A new policy brief has warned that Nigeria’s healthcare system faces a deepening crisis as the continued departure of doctors and nurses threatens access to quality care nationwide, unless urgent welfare-focused reforms are implemented.
The analysis, authored by health policy expert Dr Emmanuel Ejimonu of the Athena Centre for Policy and Leadership, reports that more than 42,000 nurses left Nigeria between 2021 and early 2024, while thousands of Nigerian-trained doctors have registered to practise abroad, particularly in the United Kingdom. The trend shows little sign of abating, with survey data indicating that nearly three-quarters of medical and nursing students plan to seek employment overseas, and about one in three having no intention of returning.
The report attributes the migration largely to domestic welfare and governance failures rather than professional ambition. Health workers cited low and irregular salaries, unsafe and overstretched working environments, limited access to funded specialist training and weak social protection as key drivers of emigration, especially amid rising global demand for health professionals.
Although the Federal Government introduced a National Policy on Health Workforce Migration in 2023 to encourage ethical recruitment and retention, the brief argues that its impact has been minimal. Implementation gaps, inadequate funding and uneven execution across states and health facilities have limited its effectiveness.
The consequences of sustained workforce losses are already evident. Teaching hospitals are reportedly struggling to maintain specialist training and mentorship programmes, while recurring strikes point to growing mistrust between health workers and government authorities. Economically, Nigeria continues to lose returns on public investments in medical training, even as staff shortages undermine service delivery in both urban and rural areas. Remaining workers face increasing burnout, further fuelling migration intentions.
Drawing on international experiences from countries including Ghana, Kenya, the Philippines and Cuba, the brief notes that health worker migration cannot be entirely halted, but can be better managed. It recommends welfare-based retention strategies supported by credible governance structures.
Central to the recommendations is a proposed Welfare-First Retention Package, which prioritises timely and guaranteed salary payments, improved workplace safety, funded career progression, fair bonding arrangements and stronger social protection. The brief also calls for disciplined use of bilateral agreements and ethical recruitment frameworks to safeguard Nigeria’s investment in health worker training.
The report estimates that, if adequately funded and implemented, these measures could cut short-term health worker attrition by up to one-third within two years and significantly improve retention over a five-year period. It concludes that reversing the crisis will require treating health worker welfare as a core economic and governance priority, warning that failure to act risks the gradual hollowing out of Nigeria’s healthcare system with serious implications for public health and national development.
