JAPA Syndrome and Nigeria’s Crumbling Healthcare System: How Do We Stem This Tide?
Nigerian citizens across different disciplines have always explored career prospects outside the shores of the country. This trend dates back many years—no big deal.
The big deal, however, is that in the immediate years leading up to 2019, the trend, especially with respect to healthcare workers of different sub-specialties, significantly saw a sharp ascent.
Confronted with gaping holes in their healthcare systems, nations in Europe and the Persian Gulf have continued to endear immigrant healthcare workers to their shores to avoid an imminent shutdown in their healthcare delivery systems. On the other side of the coin, nations like Nigeria have gone deeper into revelry, becoming open harvest fields for healthcare manpower.
It is no longer news. Nigeria’s healthcare delivery system is crumbling. Private hospitals are shutting down right now. Public facilities are becoming eerie and haunted places, with tales of abandonment, absent workers, and poor care.
And so we’ve got this scenario unfolding before our eyes—a spectacle both of shame and fear…
Let us make no mistake about this grim challenge; it is not a failure of policy. It is a failure of governance. It is a depiction of how nonchalant the Nigerian system has become. It also points to how the already dazed citizenry has become conditioned to not raise the alarm even in the face of deathly danger!
The Japan Syndrome is not a haphazard or unpleasant phenomenon that is happening to Nigeria because of some strokes of ill luck. It is a result of the cumulative years of neglect, misgovernance, and misdirection that the nation is contending with. It is true that there is a global shortfall of manpower in key areas, especially healthcare delivery, with WHO estimating a shortfall of over 18 million healthcare workers around the world in 2020. However, what is truer is that this shortfall is skewed even more unfavourably towards low and middle-income countries, especially in sub-Saharan Africa, where they are burdened with lackadaisical, unresponsive, and corruption-plagued leaders.
Read Also: The Japa Syndrome: A Looming Crisis for Nigerian Universities
It is a fact that sub-Saharan Africa is one of the most badly governed regions of the world, and Nigeria is at the centre of this ugly narration. In 2006, WHO posited that while the region accounted for about 11% of the world’s population and 25% of the global burden of disease, it possessed only a disproportionate 3% of the number of health workers globally and accounted for less than 1% of the world’s expenditure on healthcare!
This inequitable distribution plunged slothful countries like Nigeria into a more vicious cycle as more health workers continued to migrate in large numbers to higher-income countries. In 2020, at the peak of the COVID pandemic, the global stock of medical doctors was put at about 12.7 million, but Nigeria, with a population estimate of about 200 million people, barely accounted for about 24,000 out of this figure!
And to put this grim scenario in proper perspective, we must note that for citizens to have a fair chance of responsible healthcare delivery, there should be about 1 doctor per 600 people. With our current numbers, one doctor in Nigeria is caring for 8,000 citizens! While Nigerians are bearing the brunt of this acute dearth of experienced personnel in their health facilities, a large number of our home-grown healthcare personnel are being absorbed daily by other nations to bolster and improve their healthcare systems.
The ironically sad reality is that today, there are more Nigerian-trained health workers outside the country than inside.
These challenges came to the fore recently when Prof. Ali Pate, Nigeria’s Minister of Health and Social Welfare, hinted that the nation has a deficit of about 400,000 health workers [doctors, pharmacists, nurses, laboratory scientists, and others] to stabilise its healthcare delivery system to be able to offer quality care adequately for the citizenry. While acknowledging the deficit, he pointed at producing more health manpower as a way out of the quagmire.
Perhaps the best thing to happen to Nigeria’s healthcare system in over a decade is the return of the erudite Prof. Ali Pate to the scene! He is a round peg in a round hole, but on a burning field!
There are two acid tests, however, that Professor Ali Pate’s ‘way out’ solution must pass…
Firstly, is there any guarantee that if we step up efforts to churn out more healthcare manpower, we will not be doing so to feed the insatiable destinations in Europe, the United States, and the oil-rich countries of the Persian Gulf?
Secondly, are Nigeria’s government and politburo genuinely interested in resolving this logjam, and will Prof. Ali Pate be able to chaperone government thinking to put citizens’ interests on top of the agenda [at least] in the matter of a responsive healthcare delivery system?
Finally, what more can we do as a nation at this time to reverse this damning tide?
We must commit to building a resilient healthcare system.
There must be deliberate efforts to ensure the protection of healthcare workers from economic adversity and violence.
The architecture of the NHIA [National Health Insurance Authority] should be retooled as a central compass to help Nigeria navigate through these stormy paths.
Bolster genuine public-private partnerships in healthcare delivery.
We must champion an appropriate reward system to convince healthcare workers to stay in their profession and remain in Nigeria.