Medical practitioners have raised an alarm over a severe manpower crisis hitting the Nigerian healthcare sector, revealing that only approximately 55,000 doctors are left to cater to a population of over 220 million people. The experts disclosed that the persistent migration of healthcare professionals, widely known as the Japa syndrome, has resulted in the departure of no fewer than 16,000 Nigerian doctors in the last five years, a development that is rapidly worsening the country's mental health crisis.
The crisis was brought to the fore at the Ordinary General Meeting and Scientific Conference of the Association of Resident Doctors, Federal Neuropsychiatric Hospital, Yaba, Lagos. The conference focused on the impact of manpower shortages on the mental well-being of citizens. Medical professionals noted that the extreme depletion of personnel has widened treatment gaps, raised the cost of medical care, and placed immense psychological pressure on the remaining specialists within the system.
Speaking on the development, the President of the Nigerian Medical Association, Prof Omoti Ernest, confirmed that while the Medical and Dental Council of Nigeria has registered over 130,000 doctors, only about 55,000 are currently engaged in active practice within the country. This leaves Nigeria with a doctor-to-patient ratio of one doctor to every 3,600 or 4,000 citizens.
Prof Ernest stated, "This ratio is far below the World Health Organisation’s recommended threshold of one doctor to about 600 people, highlighting the significant shortage of medical personnel and the strain on healthcare delivery. Many Nigerian-trained doctors have emigrated or are no longer engaged in active clinical practice, contributing to the country’s healthcare workforce shortage,"
He explained that the mass migration has severely crippled operational efficiency across public health institutions. He added, "Thousands of doctors and other healthcare professionals have left the country in recent years, leading to severe staff shortages, increased workload for those who remain with many suffering from burnout, longer waiting times for patients, and declining quality of care in many public hospitals. Rural and under-served communities have been particularly affected, as they already struggle with limited access to healthcare services. The reasons behind this migration include poor remuneration, inadequate working conditions, insecurity, limited opportunities for career advancement, and insufficient investment in healthcare infrastructure, among others. Many professionals are attracted by better pay, improved facilities, and more stable environments in countries such as the United Kingdom, Canada, and the United States."
Proffering solutions to the brain drain, the NMA president urged the federal government to enhance welfare packages and prioritize the development of medical infrastructure. He noted, "Strengthening security, ensuring timely payment of wages, and providing incentives for professionals to work in under-served areas will also help retain talent. In addition, partnerships with the private sector and diaspora engagement programmes could encourage Nigerian healthcare professionals abroad to contribute their expertise and support development of the country’s healthcare system."
In his presentation, a Consultant Psychiatrist at the Neuropsychiatric Hospital, Aro, Dr. Yesir Kareem, pointed out that the doctor-to-patient ratio has plummeted even further in certain areas, sometimes exceeding one doctor to 10,000 patients. He emphasized that the fallout is particularly disastrous for psychiatric healthcare delivery.
Dr. Kareem stated, "Only about 55,000 doctors remain to serve a population of over 220 million Nigerians. More than 40 million Nigerians suffer from mental health disorders, yet about 85 per cent of them do not have access to mental healthcare services,"
He warned that untreated psychiatric conditions often lead to severe societal issues such as substance abuse, unemployment, delayed clinical diagnosis, and family breakdowns. He added, "The economic consequences are equally devastating, with billions of dollars lost annually due to untreated mental health conditions," while further revealing that a total of 94,000 doctors and nurses have left the country since the onset of the migration wave.
The President of the Association of Psychiatrists in Nigeria, Dr. Veronica Nyamali, lamented that the severe shortage of personnel has forced highly placed consultants to take up basic clinical duties, abandoning research and advanced specialist tasks.
Dr. Nyamali remarked, "There are gaps everywhere. Work that should be done by four psychiatrists is now being handled by one or two people. Consultants are increasingly forced to work at lower levels because the doctors they are supposed to supervise are no longer there,"
She stated that the continuous flight of specialized medical trainees leaves constant vacancies across various neuropsychiatric facilities in the federation, adding, "Those we train are leaving. Junior registrars, senior registrars, many complete their examinations and return abroad. The result is that we have shortages at every level of care,"
According to Dr. Nyamali, Nigeria currently has fewer than 150 practicing psychiatrists, a situation that drives up the cost of psychiatric care and isolates rural populations. She said, "When specialists become scarce, services become more expensive. Access becomes difficult because patients must travel long distances to find care. This is contrary to the principle of universal health coverage, where mental health services should be available, affordable and accessible to everyone,"
She noted that due to the deficit, many patients default to traditional and faith-based healers. Dr. Nyamali explained that psychiatrists are now working with these unorthodox healers to eradicate abusive practices, stating, "We recognise that people go to them first because they are available, accessible and affordable. Rather than confront them, we are engaging them and providing basic mental health education so that harmful practices can be eliminated and patients referred appropriately,"
She connected the increase in psychiatric ailments to harsh macroeconomic conditions, stating, "People are being traumatised daily. Poverty, joblessness, violence and insecurity are all social determinants of mental illness. Those already living with mental health conditions are relapsing more frequently, while many others are developing new mental health challenges because of the pressures of daily living,"
She also condemned the current out-of-pocket funding model for healthcare, stating, "Mental illness is not properly covered under health insurance. Many of the newer medications are not included in insurance drug lists, leaving families to bear enormous treatment costs. The burden on care-givers is huge,"
Corroborating these assertions, the President of the ARD, FNPH Yaba, Dr. Okuwoga Temitope, noted that resident doctors are struggling with severe clinical burnout, anxiety, and depression due to the massive workloads.
Dr. Temitope stated, "As mental health professionals, we witness first hand the widening treatment gap, the burden on already stretched healthcare workers and the impact these shortages have on access to quality mental healthcare for Nigerians,"
In a communique issued at the conclusion of the national conference, the association called on the government to integrate mental healthcare into the primary health structure and leverage telepsychiatry. The group also requested the management of the Federal Neuropsychiatric Hospital, Yaba, to fast-track the enrollment of newly employed resident doctors into the Integrated Payroll and Personnel Information System to eliminate financial hardships caused by wage delays. They additionally praised the medical director of the facility, Dr. Olugbenga Owoeye, for resolving a protracted electricity outage across the institution's campuses, while emphasizing the need for stable power grids to facilitate medical training.
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