Healthcare workforce migration: Action is key, not just words

BY JOSHUA OPANIKE

The National Policy on Health Workforce Migration was reportedly signed by President Bola Ahmed Tinubu earlier this week. The document was developed by the federal ministry of health with inputs from stakeholders in the healthcare sector in order to ensure that migration of healthcare workers does not compromise adequate delivery of healthcare in Nigeria.

This is not the first time the government is responding to the current japa wave. Sometimes ago, a memo directing medical schools to double the quota of admission into medical school circulated in the media with no mention of government’s commitment to support training institutions with required human and material resources for this upgrade. Similarly, there was a plan to recruit retired medical professionals to fill spots, an intervention that was problematic in its entirety.

Nonetheless, this policy development is a thoughtful response to the dangerously rising trend of emigration of healthcare workers in Nigeria. Although, in the context of our national governance, policies do not usually translate to actionable endeavors by the government its agencies. At best, they are locked up in a store where they gather dusts for years.

Yet in ideal settings, a policy framework is the most basic endeavor deployed by government to address any issue and when fully supported with adequate resources, it yields great results.

The general premise of the National Policy on Health Workforce Migration policy document recognises the severity of the condition and attempts to approach the subject from different perspectives; with extensive collaboration with private sectors and international partners as well as inter-sectoral cooperation in the government.

These are laudable however, specific policy statements do not demonstrate adequate provision for addressing some other salient issues that are the bedrock of the human resources crisis in Nigeria’s healthcare sector.

A major highlight of the policy is monitoring of migration of healthcare workers especially for data gathering and policy formation. Despite mentioning a commitment to recognise the rights of professionals to migrate and seek self-fulfillment, there is no way to know that such activities will not lead to invasion of privacy and harassment of professionals. A consequence that will further worsen the situation. It remains to be seen how this endeavor will actually address the issues in the immediate and long term.

Another important highlight is the ethical recruitment of professionals. Recruitment into public service in Nigeria is usually influenced by nepotism and favoritism. Despite identifying the problem, the policy provides no innovative approach to addressing this quagmire. It is the same old song of the Federal Character Commission. An efficient recruitment process that will therefore address the workforce deficit needs an overhaul of the entire process.

Moreover, the current practice of recruiting interns is particularly an eye sore. There are several newly qualified graduates in medical and health allied professions who have been waiting for months to fill spots for further training in tertiary centers. Only those with the right connections get in and there is no regard for excellence and skill.

Whereas, the policy is uncomfortably quiet on its plans for young and early career professionals. Any intervention to keep the workforce must specifically bear this crop of professionals in mind especially because they are the future of the healthcare sector we aim to secure. And contrary to the notion that we are producing medical graduates in abundance, we are not.

Most of these destination countries produce more professionals locally than we do. So the government must realise that healthcare professional emigration is not an endeavor we have the capacity to afford. The government must therefore demonstrate commitment to improving working conditions and offer attractive conditions and opportunities for career development to young and vibrant professionals who must be a central focus for any intervention to boost healthcare workforce.

While the policy also aims to improve remuneration and working conditions there are other intra-industry factors that stifle work satisfaction that must be addressed. Particularly important is the structure of training as well as hostile conditions such as violence against healthcare workers, bullying and professional rivalry.

The policy must do beyond lip service to mental health and promote the entire well-being of healthcare workers. Furthermore, other factors unrelated directly to the health sector like insecurity, poor economic climate and government failure are crucial issues that must be addressed in order to convince healthcare professionals that they are able to live their best lives in this country.

In conclusion despite its inadequacy, the policy is a welcomed development. However, public trust in the government’s ability and readiness to implement its policies is almost non-existent. Therefore, stakeholders must work assiduously to ensure that this crucial rescue mission for the healthcare sector is not condemned into a storeroom to gather dust and feed termites.

Joshua Opanike is a medical doctor in Nigeria. You can contact him via [email protected]