Medical professionals have raised urgent alarm over Nigeria's deepening healthcare manpower crisis, warning that only about 55,000 doctors remain to serve a population exceeding 220 million people—a ratio far below international standards.
The warning came during
the Ordinary General Meeting and Scientific Conference of the Association of
Resident Doctors (ARD) at the Federal Neuropsychiatric Hospital (FNPH), Yaba,
Lagos, themed "Too Few Doctors, Too Many Patients: The Consequences of
Manpower Shortage on the Mental Well-being of Nigerians."
Mental health experts at
the conference expressed grave concern that the situation is severely limiting
access to psychiatric care, leaving millions of vulnerable Nigerians without
treatment. They disclosed that no fewer than 16,000 Nigerian doctors have
emigrated in the last five years, compounding an already dire shortage.
The sustained exodus of
healthcare workers under the widely known "Japa" syndrome, they
warned, has depleted the country's mental health workforce, widened treatment
gaps, increased the cost of care, and placed enormous pressure on the few
specialists remaining.
NMA
President Confirms Alarming Doctor-to-Patient Ratio
Confirming the situation
to Vanguard, the President of the Nigerian Medical Association (NMA), Prof.
Omoti Ernest, said recent data from the Medical and Dental Council of Nigeria
(MDCN) shows that while over 130,000 doctors have been registered, only about
55,000 are actively practicing within Nigeria.
With a population
exceeding 220 million, he noted, this translates to roughly one doctor for
every 3,600 to 4,000 people.
"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," Prof. Omoti stated.
He attributed the
shortfall to emigration and doctors no longer engaged in active clinical
practice.
Why
Doctors Are Leaving
Prof. Omoti outlined
several factors driving the exodus of healthcare professionals, including:
Poor remuneration and
delayed salaries
Inadequate working
conditions
Insecurity and unsafe
environments
Limited career
advancement opportunities
Insufficient investment
in healthcare infrastructure
"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," he said.
He noted that rural and
underserved communities have been particularly hard hit, as they already
struggle with limited access to healthcare services.
"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,"
he added.
Solutions:
What Can Be Done
To address the trend,
Prof. Omoti called on the Federal Government to:
Prioritise salaries and
welfare packages for healthcare workers
Invest more in modern
medical equipment and hospital infrastructure
Expand residency and
specialist training opportunities
Create clear career
progression pathways
Strengthen security
across health facilities
Ensure timely payment of
wages
Provide incentives for
professionals to work in underserved areas
He also recommended
partnerships with the private sector and diaspora engagement programmes to
encourage Nigerian healthcare professionals abroad to contribute their
expertise.
Mental
Health Crisis Deepens
Speaking at the
conference, Consultant Psychiatrist at the Neuropsychiatric Hospital, Aro, Dr.
Yesir Kareem, painted an even grimmer picture, stating that Nigeria's
doctor-to-patient ratio has fallen to about one doctor for more than 10,000
patients—far below the WHO recommended ratio of 1:600.
The consequences, he
said, are particularly devastating for mental healthcare.
"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," Dr. Kareem revealed.
He warned that untreated
mental illnesses contribute to family breakdowns, substance abuse,
unemployment, delayed diagnosis, and premature deaths.
"The economic
consequences are equally devastating, with billions of dollars lost annually
due to untreated mental health conditions," he added.
Dr. Kareem also noted
that 94,000 doctors and nurses have left Nigeria since the "Japa"
syndrome began, driven by poor remuneration, overwhelming patient loads, better
work-life balance abroad, inadequate equipment, limited career advancement, and
insecurity.
Consultants
Forced to Abandon Specialist Roles
President of the
Association of Psychiatrists in Nigeria (APN), Dr. Veronica Nyamali, described
the manpower shortage as a crisis that has forced consultants to abandon
higher-level responsibilities—such as research and specialist care—to fill gaps
left by departing doctors.
"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 lamented.
She expressed frustration
that many doctors undergoing specialist training now leave before completing
their careers in Nigeria, creating persistent vacancies across psychiatric
facilities.
"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," she stated.
Disclosing that the
country currently has fewer than 150 psychiatrists, she warned that the
dwindling number of specialists is making mental healthcare increasingly
expensive and inaccessible, especially for patients in rural communities where
psychiatrists are virtually non-existent.
Specialists
Now Scarce, Services Expensive
"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," Dr. Nyamali said.
She also linked the brain
drain to a shrinking pharmaceutical landscape, with several companies scaling
down or exiting Nigeria, reducing access to newer and more effective
psychiatric medications.
"We now have fewer
treatment options. Some of the newer drugs that offer better outcomes are no
longer readily available. At the same time, the market is being flooded with
fake medicines, making treatment even more challenging," she warned.
Dr. Nyamali noted that
the shortage of specialists has increased reliance on traditional and
faith-based healers, who are often the first point of contact for people with
mental illnesses. She said psychiatrists are increasingly collaborating with
these healers to discourage harmful practices such as chaining, flogging, and
unlawful confinement.
"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 explained.
Economic
Hardship Fuelling Mental Illness
Dr. Nyamali also
highlighted the growing burden of mental illness in Nigeria, linking rising
cases to worsening economic hardship, insecurity, unemployment, substance
abuse, kidnappings, and other traumatic experiences.
"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
said.
She expressed concern
that mental healthcare remains largely financed through out-of-pocket spending,
despite the chronic nature of many psychiatric conditions.
"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 caregivers is huge," she added.
Resident
Doctors Speak Out
At the conference, the
President of ARD, FNPH Yaba, Dr. Okuwoga Temitope, said the shortage of doctors
has become a major threat to access to quality mental healthcare in Nigeria.
"As mental health
professionals, we witness firsthand 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," he said.
Dr. Temitope noted that
resident doctors are increasingly battling burnout, anxiety, stress, and
depression due to overwhelming workloads caused by manpower shortages.
Communiqué:
Urgent Actions Needed
In a communiqué issued at
the end of the conference, the association called on federal and state
governments to:
Improve remuneration and
strengthen welfare packages
Expand specialist
training programmes
Improve working
conditions
Increase investment in
mental healthcare
Integrate mental health
services into primary healthcare centres
Deploy telepsychiatry
more widely
Increase public awareness
to reduce stigma and improve early treatment seeking
The association also
urged the management of the Federal Neuropsychiatric Hospital, Yaba, to
expedite the enrolment of newly employed resident doctors on the Integrated
Payroll and Personnel Information System (IPPIS) to prevent salary delays and
financial hardship.
The doctors commended the Medical Director of the hospital, Dr. Olugbenga Owoeye, for restoring public electricity supply to the Yaba and Oshodi arms of the institution after a prolonged outage, while calling for more stable power to support patient care and residency training.