Nigeria’s Public Healthcare System in Crisis: The Impact of Japa, Underfunding, and Inefficiency

Nigeria’s public hospitals are facing unprecedented challenges that threaten the delivery of quality healthcare. From chronic underfunding to mass migration of healthcare workers (the ‘Japa’ phenomenon), the sector is struggling with staff shortages, outdated infrastructure, and inefficient management. Patients are bearing the brunt, encountering long wait times, inadequate medical resources, and overcrowded hospitals.

The Japa Effect: A Devastating Brain Drain

One of the most significant issues affecting Nigeria’s healthcare system is the mass exodus of medical professionals seeking better opportunities abroad. Doctors, nurses, pharmacists, midwives, and lab scientists are leaving in droves due to poor wages, harsh working conditions, and insecurity. This migration is worsening an already dire situation.

Between 2019 and 2024, at least 16,000 doctors have relocated overseas, while 17,000 have switched jobs within Nigeria. The country currently has around 90,000 registered doctors, but the doctor-to-patient ratio remains alarmingly high at over 1:2,000—far from the World Health Organization’s recommended 1:600.

Workforce Shortages and Overcrowded Hospitals

The shortage of medical personnel is exacerbated by Nigeria’s limited hospital infrastructure. Many hospitals receive far more patients than they were designed to accommodate, leading to overcrowded wards and excessive workloads for doctors and nurses. The nurse-to-patient ratio stands at 1:1,160, far below the WHO standard of 1:5 in general wards.

Patients’ Struggles in an Overwhelmed System

Patients face numerous challenges, from long wait times to inadequate medical care.

• Yetunde Adebayo’s Story: When Yetunde’s husband suffered a stroke, she rushed him to multiple hospitals, but each one was either full or lacked electricity. With no available bed, he passed away while waiting for care.
• Janet’s Ordeal: A 42-year-old mother of four had to wait six weeks for a hernia surgery because the hospital lacked the necessary tools. The delay worsened her condition, leaving her in pain and frustration.
• Shade’s Experience: After a routine procedure at a Lagos general hospital, Shade developed an infection due to poor hygiene standards, further complicating her health.

Investigation: Inside Nigeria’s Ailing Hospitals

A government assessment of 20 tertiary hospitals uncovered severe problems:

• Infrastructure Decay: Many facilities have outdated buildings, broken equipment, and insufficient space.
• Staffing Deficits: A severe shortage of specialists, nurses, and support staff.
• Poor Service Delivery: Delays in treatment, inadequate patient care, and failure to follow clinical guidelines.
• Lack of Government Funding: Hospitals rely heavily on out-of-pocket payments from patients, leading to accessibility issues.

The Coordinating Minister of Health and Social Welfare, Prof. Ali Pate, has acknowledged these challenges and pledged to address them by increasing healthcare funding, improving hospital infrastructure, and expanding medical training programs.

The Case for Healthcare Reform

Experts emphasize that Nigeria must urgently reform its healthcare sector:

• Increased Funding: Nigeria’s health sector receives less than 15% of the national budget, leading to poor infrastructure and inadequate services.
• Private Sector Involvement: Dr. Paul Faduola suggests that specialist hospitals should be privatized to enhance efficiency, as seen in India.
• Better Pay for Medical Professionals: Improved salaries and working conditions could help retain local talent and reduce the Japa phenomenon.
• Strategic Investment in Medical Infrastructure: Prof. Oladapo Ashiru advocates for establishing centers of excellence for specialized medical treatments.
• Stronger Emergency Response Systems: Overcrowded emergency units are undermining urgent care, leading to preventable deaths.

Conclusion: A Call for Urgent Action

Nigeria’s healthcare system is in crisis. Without decisive action to address underfunding, inefficiency, and the Japa-induced brain drain, the nation risks further deterioration in medical services. Increased government investment, public-private partnerships, competitive salaries for medical professionals, and a well-structured healthcare insurance system are essential steps toward restoring confidence in Nigeria’s hospitals.

It’s time for policymakers to prioritize the health sector and implement sustainable reforms that will ensure access to quality healthcare for all Nigerians.