruitment,” Bassey explained.

    He further noted that UUTH achieved a 99.99 per cent release of overhead funds but faced delays in implementing a radio diagnostics centre project due to bureaucratic bottlenecks at the Federal Executive Council.

    For 2025, UUTH has proposed a total personnel budget of N19.93 billion, overhead costs of N482 million (approximately N40 million monthly), and a capital budget of N21 billion.

    Prof. Adeyemo of LUTH stressed the urgent need to improve remuneration for health workers to curb the brain drain, warning that Nigerian hospitals could soon be empty if the trend continues.

    “The primary reason workers are leaving is economic. We witness resignations every day. If this continues unchecked, our hospitals may become empty in the next one or two years.

    “While the government invests in infrastructure, hospitals remain empty due to the lack of staff,” Adeyemo said.

    LUTH’s 2024 budget of N19.2 billion included N13.57 billion for personnel and N33.2 million for overhead.

    Adeyemo reported 100 per cent overhead utilisation and 91 per cent personnel performance but noted that capital project performance stood at only 45 per cent, with significant outstanding releases.

    For 2025, LUTH proposed a budget of N32.7 billion, including N20.3 billion for personnel, representing a notable increase from the previous year.

    Prof. Abiodun of UCH expressed frustration over delayed fund releases, which he said had hampered operations.

    He said only 38 per cent of the hospital’s N5.59 billion capital appropriation for 2024 had been released, leaving a balance of 72 per cent.

    Read Also: Akande calls for establishment of moremedical institutions to tackle the brain drain

    “Payments only began in December. We were able to utilize the 38 per cent because we had already prepared a cash plan.

    “For 2025, we are proposing N4.39 billion for capital, slightly lower than 2024, as we had to adjust to the envelope system,” Abiodun stated.

    He added that UCH’s overhead budget proposal for 2025 is N690 million, reflecting an increase due to rising electricity bills from the Ibadan Electricity Distribution Company.

    Rep. Umoh described the situation in tertiary health institutions as precarious.

    He emphasised the need for fiscal responsibility and pledged the Committee’s commitment to ensuring that allocated funds are properly utilised.

    While the Committee could not address all institutions during the session, it resolved to collect written submissions for further review. Members later convened a closed-door session for additional deliberations.

    Pate said the Federal Government was addressing the issue.

    He told The Nation:  “Waivers have been officially granted to CMDs of tertiary health institutions, empowering them to recruit health personnel based on their specific needs and operational requirements.

    “In a concerted effort to improve healthcare delivery, the President has directed the Coordinating Minister of Health and Social Welfare to collaborate with various key stakeholders, including the Ministry of Health, the Office of the Head of Service, the Budget Office, the Ministry of Labour, and the Federal Character Commission.

    “This collaboration aims to thoroughly evaluate and consider the waiver requests submitted by tertiary health institutions.

    “This initiative is a crucial component of the Federal Government’s broader strategy to address the significant professional gaps in the healthcare system.

    “By enabling these institutions to bring in qualified personnel tailored to their unique demands, the government seeks to enhance the overall quality of care provided to the public and ensure that health facilities are adequately staffed to meet various health challenges.”

  • Increasing retirement age of health workers will address brain drain, says NMA

    Increasing retirement age of health workers will address brain drain, says NMA

    The first vice president of the Nigeria Medical Association (NMA), Benjamin Olowojebutu, has said increasing the retirement age of health workers from 60 to 65 will address the problem of brain drain, popularly known as “Japa” in the health sector.

    This was as he called for speedy passage of the Bill to increase the retirement age of health workers in the country from 60 to 65 and also increase the maximum pensionable years of service from 35 to 40.

    He said this when he and some members of NMA paid a visit to the member representing Agege federal constituency, Lagos State, Hon Wale Ahmed, in his office at the National Assembly Complex, Abuja to express appreciation for sponsoring the Bill.

    The Bill is titled: “A bill for an act to make provisions for the retirement age increment for health workers in Nigeria and for related matters.”

    “We are here to say a big thank you to our colleague and a member of the House of Representatives, Honorable Doctor, Wale Ahmed, for championing this important bill in the quest for healthcare delivery in this country. This is a way to reverse medical Japa and medical retirement.

    “One of the things we realize is that a lot of our doctors have experience, and when they exit after retirement those who replace them are younger colleagues that still need experience.

    “So one of the things to do is to increase their age so that there are more experiences for those younger doctors to learn from when they retire.

    “So we’re glad that we’ve come to see him today, and he has shown a lot more commitment to expedite the bill to become law in this country. And I can assure you, it will improve the morale of doctors in this country.

    “It will increase the capacity of training. It will improve the experience of our younger colleagues going forward. So we’re grateful to God, and we thank him for all he has done. We’re praying that God gives him more strength and more wisdom and also gives him good health in making this dream come through for Nigerian doctors now and beyond.

    “We want to appeal to the leadership of the House to look at this bill as a comprehensive bill that will aid healthcare delivery in this country that will support the livelihood of medical doctors that have served this country for a long time, and the passion we have put into this country.

    “A lot of our friends have left the country, but some of us are still very dogged and passionate about staying in the country because we are patriotic. We have a lot of passion for the health care of this nation, so we appeal to the leadership of the House to help us expedite this bill and let us enjoy the passion and the commitment we are giving to the Nigerian population,” he said.

    President of the Medical and Dental Consultants Association of Nigeria, Mohammed Aminu Mohammed, said the bill improves health care service delivery in the country.

    “Proposing this bill that has passed the second reading to increase the retirement age of healthcare workers to 65 is a worthy bill that needs urgent attention.

    “I plead to the leadership of the National Assembly, especially the Federal House of Representatives, the speaker and his able lieutenants to facilitate, to give this bill the urgency it deserves, just like the way they are given the national budget the urgency it deserves because it is going to touch the life of the masses from the cradle. That means, from when they were born to the oldest person in Nigeria.

    “We discovered that, as it affects our members, which is the apex of the medical profession, we have just a little over 6000 consultants in Nigeria. In a study that we conducted this year, we found out that about one-quarter of this number has replaced those country have left this country in the last five years.

    “To make this bill more relevant, we also found out that one, 1/3 that is 33.3% of all consultants that we have in Nigeria are already 55 years and above which means in the next five years, this number 1/3 is going to retire if nothing is done to this bill.

    “So pray that the National Assembly will view it as a point of national importance to pass this bill with all the urgency to which it deserves.

    “The passage of the bill is going to prolong the service years of the most experienced health care professionals in Nigeria. That is by no means going to improve the quality of health care in Nigeria and reduce the bad or the poor health indices that we have in this country because the most experience is going to remain in service so that they can impact their experiences.

    “They can impact the knowledge they gather over time. They can also continue to train others who will now become doctors. So they are not going to be doctors and healthcare workers alone, but they are going to come up right from the beginning with the wealth of experience that they have extracted from the people who have had their years of service extended.

    “With this, it is going to go a long way in making sure that we have a better health care service. We have well-motivated healthcare providers so that collectively, it can impact positively on the healthcare delivery in Nigeria,” he said.

    A representative of the Medical Women Association of Nigeria, Dr Izuagba Kelechi Udoka, lauded the lawmaker for his efforts in pushing the bill.

    “I believe with this, it will entice some of the people who have travelled out to come back and then be part of this force to move medical services and delivery,” she said.

    Hon Ahmed in his response said he was only doing his job as a legislator.

    He said his primary motive was representing all the people of Nigeria and improving the healthcare delivery system in Nigeria.

    “It also translates to the fact that doctors will be able to stay doctors and other healthcare professionals will be able to stay longer in service to pass on the experience to younger people and to maintain the required number of staff, which had never been enough at any time not to talk of, is now being depleted by migration and by retirement at the age of 60.

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     “So I was only doing my job and serving the people of Nigeria, but I’m happy it came to light. I want to thank the leadership of the House and all my colleagues for allowing it to scale through the second reading, and I’m using this opportunity to make a commitment that I will work as assiduously to make sure action is expedited on the passage of the bill,” he said.

    Recall that the Nigerian House of Representatives on Thursday, October 31st, 2024 passed for the second reading a bill extending the retirement age for health workers in Nigeria from 60 to 65 years.

    The proposed bill when becomes law would also increase the maximum pensionable years of service from 35 to 40.

    Also present during the courtesy visit are Dr Ayoku Emeka, Chairman, NMA FCT,

    Dr Tasie Obinna, MMA FCT liaison to National Assembly, Professor Alhaji Ibrahim, Secretary General, Medical and Dental Consultants Association of Nigeria, MDCAN among others.

  • N/Assembly to create opportunities for youths, tackle brain drain

    N/Assembly to create opportunities for youths, tackle brain drain

    The Deputy President of the Senate and 1st Deputy Speaker of the Parliament of the Economic Community of West African States (ECOWAS Parliament), Senator Barau Jibrin, has said the National Assembly will continue to enhance the relevant legislative framework to create more opportunities for Nigerian youths and tackle brain drain in the country.

    This is even as he assured of the readiness of the ECOWAS Parliament to create an enabling environment within the West African sub-region through legislation to promote the socio-economic welfare of the people.

    Senator Barau spoke yesterday at The Companion (Association of Muslim Men in Business and the Professions) 2024 conference and the 6th National Discourse at the National Universities Commission in Abuja.

    He noted that the theme of the conference, ‘Between patriotism and self-preservation’ and the topic, ‘Dilemma of the Nigerian youth: challenges at home, uncertainties abroad’, reflect the ethical dilemma confronting some of the country’s youth whose skewed mindset is not allowing them to appreciate the value and true essence of being Nigerians.

    He added that working with the executive arm, the federal legislature will create opportunities for the youth to pursue their potential to the highest levels within the country’s shores.

    “The theme of today’s discourse ‘between patriotism and self-preservation’ and the topic, the ‘dilemma of the Nigerian youths, challenges at home and uncertainties abroad’ aptly captures the dilemma confronting some of our youths whose skewed mindset is not allowing them to appreciate the value and true essence of being Nigerian.

    “I commend the organisers of this event for creating such a promising platform for sharing ideas that will advance the cause of our national values and development. You couldn’t have targeted a better segment of our society than the youth who are the leaders of today and tomorrow because they have enormous talents, energy, creativity, courage, industry and dedication to whatever they believe in.

    “Let me use this opportunity to iterate that the National Assembly is committed to enhancing relevant laws that will make Nigeria conducive for our youths and make them remain here to contribute to national development.

    Read Also: NMA asks FG to declare state of emergency on medical brain drain

    “I assure you that the legislative and executive arms of government are working together to create opportunities for our teeming youths to reach the zenith of their potential.

    “I will also ensure that given my position as the 1st Deputy Speaker of the ECOWAS Parliament, the parliament shall have seamless legislation that will promote the socioeconomic welfare of the people of our sovereign nations, especially the youth,” he said.

    Earlier, in his welcome speech, the President of the organisation, Engr. Kamil Olalekan pointed out that recognising the net detrimental effect of excessive immigration on Nigeria’s national development is crucial and stressed that a pressing issue of national concern is how to retain Nigerian youth, particularly professionals and skilled workers, to contribute to national development.

  • NMA asks FG to declare state of emergency on medical brain drain

    NMA asks FG to declare state of emergency on medical brain drain

    …demands immediate rescue of Kidnapped Kaduna Doctor

    The Nigerian Medical Association (NMA) has asked the federal government to as a matter of urgency declare a state of emergency on medical brain drain in the country to address the challenges making medical doctors run away from Nigeria.

    This was as the medical association called for the immediate rescue of their colleague, Dr. Ganiyat Popoola of the National Eye Centre, Kaduna, who was kidnapped at her hospital quarters over seven months ago.

    Addressing a press conference ahead of its Annual General Meeting and Scientific Conference slated for 10th August, the chairman of NMA Kaduna state branch, Dr Madaki David Sheyin, said statistics have shown that, over 15,000 Nigerian-trained Medical Doctors, have moved from Nigeria in search of greener pasture.

    He identified poor remuneration, poor facilities, security challenges and overstretched manpower as part of the challenges responsible for the medical brain drain, asking the government at all levels to declare a state of emergency to address the challenges.

    According to Sheyin, “We as an Association have continually advocated for better funding for the health sector over the years, we have had to grapple with dilapidated infrastructures, poor working environment, poor remuneration that has worsened the brain drain in the State and by extension the persistent shortage in manpower and inability to attract the required number of human resource for health in the right skill mix.

    “Security and safety of the healthcare workers has been a challenge as well, as hospitals and doctors have become soft targets by kidnappers for ransom. All this has put the state of our healthcare at risk, and the crass failure of previous administrations to tackle these challenges head-on has left more questions than answers.

    “As the parent body of all doctors in the State, we have led discussions with the current administration of Gov. Uba Sani who has shown empathy for the plight of healthcare workers as regards the challenges being faced, his government is giving us a listening ear which is a departure from our experience with the previous administration, there seems to be a resolve towards addressing the fundamental issues that has given rise to these challenges over the years.

    “We are not there yet but the journey of a thousand miles begins with a step. The initial steps the Kaduna State Government has taken are commendable and give us some glimmer of hope that after all there might just be light at the end of the tunnel. The progress made needs to be improved upon as there is still more work that remains to be done.

    “The ongoing renovation, reconstruction and upgrading of some secondary health facilities across the state have been long overdue and we commend His Excellency for this amongst other achievements in the last 13 months, the gradual improvement in the CONMESS salary scale for doctors is ongoing and this should be followed up with the implementation of the new hazard allowance for healthcare workers, accoutrement allowance and a sustained payment of Medical Residency Training Fund for Resident doctors that has been rather epileptic.

    “The challenges encountered by doctors in Barau Dikko Teaching Hospital need to be addressed squarely and we have previously recommended severally that giving the only State Tertiary Hospital full autonomy will solve over 90% of her lingering problems and eliminate the administrative bottlenecks encountered in funding and close gaps occasioned by acute shortage of manpower.

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    “The hydra-headed monster of medical quackery has been on the increase and can be tied to the inadequate number of qualified medical practitioners in the right skill mix across the state. The state government agencies charged with the responsibility of checkmating the activities of these quacks must up their game and come up with innovative ideas to stem this practice that has sent many innocent lives to their early graves.

    “More collaborative efforts must be employed with health professional groups to assist government identity such quacks so that the full scale of the law is applied to erring persons to serve as deterrents to others engaging in these unwholesome acts.

    “The NMA will not condone any form of aiding or abetting of malpractice by any member regardless of their status. We will always be willing to cooperate with law enforcement agencies including the Nigerian Police to ensure sanity and professional ethics are maintained.

    “The worrisome spate of kidnappings involving our members and their families have become a cause for worry and concern to us. The government must do all it takes to prevent such disturbing occurrences from happening. We are saddened by the continued captivity of Dr. Ganiyat Popoola a resident doctor kidnapped over 7 months ago from the National Eye Centre Kaduna hospital quarters, this is unacceptable and condemnable. 

    “Despite assurances of security agencies from both State and Federal levels on efforts to secure her release, Dr. Ganiyat, a breastfeeding mother still remains in captivity, reports of her failing health and harsh conditions she’s being exposed to calls for the need by all the relevant security apparatus in the country to intensify efforts to secure her release.

    “We call on the Governor as the Chief Security Officer of the State to immediately intervene and save Dr. Ganiyat and reunite her with her family and colleagues. It is imperative to state that all health facilities (Primary, Secondary, and Tertiary) across the State must be well secured, this will give all healthcare workers a sense of safety seeing that we provide essential humanitarian services 24 hours a day.

    “The NMA is in the process of developing a security/kidnap prevention advisory for our members,” he said.

    Speaking on the Annual General Meeting and Scientific Conference, the NMA Chairman said, “As we prepare for our Annual General Meeting and Scientific Conference coming up later this week (10th August) with the theme: Enhancing Healthcare Delivery amidst challenges: Strategies for a Sustainable Medical Practice in Nigeria, we must acknowledge that the challenges in the healthcare system are quite enormous and requires all hands to be on deck to tackle them and put us back on the right track towards a sustainable improved quality healthcare delivery system.

    “The focused investments of the current administration of Sen. Uba Sani need to be encouraged, despite the dwindling finances of the State and mismanagement and or non-appropriation of funds by the previous administration the governor seems resolute to change the narrative in the healthcare sector.

    “We trust and believe that the Governor will reposition the health system for greater achievements and better health outcomes. The sub-theme for the scientific conference aims to address safety and legal issues in medical practice to be delivered by a renowned Professor of Medical and Health Law, this will better inform members and the general public about professionalism and ethical issues in medical practice.

    “In the face of the nationwide protests, we urge our members to continue to provide medical services especially emergency services across the State. We advise members to be security conscious and watch out to prevent being caught up in any fracas that may arise from the protests,” he appealed.

  • Don challenges govt on brain drain among radiologists

    Don challenges govt on brain drain among radiologists

    • By Tosin Odunewu

    A Professor at the Department of Radiation Biology, Radiotherapy and Radiodiagnosis, University of Lagos(UNILAG),  Kofoworola Oluwatoyin Soyebi has urged  government at all levels to provide adequate facilities in hospitals  to mitigate brain drain among medical professionals, particularly radiologists.

    She delivered the  10th inaugural lecture of the institution entitled: “Bearing the Torch Aloft: The Trials and Triumphs of a Radiologist”, at the J.F. Ade Ajayi Auditorium.

    The event  attracted family, colleagues, friends, and well-wishers.

    She said: “Radiology is not a game of Spotting the Difference by an individual with a pencil in hand and paper bearing two sets of pictures trying to figure out and mark the difference between them. Rather, Radiology is a medical specialty that uses imaging technology to diagnose and treat diseases.”

    The don highlighted the challenges Radiologists  face in the country.  These include inadequate infrastructure, limited access to modern equipment, and insufficient training opportunities.

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    She said:  “There is insufficient number of radiologists graduating in medical schools to meet the demand exacerbated by the recruitment crisis. The resultant strain on the workforce will lead to burnout and overwork among the remaining physicians, so Nigeria government needs urgent strategic solutions to bridge this gap.”

    Soyebi called on government for increased support, improved funding for healthcare facilities, and enhanced educational programmes to empower radiologists and enhance their capabilities for more effective services to their community.

    While highlighting her research efforts and accomplishments,  she  described herself as “one of the lucky few who by providence early in her career had opportunities to travel to more advanced places to receive training in capacity building.”

    She noted that these opportunities enabled her to impact and contribute her quota in delivering trainings, conducting clinical research, as well as benefiting from collaborative opportunities and funding to actualise her vision.

  • Japa and challenge of brain drain

    Japa and challenge of brain drain

    • By John Amabolou Elekun

    Sir: Brain drain, the emigration of highly skilled and educated individuals from one country to another has become a pervasive global phenomenon. This phenomenon has significant implications for the countries of origin, particularly in the developing world. One such country grappling with the repercussions of brain drain is Nigeria.

    Migration has been an integral part of human history, driven by economic, social, and political factors. In recent decades, globalization has accelerated the movement of people across borders, with skilled professionals seeking enhanced career prospects and improved quality of life. The United States, Canada, the United Kingdom, Australia, and France have been among the favoured destinations for individuals pursuing a better future.

    Several factors contribute to brain drain, with economic opportunities and job prospects being primary motivators. Developed countries often offer higher salaries, better working conditions, and advanced research facilities, attracting skilled professionals from around the world. Additionally, political instability, lack of job security, and limited career advancement opportunities in some countries further drive the emigration of talented individuals.

    Nigeria, the most populous country in Africa, has experienced a significant outflow of its skilled workforce, including medical doctors and nurses. Several factors contribute to this phenomenon: Nigeria faces economic challenges, including a high rate of unemployment and insufficient financial incentives for professionals. The allure of better salaries and improved living standards in developed countries is a powerful force drawing Nigerian talent abroad.

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    Inadequate infrastructure and challenging working conditions in Nigeria, particularly in the healthcare sector, push professionals to seek environments with better-equipped facilities, advanced medical technologies and improved patient care standards.

    Limited access to cutting-edge educational resources and research opportunities in Nigeria can discourage professionals from staying in the country. The prospect of advanced training and research in well-established institutions abroad is a significant pull factor.

    Periods of political instability and insecurity in Nigeria contribute to a sense of uncertainty among its citizens. Seeking a stable and secure environment becomes a priority for those with the means to migrate. Concerns about the overall quality of life, including access to education, healthcare, and social services, motivate individuals, including healthcare professionals, to relocate to countries offering a more comprehensive welfare system.

    Brain drain is a complex and multifaceted issue with far-reaching implications for countries like Nigeria. Addressing this challenge requires a holistic approach, including economic reforms, investments in education and healthcare infrastructure, and efforts to create a conducive environment for professional growth. Only through comprehensive strategies can nations hope to retain their skilled workforce and foster sustainable development.

    •John Amabolou Elekun,

    Iju-Ajuwon, Lagos

  • ‘Brain drain solution needs a multifaceted approach’

    ‘Brain drain solution needs a multifaceted approach’

    The Chief Medical Officer (CMD), Alimosho General Hospital, Dr Adedapo Soyinka, says the brain drain needs a multifaceted approach. The specialist in Obstetrics and Gynaecology, who graduated from the College of Medicine Idi-Araba, University of Lagos, in 1995, did his postgraduate studies at Obafemi Awolowo University before traveling abroad for further training. He bared his mind on the state of healthcare delivery system in the country, the worsening crisis posed by brain drain and how it can be managed as well as the challenges of managing a public hospital with meagre resources. He spoke with CHINYERE OKOROAFOR.

    How to solve brain-drain problems

    octors have been talking about the way forward. The solution to the brain drain needs a multifaceted approach because I’m sure you have heard people talk about the pull and push factors. The push factors are the things pushing people away from here. Why? We want a better infrastructure; we want our working environment to be decent and conducive. To retain people, the infrastructural upgrade needs to be optimised. Welfare is another pull factor. Inflation has cut off what anybody is collecting now; salaries need to be increased or doubled to make sense and gladly the government has gone back to the drawing board. If the government does that, maybe more people will be willing to stay.  There should be training opportunities for doctors and nurses to make progress in their careers. I went abroad and the practice abroad is that once you are done, you don’t stay stagnated. While you are a medical officer, there are many opportunities for you to go for training. Some people are medical officers for years, some have even done postgraduate exams, they passed and there is no available space. Not all hospitals can train but hospitals like Alimosho should be a training place for even postgraduates, because more people will stay when they have that fulfilment that they are making progress in their career. So that is another aspect to look at.

    Other social amenities, which I think government should look into is that before, the practice used to be that when you are qualified as a doctor, you have access to house and car loans and other housing facilities. If we can bring that back, in fact, I see it as a smart way to tie people down, give somebody a building and say pay over the period of 10 years. Here is a car loan, pay over a period of time too, government is your guarantee and a portion will come from your salary. People wouldn’t be in a hurry to leave. The pull factor you may not be able to do much about but the push factor we can do something about what is pushing people away. What is pulling people abroad is stronger than us; so we have to respond by addressing the push factors. There should be accommodation facilities for staff to attract more workers.

    Challenges of managing a public hospital and coping strategies

    Top of the list of challenges is that there is a very strong wave of staff attrition. Every week, I see resignation letters from nurses who are top on the list and doctors and paramedics staff. The brain drain is affecting the hospital where we have over 30 departments and handle major sub-specialisation in medical practice. For every nurse or doctor that leaves, it is a major depletion in our workforce and that affects the services that we render. If there is anything, I need more; it is more staff right away. When a staff leaves, the implication of that is that we redistribute staff to make sure that the gap is covered and of cause the implication is that there is more pressure on the staff, which affects their quality of service, their attitude to work and the psyche of the personnel.

    The World Health Organisation says that one doctor should attend to 600 patients and you discover that, at times, a doctor sees thousands of patients in this part of the world. Honestly, the doctor and nurse patients’ ratio is quite absurd. For us, we make sure that the work keeps going. We also have the challenge of capital. As you know, being the CMD, I have access to my Internally Generated Revenue (IGR), which is supposed to be used for recurrent costs, power, oxygen, consumables and minor repairs, but we are forced to use some of these limited funds from our IGR to do capital projects because the approvals are not coming in as quick as they ought to be. And you can’t afford to have interruptions in providing services. At times, we have to use our IGR to do a hire purchase because we are yet to get approval to replace a machine that has gone bad or we buy and pay installmentally. It is also from the IGR that we maintain the building where the intern or in-house officers stay. It was built by SGDs. We have a facility manager who takes care of the place. There are also a lot of challenges in trying to keep the hospital stable; most suppliers have increased the prices of all the things used in the hospital but we’ve tried to not increase the tariff. Despite the inflation, we’ve tried to keep the hospital tidy with an increase in a few items.

    Having a dumpsite near our hospital is a challenge

    Another challenge is also the dump site. It is a major problem that is beyond me; it affects us because it smells and during the rainy season, it’s awful. At times when I’m frustrated, I call the General Manager of Lagos Waste Management Authority (LAWMA) and he has been cooperative. He will mobilise and they will put chemicals and turn the dirt over and the smell will only become bearable. The Commissioner of Environment and the Permanent Secretary are aware. Even the governor when he came to commission the Mother and Child Centre, he promised that they were going to look into it. So I’m sure the government is giving it a lot of consideration. If there is anything I would want to change, it would be the dumpsite because during accreditation of the hospital, supervisors also complained about it, which affects our performance. International agencies come to assess the hospital and they always said the dumpsite shouldn’t be close to the hospital. So in terms of the environment, we score zero on accreditation. The waste can also seep into the water of the community.

    High medical cases at Alimosho General Hospital

    There are so many departments, which are difficult to compare but I can mention some departments and tell you what seems to be the major problem there, for example, the paediatrics department. In this department, there are lots of birth asphyxia (suffering of a child’s brain during childbirth) which is responsible for a lot of deaths that came from referrals who gave birth at home. The babies don’t cry well and some of them need oxygen, an incubator or special care. In medicine, we see a lot of stroke and kidney problems. Hypertension is also on the rise and some of the complications of hypertension are heart failure or cardiovascular accident, which is stroke and renal problems. Another department is Obstetrics and Gynaecologist department where the general problem is malaria, low blood, and high blood pressure in pregnancy. 

    Why more medical departments were created

    It was a necessity because patients that we were often referring to teaching hospitals can now get the treatment they want here at Alimosho. In this hospital, we’ve improved tremendously and I can say this with all boldness. Since assuming office, we have been able to introduce five new speciality departments that were not here before such as the Neurology clinic (specialises in male issues], Orthodontist, Ear, Nose and Throat (ENT) clinic and that unit is pulling a lot of crowds because, in this axis, no hospital has an ENT surgeon. We didn’t have endocrinologist before, but we were fortunate the Lions Clubs had one for us which is called the Diabetes Centre. We didn’t have a Histopathologist before but now we have and we are planning to do higher things like autopsy in that department because the Sustainable Development Goals (SDGs) department from the Presidency built a morgue for us, which is awaiting commissioning. We also have Burns and Plastic department. 

    There is also a partnership that was supposed to have taken off, which is a Public Private Partnership (PPP) arrangement with another firm, which is about to start soon. Part of what these are bringing to the table is Molecular Biology and DNA typing and analysis. We also have a Wellness and Diagnostic Centre, a 50-bedded accident and emergency buildings that is awaiting commissioning.  What we don’t have in this hospital right now is a brain surgeon but we are working on how to get one and it is not easy because they are not so many and they are at the teaching hospitals. And one of the things we need for a neurosurgeon is an ICU so I have decided by the grace of God before the end of this year we will have a 10-bedded ICU, which is almost 90 per cent ready and there will be oxygen piped there. There are some kinds of cancer that we can manage here as well such as breast lumps but when it comes to administering chemotherapy, some can be done in-house by the speciality in that department. Some we will need a cancer specialist particularly in radiotherapy to kill the cancer cells that we will have to refer. 

    Addressing patients’ complaints and managing workers’ stress

    Occasionally, we take ourselves out. I remember the year, a few months back, I had a day out with the doctors, and we went to the beach. All work and no play makes Jack a dull boy. We also do monthly sports activities, distribute welfare packages and encourage the best workers of the month, quarter and year – both junior and senior workers. We also sponsor our workers for training so that they can upgrade themselves.

    The complaints have reduced now. I remember when I came, it was war. The number one complaint of patients has to do with medical records. The traditional practice is that everybody resumes at 8 am. If you have gone to government hospitals and you have a card, they will just say your appointment is say tomorrow by 8am and imagine the outpatients’ ward where you are going see 300 to 400 patients and all of them come at the same time or 80 per cent of them come at 8am. And then we also have the problem of retrieving folders. People will queue outside the office lamenting why their files can’t be seen.

    And to a patient, if you say you can’t find their file, it is a grievous crime. It is like saying to them that they don’t exist in the hospital; so they become annoyed and they begin to complain. So I saw that there was a need to move from manual files to electronic files. We called in an expert in the field who did the costing and we said that we don’t have money, but can pay in instalments. He was able to dance to our tune and he installed the infrastructure and we started with the outpatients and it worked well. So, we extended it to another speciality clinic. Now the whole hospital is on the electronic medical report; so it’s bye-bye to paper files in Alimosho General Hospital.

    What we are also trying to do now is to upload the older files into the system and all our records are saved in the cloud. We also have a specialised register where patients can book the time of their appointment. So after that time, we attend to people who have urgent but not emergencies; so the waiting time is reduced and it has started in all our departments. Our ICT department was trained by the consultant who left his staff for a year to teach them how to run it and do the maintenance. In addition to that, I got a machine called the Queue Management System (QMS) that maintains first-come-first-served priority.

     We also started what we call staggering appointments. In staggering appointments, we look into how many patients we see in a day. Let’s say a particular clinic sees patients in a day, we agreed that not all of them should come at the same time and keep a long wait. Now, we have a specialised register where we can book you based on the time you want to see the doctor.

  • Brain drain: Show us we are valued, appreciated – Nurses tell FG

    Brain drain: Show us we are valued, appreciated – Nurses tell FG

    Nurses on Monday appealed to the Co-ordinating Minister of Health and Social Welfare, Prof. Muhammad Pate, to ensure adequate investment in manpower and infrastructure to transform Nigeria’s health sector.

    Mr Toba Odumosu, Secretary, National Association of Nigerian Nurses and Midwives (NANNM), Lagos Zone, made the appeal in an interview with the News Agency of Nigeria (NAN) on Monday in Lagos.

    Odumosu also urged the minister to ensure that budgetary allocation to the health sector aligned with the 15 per cent Abuja Declaration pact.

    NAN reports that Heads of State of African Union countries met in April 2001 in Abuja and pledged to set a target of allocating at least 15 per cent of their countries’ annual budgets to improve the health sector.

    Read Also: Film on brain drain exposes a lot

    According to Odumosu, the health sector has been grossly underfunded for years, leading to emigration of healthcare workers.

    He also told NAN that the Nigeria’s current system did not support professional development of nurses and midwives.

    He, therefore, urged the minister to ensure that adequate manpower development and robust reward measures were put in place to discourage brain-brain in the health sector.

    He advised the minister to remove disparities in salary structures of healthcare workers to give a sense of belonging, fulfillment and inclusion to all of them.

    Odumosu said that disparities in salaries had led to series of strike by NANNM and Joint Health Sector Unions, noting that while adjustment was made for medical doctors, salary structures of other health professionals had yet to be adjusted.

    He said that there was the need for a radical approach to Nigeria’s primary healthcare system development, noting that there were many non-functional Primary Healthcare Centres (PHCs) across Nigeria.

    According to him, the non-functional PHCs were putting a strain on the secondary and tertiary healthcare.

    “We need to improve the funding of PHCs so that they can deliver preventive and quality healthcare to citizens.

    “The minister has a wealth of experience in PHC system; so, he is familiar with the terrain,” he said.

    Reacting to the plan of the Nursing and Midwifery Council of Nigeria to develop a migration policy to curtail brain-drain in the health sector, he said: “What we expect are policies that should encourage people to stay back.

    “One of the major concerns to nurses is working in a system that doesn’t support one to practise to the full extent of one’s professional qualification and training.

    “Imagine an instance that the Federal Ministry of Health had to issue circular before midwives were allowed to take child delivery in tertiary hospitals in the country.

    Read Also: Film on brain drain hits Abuja

    “If you seal up the ceiling of legitimate aspirations, how do you expect people to stay or thrive there?” he asked.

    According to him, the policies should show that nurses are valued, recognised and appreciated.

    Odumosu appealed to the Federal Government to ensure inclusivity of various health professionals in its cabinet and boards of health ministries, departments and agencies.

    “The last time we had a nurse as a minister of health was when Sulaiman Bello was there during Goodluck Jonathan’s administration.

    “Nurses want to participate in leadership, they want to be members of boards, have a sense of belonging and inclusion in healthcare service delivery system,” he said. (NAN)

  • Govt ready to curb doctors’ brain drain

    Minister of State for Health, Dr. Osagie Ehanire in this interview with Omolara Akintoye talks about government’s plan to take care of the health sector and make it better

    HOW can 432 orthopaedic surgeons handle 190 million Nigerians and what is government doing to increase this number to enhance the required target?

    Not only are we trying to increase the number of orthopaedic surgeons in the country, the universities and orthopaedic hospitals are helping to train specialists in this field. We are also going beyond that to increase the number of health care givers in the area of orthopaedic nursing, and also emergency response i.e. emergency medical technicians are also being trained to handle response issues and nurses who specialize in working with trained surgeons particularly in the theatre and also in service delivery. Efforts are ongoing to increase the capacity and to improve the quality of manpower. All these of course is subject to resources as well as the drainage of manpower in terms of those trained by the government and at the end leave the shores of Nigeria for greener pastures. We try to encourage them as much as we can to stay.

    Talking about sport injury, it is true that accidents occur in sports all the time, but it is sad to discover that Nigeria being a sporting country lacks the database to report sport injuries, why don’t we have a national mandate to report sport injuries as we have for Tuberculosis, malaria cases among others?

    I believe we are developing in all areas and in the area of sport injuries, efforts and initiatives are in place to create data and to have records in the area of activity in this country and sport injuries will not be exempted. Yes we have sport surgeons, doctors and nurses and they go with our teams wherever they go to play. Sport men and women who are injured are given very specialized treatment.

    The issue of inadequate funding of our health institutions is still a major problem, no equipment to work with, lack of adequate manpower and the issue of power failure. Records have shown that for these institutions to get fund, everything stops at your table, what is your Ministry doing in this area?

    Well, I will not say that there is any ministry or agency that has adequate funding for its ministry, and Nigeria is still very far behind in the area of development. In fact, you are to ask any of the ministers they will tell you that they want a state of emergency declared in their sector. In the area of healthcare we do hope that funding will increase and things will improve with time. We are also aiming ultimately for the 15% Abuja intervention in the health sector. It has increased with the introduction of the Basic Evacuation Fund since the last budget cycle and we hope it continues that way and additional resources will be brought in as we improve on our own healthcare delivery system. But then there is also the aspect of efficiency, we must also learn to make the best use of the available resources, need to increase productivity, to be more innovative and deliver better service with the little we have so that the budgetary department will be encouraged by what we are doing in the health sector and increase the funding.

    You mentioned earlier that we have more death cases from road accidents than HIV/Tuberculosis combined. Do we have the manpower to handle emergency cases?

    My Ministry is partnering with all organs concerned: Federal Road Safety Corps (FRSC), Ministry of Works, Transport, Health, Police, and Civil Defence Corps, even the Fire Service and Civil Societies, National Union of Road Transport Workers (NURTW), among others. It is true that a lot still needs to be done and most of what needs to be done is in the area of prevention. The Vehicle Inspection Unit must also be part of the team because the percentage of road accident due to poor quality of vehicle maintenance is significant, the deplorable condition of roads, lack of road signs, and poor quality of driver training. If we are able to take care of this, then the number of deaths on our roads will be reduced tremendously. The next will be the doctors’ work, response, rescue, First Aid and treatment. For that we have the basic health care provision fund which provided 5% for emergency care which we are working on to ensure that it is judiciously spent.

    Give us more insight into the 5% Emergency Fund which your ministry is proposing to give easy access to emergency cases. When is this going to be implemented?

    One of the greatest problems we have is that once victims of road accidents are taken to the hospital, they are unable to pay, though some of them might be very wealthy but at that very moment, they may not have money on them. So we observe that there are lots of casualties, there are losses of lives due to the fact that there is delay and there is hesitation on the part of hospitals to do treatment because they are worried about who will pay for it. So we are proposing for the creation of the Health Emergency Fund, out of which there will be ‘seed money’ from the 5% that is provided in the basic health care provision fund for emergency care. That will be seed money and it will be managed in such a way that we shall guarantee all accredited hospitals who are registered with the National Emergency Medical Service that they will be paid for treating patients who are brought in and there will be no need to ask such patients to pay a deposit and there should be no restrictions so that we can save lives in that way. This is what is applicable in all developed countries. This fund will be seed money and contributions from all parties and partners to grow it and has to be managed in an efficient way. The concept is still being developed; we are working on a committee that will create the terms of reference, the modus operandi to get the fund working in the most effective ways. We are also identifying urgent care centres that will be developed from existing assets along the road corridors at reasonable intervals where urgent care will be done, they will be certified, both public ambulances and private to declare themselves fit to participate in the scheme and provide a network of services for ambulances and urgent care before referrals to definitive hospitals which will include trauma centres that we are trying to set up.

    How soon do we expect this?

    Well, first of all, we must develop a concept and then we begin to look for budgetary provisions to get this idea into fruition to have a modern ambulance and emergency response system.

    How will your ministry tackle the problem of brain-drain in the health sector coupled with the limited number of doctors and healthcare givers without increase in the minimum wage and many people are sick?

    The good news is that there are so many Nigerians trained abroad and are also coming back home. Yes, the issue of brain-drain is still a serious concern because so many of our health care givers are seeking for greener pastures. We are looking for ways to address this, but then it is difficult to remove completely with the salaries that are paid abroad because of our level of economy. Nevertheless, we still need to do the best with the little resources available to us; we need all hands on deck to find solutions to our problems. All players in the health sector need to come on board to contribute their own quota to the development of the country.