Why 50% of Nigeria-trained doctors practise abroad, by minister

Doctors should develop entrepreneurial skills, look beyond medicine
Minister of Health, Prof. Isaac Adewole, has offered reasons why about 50 per cent of Nigerian trained doctors are either practicing abroad, not practicing at all or are dead.
Speaking in an interview with The Guardian, he noted that not all doctors could be specialists because the country does not have space for everybody, adding that they should develop entrepreneurial capabilities and look beyond medicine.

His words: “That is the available data, about 50 per cent or a little less. But when you look at the doctor-patient ratio, it is not what I would love to see, but it does not constitute a human resource crisis as of today.

“My challenge as a doctor and minister is that I will like to see the distribution reprioritised. I would want to see more doctors in the rural areas and I am going to work with the ministry, National Youth Service Corps (NYSC) to post doctors to rural areas, at least to Local Government Area headquarters rather than post them to ministry of health, teaching hospitals, let them function at General Hospitals.

“Then we use nurses and midwives to drive our Primary Health Care (PHC). When you look at doctor to patient ratio in Nigeria it is about one to 5,000. In South Africa it is about 1:4,000. The only country that is far ahead of us is Egypt which is about 1:1,235.”

Reacting to the crisis in the resident doctors’ training and his earlier comment that some doctors could be farmers, Adewole said: “I have said it many times that really, I was quoted out of context and the message was lost. What I said was borne out of reality that not all doctors can be specialists because we do not have space for everybody.

“Currently, I made mention of one of our hospitals that interviews 800 people and has room for less than 150, which is less than 1:5. The last time University College Hospital (UCH) did recruitment test for residents into Obstetrician and Gyneacology (O&G) department, over 200 persons applied for six positions. They set examinations for them and I think about 50 passed and yet only six of them were needed.”

Adewole added that in spite of the challenges, Nigeria has the third best doctor-patient ratio of one doctor to 5,000 patients compared to 1:4,000 in public healthcare in South Africa and 1:300 in private healthcare in South Africa.

According to the Minister, Egypt has the best doctor-patient ratio in Africa with 1:1,235. Others are Ghana (1:14,310); Tanzania (1:20,000); Ethiopia (1:118,000); Kenya (1:16,000); and Cameroon (1:40,000).However, no African country has met the World Health Organisation (WHO)’s recommendation of one doctor to 600 patients (1:600).

On why Nigeria has not met the WHO recommendation, he said: “That is the ideal, but only few countries have attained that. We need more doctors. We need to change the reward system. I just came back from India where doctors are given free accommodation. They are not only given free accommodation, the faculty staffs are paid to attend international conferences every year.

“We really need to look at our reward system to keep our doctors here. What we are also doing is to attract those that have gone to come back home. Not to stay for life but to impact knowledge and offer help to our people.”