Seun Ajoseh is a graduate of Sociology (B.S., M.S.) with distinction from Lagos State University, Nigeria. He is currently a Ph.D. researcher in Sociology at the University of Florida, United States. In this interview, Seun discusses his recently published paper on the medical brain drain bill proposed by a legislator in Nigeria’s House of Representatives.
What is the rate of the medical brain in Nigeria?
Nigeria is experiencing a large emigration of health professionals. Approximately half of licensed medical doctors in Nigeria have emigrated. The country’s doctor-to-population ratio is 1:9083, significantly lower than the WHO recommendations of 2.5 medical staff per 1,000 population. The brain drain in Nigeria has led to shortages of healthcare workers, an increased workload for the remaining workers, a rise in healthcare costs, poor health outcomes, and limited development in healthcare.
What do you think about the approach of the House of Representatives members to mitigate the trend?
The Medical and Dental Practitioners Act Amendment Bill proposed by Honorable Ganiyu Abiodun Johnson in the House of Representatives, to retain medical doctors, is flawed and may not provide the intended solutions. The bill mandates that graduates of medical and dental professions serve in Nigeria for five years after they graduate before obtaining a license. The goal of the bill was to encourage medical graduates to stay back in Nigeria for practice. However, the bill’s approach will escalate the problem of brain drain.
How will the bill escalate the brain drain?
The bill did not address the main cause of the brain drain, which are the broader socioeconomic and political issues, such as corruption, inadequate public health funding, lack of confidence in the healthcare sector, insecurity, and lack of opportunity for career advancement, among others. In our recently published paper “Navigating brain drain: understanding public discourse on legislation to retain medical professionals in Nigeria”, in Globalization and Health, we observed that some of the supporters of the bill, supported it because they believed that staying back shows patriotism to the country since medical education is subsidized compared to the cost of training in developed countries. However, critics of the bill argued that the bill was not addressing the root causes of the brain drain, such as lack of infrastructure, inadequate remuneration and welfare, poor working conditions, and low investment in healthcare, and poor socioeconomic development. Also, the bill violated the fundamental human rights of the doctors and breached labour laws, demonstrating the hypocrisy of the legislators and the lack of clarity in the bill about when the five-year period will commence. The question raised by others is what kind of license will be given to doctors to practice in the five years they are restricted. The bill would increase unemployment and underemployment rates of medical doctors and might aggravate brain drain in a way that students emigrate to get foreign medical training elsewhere.
What could be done about the bill?
When creating a bill to retain medical doctors, it should include provisions for a bonded agreement. This agreement will outline specific clauses regarding the financial support provided by the government for doctors’ training and the required number of years they must work for the government in return. The agreement should also include an option for doctors to opt out of the program, with all terms and conditions clearly defined from the outset. Any policies and laws in the health sector must be developed in consultation with stakeholders, ensuring that doctors voluntarily agree to sign such agreements. However, it might be hard to convince medical students to sign such agreements if the general sociopolitical and economic indicators are not improved.
What can be done to reduce the medical brain drain in Nigeria?
Retaining medical graduates will require greater investment and funding in healthcare, utilization of public healthcare by Nigeria’s political elites, and development in healthcare. Improving the broader socioeconomic and political environment is crucial to making the healthcare sector more attractive to professionals, both within Nigeria and the diaspora. Key measures include ensuring political stability, upholding the rule of law, enhancing security, raising the quality of education, fostering economic stability, increasing funding in healthcare, and restoring confidence in Nigeria’s healthcare. These efforts collectively create a supportive environment that encourages healthcare professionals to remain in or return to the country.
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