Migration: Africa risks 6.1 million shortage of health workers — Nigeria–Ghana PSI unions

… urge African governments to recommit to 15% budget allocation to health

Public service health unions in Nigeria and Ghana have warned that Africa is heading towards a catastrophic shortage of health workers, projected at 6.1 million by 2030, unless governments urgently reverse years of underinvestment, poor working conditions and unregulated labour migration.

The warning was issued at a high-level Health and Care Workforce Migration Joint Symposium convened on January 21, 2026, by Public Services International (PSI) and its health sector affiliates from both countries.

The meeting brought together policymakers, civil society organisations and international partners to address what the unions described as a deepening crisis threatening public health systems across the continent.

Contained in communiqué jointly signed by the President of the National Association of Nigerian Nurses and Midwives, Comrade Haruna Mamman; the President of the Medical and Health Workers Union of Nigeria, Dr Kabiru Ado Sani-Minjibir; and the President of the Ghana Registered Nurses and Midwives Association, Perpetual Ofori-Ampafo, the unions said that Africa’s projected deficit represents “more than half of the global shortfall of 11.1 million health workers,” a situation they said is particularly alarming given that “about 85 per cent of Africa’s health workforce is employed in the public sector.”

They warned that continued neglect of public healthcare financing directly undermines access to quality care for millions of Africans.

Presenting country-level figures, the unions noted that Ghana has an estimated 298,382 qualified health workers, translating to “one health worker per 5,707 people,” while Nigeria has approximately 940,193 health workers, with a skilled health worker density of “1.83 per 1,000 population.”

ALSO READ: NICRAT empowers health workers with AI application skills for cancer care

These figures, they stressed, fall far below the World Health Organisation (WHO) benchmark of 4.45 health workers per 1,000 people.

“These figures are worrisome,” the unions said, linking the crisis to governments’ failure to honour the 2001 Abuja Declaration, in which African leaders committed to allocating at least 15 per cent of national budgets to health.

“They recalled that by April 27 this year, it would be 25 years since the declaration was launched in Abuja, yet countries like Ghana and Nigeria are still far from meeting these targets.”

The unions argued that the consequences of this failure are evident in overstretched and fragile public health systems struggling to serve rapidly growing populations.

They also pointed to austerity measures promoted by international financial institutions, stating that “austerity policies proposed by institutions like the IMF have worsened the shortage of health workers and continued to undermine access to quality care across the continent.”

Describing the ongoing wave of migration among health and care workers as a symptom of long-standing structural failures, PSI and its affiliates said the exodus is driven by “chronic underfunding of public health systems, privatisation, weak governance, unsafe working environments, and the absence of decent work, training and professional development opportunities.

“These conditions continue to push skilled health workers to seek safer, better-paid and more stable employment abroad, often at great cost to the communities they leave behind,” the unions said.

They further raised concerns about cases of African health workers becoming victims of “sexual and gender-based abuse, exploitation and trafficking in destination countries,” often facilitated by “fraudulent and unchecked recruiters who prey on the desperation of skilled professionals seeking greener pastures.”

The unions emphasised that women, who dominate nursing and midwifery, are particularly affected. They noted that women health workers continue to face “persistent pay gaps, discrimination, workplace violence and unpaid care burdens,” factors they said are powerful drivers of migration.

Minority and marginalised groups, they added, also face restricted access to training and career progression, further weakening workforce retention.

Throughout the discussions, participants stressed that without genuine social dialogue and workers’ representation, efforts to manage migration and address workforce shortages would fail.

“Health and care sector unions must be central to decision-making on workforce policies,” the communiqué stated, adding that gender-responsive and inclusive policies ensuring fair pay, safe working conditions and non-discrimination are essential for building a sustainable health workforce.

The unions called on African governments to urgently recommit to the Abuja Declaration by allocating at least 15 per cent of national budgets to health, arguing that protecting health workers’ rights is inseparable from protecting public health.

They demanded living wages, increased staffing levels and transparent pay structures to close wage gaps, especially those affecting women in nursing and midwifery, while also urging governments to halt health sector privatisation and outsourcing, which they said undermine decent work.

They further called for increased investment in public health training institutions, continuous professional development and clear career progression pathways, alongside the implementation of gender-responsive policies to address workplace violence and harassment.

On migration, the unions urged governments to align national frameworks with the WHO Global Code of Practice, ILO standards and UN fair recruitment principles.

The communiqué also stressed the need to institutionalise meaningful social dialogue by formally including health sector unions in workforce planning, migration policy design and health sector reforms.

It called on unions and civil society organisations to use union-led evidence to strengthen collective bargaining, advocacy and policy engagement, while pushing for a continental framework on health workforce retention grounded in public service values and workers’ rights.

International partners, the unions said, should support union-to-union cross-border cooperation to assist migrant health workers in destination countries. They also emphasised the importance of mobilising domestic resources through “fair taxation of wealth, reducing harmful incentives and reclaiming public money for public services.”

In a show of solidarity, the unions expressed support for the ongoing industrial action by the Joint Health Sector Unions (JOHESU) in Nigeria, urging the federal government to meet health workers’ demands for salary adjustments and to refrain from criminalising strike actions.

“Protecting the rights of health workers is essential to protecting public health, strengthening health systems and achieving universal health coverage in Africa,” the unions said, reaffirming PSI’s commitment to promoting decent work and rights-based labour migration policies.

“We will continue to act until African governments implement decent work practices, improve universal access to quality public services and uphold fair labour migration policies.”