6,300 Nigerians : 1 Physician

The register of the Nigeria Medical Association (NMA) has 27,000 members listed in it.  Nigeria has an estimated population of 170 million people. The implication of this mathematics is simple: if one medical doctor is attached to segments of the population in equal proportion, it would come down to about 6,300 served by a doctor.

The global standard set by the United Nations is in the ratio of one physician per 1,000 people. Keeping to that standard would require Nigeria having a minimum of 170,000 medical doctors, a distant cry from what obtains now.  

So when the former president of the NMA, Dr Osahon Enabulele, raised the alarm of this distressing disparity, the government should do well to listen. Speaking in Eket at a recent meeting of the association, Enabulele noted that the shortage of doctors has led to a huge gap in the nation’s healthcare sector, presenting another challenge of excessive workload.

Various factors account for the dearth of medical doctors described by the NMA, fundamental among which is the failure by successive governments in the country to have a national development plan for the health sector.  Such plans of action would project the technical and professional needs of the sector at all tiers of the system within the context of Nigeria’s national demographic growth in given periods. For example, the expansion of Nigerian institutions that train medical doctors has not been proportionate in the last three decades to the number of doctors required in the country. Besides, even some of the existing admission slots in medical schools have continued to contract over the years. At the Ahmadu Bello University, Zaria, for instance, admission in to the Bachelor of Medicine and Surgery (MBBS) programme has been suspended for two academic sessions running.

Poor working condition is another reason for the current inadequate number of doctors in the country. Some of the few doctors available to manage the healthcare delivery system of the country are challenged by comparatively unattractive working conditions. Some prefer to seek better alternatives outside the country. This consequently results in fewer doctors coping with the tasking demands of a grossly understaffed sector.

The collapse of the country’s primary healthcare system, which owes much to the pioneering effort of Professor Olikoye Ransome-Kuti  when he was Minister of Health, has in recent years brought the secondary and tertiary healthcare institutions in the country under severe strain, overworking the limited manpower particularly at the tertiary medical institutions. 

The basic functions of community health centres and rural health dispensaries, which include the diagnosis and management of tropical and communicable diseases such as malaria and typhoid fevers, diarrhoea, dysentery, cholera, cough, etc, have shifted to general hospitals and tertiary health institutions that were established to essentially manage more complex and critical medical and surgical cases. This has its resultant effect on the workload of doctors in the higher tier of the country’s healthcare system.
The government should introduce strategic planning, by which it must design long term solution to this problem. This should include building additional and well equipped colleges of medicine in Nigerian universities to expand admission spaces and the number of medical doctors that would graduate annually. To be able to employ and retain medical doctors at the various health institutions in the country, basic working conditions have to be vastly improved.

The more the government makes the job of a medical doctor attractive, the lesser there would be incentives for them to take up offers abroad. But the NMA also needs to contribute in making the working environment for young and budding medical professional less burdensome by embarking on strikes less frequently, if at all. Better services in an environment conducive to both patient and doctor would reduce the current high rate of medical tourism that has seen many Nigerians travelling to foreign lands. Nigeria’s primary healthcare delivery system will also improve if community health centres across the country are revived and properly equipped.

Source: Dailytrust