Introduction
Recently, the Nigerian government unveiled a National Policy on Health Workforce Migration to address the growing issue of healthcare worker migration. There has been a severe scarcity of qualified health workers because of the ongoing exodus of health experts from Nigeria. The nation's efforts to attain Universal Health Coverage (UHC) and deliver quality healthcare services to its citizens are threatened by this scarcity. Therefore, the policy aims to lessen these difficulties, mitigate the negative effects of this migration and improve Nigeria's healthcare system, through specific goals and strategies.1
Key Objectives of the Policy
The National Policy on Health Workforce Migration is built around several main goals such as:2
- Improving Healthcare Services: One of the policy's main goals is improving healthcare services throughout Nigeria. To accomplish this, the policy suggests that the migration of health personnel should be coordinated to ensure those who live in Nigeria have the tools and assistance needed to provide high-quality and integrated care. To this end, among other obligations, the policy places a duty on the Federal Ministry of Health and the Federal Ministry of Communication and Digital Economy to engage in international collaboration to advance the use of telemedicine and other digital health practices.
- Encouraging Workforce Retention: To ensure the retention of healthcare professionals, particularly in remote and underserved areas, the policy highlights the incentives to be offered by the government. Some of these incentives are financial benefits, better living and working conditions, opportunities for professional development, and clear pathways for career advancement.
- Strategic Workforce Planning: The policy also emphasises the importance of strategic planning for managing the migration of healthcare professionals. This includes understanding the healthcare system's current and future needs and ensuring that healthcare workers are distributed efficiently across the country.
Highlights of the Policy
- Incentives for Retaining Healthcare Workers To
make Nigeria attractive to healthcare professionals and investors,
the policy suggests several incentives such as:
- Financial Rewards: competitive salaries, bonuses, special credit facilities, tax holidays, and other financial and allied incentives, particularly for those working in underserved areas.3
- Professional Development: Opportunities, within the shores of Nigeria, for continuous and internationally recognised training to enhance the skills of healthcare workers.4
- Career Advancement: Clear pathways for career growth and promotion within the healthcare system.5
- Strengthening the Healthcare System Through Managed
Migration According to the policy, Nigeria can use managed
migration as a tool to strengthen its healthcare system. It
encourages the return of skilled professionals from the diaspora
who can contribute to the health sector through knowledge transfer,
training, and innovation.6 This approach is part of a
broader effort to build the capacity of Nigeria's healthcare
system and improve service delivery.
Furthermore, the policy outlines initiatives that the federal and state governments should take to expand and equip health training institutions in Nigeria. These institutions will collaborate with international organisations to train a workforce well-versed in contemporary global trends in medical services.7 - Ethical Recruitment and International
Cooperation
A significant aspect of the policy is the promotion of ethical recruitment practices and international cooperation. The policy encourages the development of bilateral and multilateral agreements with other countries to manage the migration of healthcare workers. These agreements aim to ensure that migration is mutually beneficial, allowing Nigerian healthcare workers to gain experience abroad while contributing to the health sector at home.8
The policy also aligns with the World Health Organization's (WHO) Global Code of Practice on the International Recruitment of Health Personnel. The policy advocates for ethical recruitment and international collaboration, urging destination countries to invest in Nigeria's healthcare training and infrastructure. Such investments will make Nigeria's healthcare system attractive and equip Nigeria with the resources needed to train an adequate number of professionals for domestic and international markets.9 Additionally, the policy reintroduces international training programs for healthcare workers residing in Nigeria and provides a wide range of support for returning professionals to ensure their reintegration into the workforce. - Data-Driven Decision Making
Effective management of health workforce migration relies on real-time data collection and analysis. The policy emphasises the importance of using data to monitor trends in healthcare worker migration, assess its impact on the healthcare system, and make informed decisions about workforce planning and policy adjustments.10 By leveraging real-time data, the policy highlights strategies to be deployed in monitoring migration trends, to enable the government to make informed decisions to meet the healthcare system's current and future needs. - Coordinated Government Approach and Effective
Leadership
The policy proposes collaboration among governmental bodies in managing health workforce migration. This involves a synergy among the Ministry of Health, Ministry of Education, Ministry of Labour, etc., to ensure that policies are aligned and efforts harmonised across sectors.
The policy also emphasises the importance of good governance and effective leadership in addressing the challenges of health workforce migration. It aims to create a structured approach for planning, coordinating, and regulating health workforce migration, ensuring ethical recruitment, and fair practices.11
The policy suggests a mechanism for effectively governing health workforce migration and implementing related policies. The Federal Ministry of Health (FMOH) will create a National Human Resources for Health Program (NHRHP), with coordinators at national and state levels. The NHRHP, in collaboration with other government ministries and agencies, will oversee Memorandum of Understanding (MOU) with destination countries to protect migrant health workers and ensure mutual benefits. Additionally, destination countries will be required to share data on Nigerian health workers, including performance and licensure. The government will encourage public-private partnerships to create new training facilities and provide resources to attract migrant health workers back to Nigeria, including offering interest-free loans for operating health facilities.12 - Engaging the Private Sector
Recognising the significant role of the private sector in healthcare delivery, the policy encourages private sector involvement in innovation, particularly through digital technologies that can expand access to healthcare services. Partnerships between the government and private sector are encouraged to enhance the health workforce and improve service delivery.13 - Implementation and Monitoring
To successfully implement the policy, there is a dire need for adequate funding, effective leadership, and continuous monitoring and evaluation. The policy recognises the need for a well-defined framework to track progress and make adjustments, when required. It also harps on the engagement of stakeholders, including healthcare professionals, civil societies, and the private sector, in the implementation process.14
Conclusion
The National Policy on Health Workforce Migration is a welcome development. It is instructive to note that it seeks to promote the freedom of movement of health workers, while ensuring that there is an adequate number of health workers to meet domestic demand. However, the Federal Government should aim to be realistic in its demands when negotiating MOUs and bilateral or multilateral agreements with destination countries and recruiters. This is premised on the fact that unrealistic demands may scare destination countries and recruiters away. Such a situation will hinder health workers' fundamental right to freedom of movement. Therefore, in line with the spirit of the policy, stakeholders should always be fully involved in the process. Governments at all levels should also religiously implement the policy, which has the prospect of transforming Nigeria's healthcare system and making it attractive to health professionals.
Footnotes
1. Page 8 National Policy on Health Workforce Migration.
2. Page 9 National Policy on Health Workforce Migration.
3. Pages 13,14, 16 and 17 National Policy on Health Workforce Migration.
4. Pages 14 and 15 National Policy on Health Workforce Migration.
5. Pages 13, 14 and 26 National Policy on Health Workforce Migration.
6. Pages 17, 18, 25, 26, 27 and 28 National Policy on Health Workforce Migration.
7. Pages 20 and 23 National Policy on Health Workforce Migration.
8. Page 28 National Policy on Health Workforce Migration.
9. Page 25 National Policy on Health Workforce Migration.
10. Pages 31 and 32 National Policy on Health Workforce Migration.
11. Pages 33 and 34 National Policy on Health Workforce Migration.
12. Ibid.
13. Pages x, 23 and 33 National Policy on Health Workforce Migration.
14. Pages 35 – 37 National Policy on Health Workforce Migration.
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