Health workers’ exodus worsens as policy brief raises alarm over looming systemic threat to Nigeria’s healthcare sector

A newly released policy brief has warned that Nigeria may be heading toward a deeper healthcare crisis unless urgent, welfare-driven reforms are put in place, cautioning that continued neglect could severely weaken access to quality healthcare across the country.

Nigeria’s healthcare system is under growing strain as the steady migration of doctors and nurses continues to deplete service capacity, fuelling concerns about the long-term sustainability of the sector.
The policy analysis, authored by health policy specialist Dr Emmanuel Ejimonu of the Athena Centre for Policy and Leadership, revealed that over 42,000 nurses left Nigeria between 2021 and early 2024. In the same period, thousands of Nigerian-trained doctors reportedly registered to practise abroad, with the United Kingdom remaining a top destination.
Findings from survey data referenced in the report indicate that the trend is unlikely to abate soon. Nearly three-quarters of medical and nursing students surveyed expressed intentions to seek employment outside Nigeria, while about one in three said they had no plans to return once they leave.
According to the report, the mass departure is driven more by domestic welfare and governance challenges than by professional ambition. Health workers interviewed cited poor and irregular remuneration, unsafe and overstretched work environments, limited access to funded specialist training, and weak social protection systems. The brief noted that these factors have made migration a rational decision amid institutional uncertainty, especially as global demand for health professionals continues to grow.
While the federal government introduced the National Policy on Health Workforce Migration in 2023 to encourage ethical recruitment and improve retention, the brief argued that the policy has delivered minimal impact. It pointed to gaps in implementation, insufficient funding, and uneven execution across states and health facilities as major obstacles to achieving tangible improvements in working conditions.
The effects of sustained health worker losses are already becoming evident. Teaching hospitals are reportedly struggling to sustain specialist training and mentorship programmes, while repeated industrial actions underscore increasing mistrust between health workers and government authorities. Economically, Nigeria continues to lose returns on public investment in training health professionals, even as workforce shortages undermine healthcare delivery in both urban and rural areas. Those who remain in service are experiencing heightened burnout, which further intensifies migration pressures.
Drawing lessons from international experiences in countries such as Ghana, Kenya, the Philippines, and Cuba, the policy brief stressed that health worker migration cannot be completely halted. Instead, it recommended managing mobility through welfare-centred retention strategies supported by credible governance frameworks.
At the heart of its recommendations is a proposed Welfare-First Retention Package, which prioritises timely and guaranteed salary payments, enhanced workplace safety, funded career development, fair bonding arrangements, and stronger social protection systems. The package also advocates disciplined use of bilateral agreements and ethical recruitment mechanisms to safeguard Nigeria’s investment in health worker training.
The brief estimated that with adequate funding and effective implementation, the proposed measures could cut short-term health worker attrition by as much as one-third within two years, while substantially improving retention over a five-year period.
The report concluded that reversing the health workforce crisis will require positioning welfare reform as a central economic and governance priority, backed by political will, fiscal discipline, and strong institutional coordination. Without decisive action, it warned, Nigeria risks the gradual hollowing out of its healthcare system, with serious implications for public health and national development.