By Jimoh Abiba

What is ‘Japa’? The term ‘Japa’ is a Yoruba word that means ‘to leave’ or ‘to exit’ a place. And in common parlance it simply refers to ‘Brain Drain” when applied to the health sector it refers to a situation whereby experienced medical/healthcare workers leave the country searching for better, greener pastures abroad.

This phenomenon of ‘Japa’ in the health sector is a menace caused by the irresponsibility of the government to adequately fund the health sector, thereby continuously making Nigeria less attractive for medical and healthcare workers to practice and medical tourism to vogue for members of the ruling elites and the super rich in the country.

The UK immigration report in 2022 put the number of Nigerian healthcare professionals granted working visas in the UK in 2021 at 13,609. Also, between December 2021 and May 2022, a total of 727 Nigerian-trained medical doctors relocated to the UK. While the UK is one of the top destinations, Nigerian-trained healthcare professionals emigrate to Canada, the US, Saudi Arabia, Australia, and other developed countries (https://www.bsg.ox.ac.uk/blog/brain-drain-healthcare-professionals-nigeria-buck-stops-government)

We cannot discussed the Brain Drain Crisis in the health sector without mentioning the factors that are responsible for it. These are the deplorable working conditions, chronic underfunding of the sector, lack of funds allocated to training and development programs, High level of economic inequality, Growing concern about insecurity, and Harsh economic conditions, among others, which are all linked to the blood-sucking capitalist system practiced in the country.

Strike actions within health sector unions (NARD, JOHESU, NMA, etc.) are not a novel occurrence. These actions are intricately linked to the myriad challenges confronting union members in the country, resulting in substandard working conditions and poor pay.

Surprisingly, rather than the Nigerian government finding ways to ease the challenges by improving funding to the sector to enhance the working conditions of healthcare professionals, they are planning on passing a law mandating medical doctors to practice for several years before they are granted permission to leave the country. This Tinubu-led administration has continued to show that it cares neither about the lives of the masses nor about easing the burden on them.

The aspiration outlined in the Abuja declaration on health funding (2001), wherein governments aimed to allocate 15% of their national budgets to health, remains elusive. This is particularly evident in Nigeria, and African with the poor financing of the health system posing a significant challenge, a vulnerability starkly highlighted during the COVID-19 pandemic.

Over the last few years, checking the Nation’s budget, less than 10% was appropriated to the health sector, which is shocking. This is happening in a country where the ratio of healthcare workers to patients is alarming. According to the Nigeria Medical Association, the doctor-to-population ratio in Nigeria stands at one doctor for every 10,000 individuals, deviating from the World Health Organisation’s (WHO) recommendation of one doctor per 600 people. The Nigerian Association of Nurses and Midwives has reported that Nigeria now has a nurse-to-patient ratio of one nurse to about 1,160 patients.

The 2024 budgetary allocation of the health sector was just 5.03%, which translates to N1.38 trillion (Source: Premium Times Nigeria). This amount is ridiculous compared to the state of the health sector in the country. We are in a country where billions of Naira are squandered on frivolous expenses to ‘improve’ the quality of life of politicians, a life that is of quality already.    

According to statistics, Sub-Saharan African countries account for 25% of the global burden of disease side by side with just 1.3% of health care workers in the countries. Breaking this down will show you why the country’s medical facilities and personnel are understaffed and lack basic tools and resources. Nigeria is blessed with enormous human and material resources that can help improve the lives of the masses, but the corrupt capitalist elites in government use these resources for their own interest and that of their cronies. 

The country’s wealth should be placed under the country of workers, artisans, and peasants to control and direct to be used to serve the interest of the majority and not the tiny minority. This will make the healthcare system accessible and affordable for all. The economic system that can achieve this is socialism, a system in which the government will be committed to creating competitive wages, building and furnishing health facilities, improving economic conditions, good working conditions, investing in health technology and telemedicine, and continuous development of health care professionals, among others. This will help to build a robust and sustainable healthcare system that meets the needs of all citizens.