Human mobility has always been an essential aspect of life. Beyond the essential physiological and psychological motivations to move, the constant quest for better living conditions, often drives migration. This has implications for public health policy, highlighting the need to consider trends in health worker migration in the formulation of health strategies and interventions.
In Nigeria, health worker migration, or 'brain drain', has been a persistent issue with many Nigerian healthcare professionals seeking better opportunities in other countries. This has led to a skilled health worker-to-patient ratio of 1:9,000 patients, far below the World Health Organisation (WHO) target, creating uncertainty in the country's ability to attain both Universal Health Coverage (UHC) and Sustainable Development Goals (SDGs) by 2030. 2030.
While a well-managed migration of health workers can play a key role in development, having a framework to manage healthcare worker migration effectively is critical to minimising the detrimental consequences of health worker migration. These were part of the recommendations from the 2018 Future of Health Conference themed 'The Diaspora as Nigeria's Brain Gain', which emphasised the need for sustained government intervention to enhance the "brain gain" by providing an enabling environment for healthcare workers to thrive.
Recently, President Bola Ahmad Tinubu, took a crucial step towards addressing the country's brain drain by signing the National Policy on Health Workforce Migration.
The policy document, introduced by Professor Muhammed Ali Pate, Nigeria's Minister of Health and Social Welfare, highlights the collective commitment to mitigating the multifaceted challenges posed by health worker migration. He noted in the policy document that "this policy is born out of a collective resolve to address the complex dynamics of health worker migration, ensuring that the exodus of our skilled healthcare professionals does not compromise the health system's integrity and the well-being of our citizens."
What is the policy is about?
The National Policy on Health Workforce Migration attempts to manage health workforce migration proactively which includes addressing the underlying issues of shortage of qualified healthcare workers, particularly in rural and neglected areas in Nigeria.
This strategy presents a comprehensive framework to address these fundamental concerns, with an emphasis on enhancing the quantity and quality of training, recruiting, and international cooperation.
These are the major highlights of the policy:
The policy also focuses on thematic areas in mitigating the negative effects of health workforce migration in the country. These include Health Workers Safety, Capacity Development, Strengthening Health Workforce Education and Training, Health Diplomacy, Ethical Recruitment, and Equality, Research, Innovation, and Strategy including Governance and Leadership.
Where similar policies have been implemented
To effectively implement this policy, Nigeria can draw valuable lessons from the successful strategies employed in countries like Thailand, Cuba, and India.
Thailand's strategy to reduce the outflow of healthcare professionals involved providing financial incentives, which improved the economic well-being of healthcare workers. By increasing salaries, offering bonuses, and ensuring timely payments, Thailand made the domestic healthcare sector more conducive, thereby reducing the desire to migrate for better-paid jobs abroad. This approach not only motivated healthcare professionals to stay but also enhanced their commitment to the local health sector.
Nigeria can implement similar strategies by revising the compensation packages for healthcare workers, ensuring competitive salaries, and establishing clear career pathways that include opportunities for training, promotion, and specialisation within the country.
Cuba's success in producing a surplus of healthcare professionals stems from its strong investment in medical education and training. By establishing a robust network of medical schools and ensuring high standards of education, Cuba has not only met its domestic healthcare needs but also created a pool of professionals who can be deployed internationally. Cuba also has a unique approach in deploying healthcare professionals abroad as part of medical diplomacy efforts. This has not only benefited host countries but also provided economic and diplomatic benefits to Cuba.
Nigeria stands to gain immensely by prioritizing substantial investments in medical education and training, to produce a more skilled healthcare workforce. This effort should include further expanding medical schools, offering scholarships to aspiring healthcare professionals, and maintaining rigorous standards of training.o By embracing this approach, Nigeria can address its healthcare challenges and expand the supply of health workers through increased medical training opportunities.
India's initiative, the Overseas Indian Facilitation Centre (OIFC), is designed to harness the resources, expertise, and abilities of Indians living abroad for the benefit of India's development. By creating platforms for engagement, offering investment opportunities, and facilitating collaborations, India has successfully tapped into the potential of its diaspora.
Healthcare organisations such as the Association of Nigerian Physicians in the Americas (ANPA), Canadian Association of Nigerian Physicians and Dentists(CANPAD), Medical Association of Nigerians Across Great Britain (MANSAG) play a vital role in harnessing the skills, expertise, and resources of the Nigerian diaspora to drive national development, with a focus on transforming the healthcare sector through policy advocacy, mentorship opportunities for young professionals, educational conferences, medical missions, and providing hands-on training. At the heart of this is the creation of an enabling environment by the Government through enabling policies for healthcare.
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The future could be bright
The newly signed National Policy on Health Workforce Migration emphasises increasing incentives for health workers, especially those in rural areas. This is a welcome development as it will enhance healthcare delivery in underserved regions, leading to improved health outcomes and progress towards UHC.
The policy's emphasis on capacity development and diaspora engagement is expected to lead to advancements in medical education, training, and healthcare technology, ultimately benefiting the entire sector.
However, the policy's success will depend on effective implementation, which requires strong governance, adequate funding, and coordination among various stakeholders, including government agencies, professional bodies, and international partners.
The policy on Health Workforce Migration is a strategic maneuver that aligns with the Nigerian Health Sector Renewal Investment Initiative (NHSRII) . By addressing the critical issue of healthcare personnel exodus, the policy aligns with the four-points of the agenda. Ultimately, the policy's emphasis on health system governance and leadership, positions it as a cornerstone for building a resilient and sustainable healthcare system, aligning with the fourth pillar of the Federal Ministry of Health and Social Welfare Strategic Blueprint for the Health sector which seeks to address health security.
