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By Rita Okoye
Nigeria must prioritize health workers’ welfare to curb their mass migration and avoid further setbacks in healthcare delivery and economic growth, according to new research by Olumayowa Adeleke Idowu.
Idowu, an alumnus of Lagos State University and University of Pittsburgh, Department of Economics, and a current PhD in Policy Studies student at Clemson University, United States, recently published an analytical review on the intersection of health workers’ incentives, their emigration, and Nigeria’s economic performance between 1999 and 2023. The research provides compelling evidence that the frequent industrial actions by health workers and their migration abroad are closely tied to poor incentives and have dire consequences on national development
“Nigeria has one of the lowest physician-to-patient ratios globally, not because we lack trained professionals, but because the system constantly pushes them out,” said Idowu. “Healthcare workers are leaving because of inadequate pay, poor working conditions, and a lack of professional fulfilment.”
According to the review, Nigeria lost about 319 working days to health worker strikes between 1999 and 2023. During the same period, over 8,400 Nigerian-trained doctors were practising in the UK and US alone, excluding thousands more in Canada, Saudi Arabia, and other countries
These losses, Idowu argues, are more than just human resource gaps. “When you undermine the health sector, you undermine the economy,” he explained. “Illness reduces labour productivity. Mass migration drains our investment in education. Frequent strikes paralyze hospital operations. These are direct blows to GDP.”
The paper highlights that Nigeria’s health expenditure has remained below 5% of GDP, with per capita spending under $100, indicating systemic underinvestment. Life expectancy remains below 56 years, and maternal mortality rates are among the highest globally
Successive administrations, the research shows, have failed to address the problem. Under President Muhammadu Buhari alone, health workers were on strike for 164 days. “These are symptoms,” said Idowu. “The real illness is corruption—budget padding, unaccounted spending, weak leadership. Until we address that, we won’t see real change.”
In 2023, the government proposed a bill mandating medical graduates to serve for five years before receiving full licences. But Idowu called it shortsighted. “You don’t solve brain drain by locking the door, you solve it by fixing the house,” he warned.
The study also tracked economic indicators, linking poor healthcare investment to weak growth. Nigeria recorded its worst GDP average (1.4%) during 2016–2023, alongside rising inflation and declining productivity
“Improving health workers’ incentives will lead to better healthcare outcomes, higher productivity, and stronger economic performance,” Idowu stated. “This isn’t charity; it’s strategy.”
He called for a holistic approach involving civil society, NGOs, professional bodies, and anti-corruption watchdogs. “We need a healthcare policy that is transparent, digitally managed, and centred on human capital development.”
To complement local reforms, Idowu urged Nigeria to adopt global best practices. “We must learn from countries that have successfully digitized and decentralized healthcare,” he said. “The problem isn’t lack of models—it’s lack of will.”
He also encouraged more robust engagement with professional bodies like the Nigerian Medical Association and Joint Health Sector Unions, adding that “policy must be participatory to be effective.”
Ultimately, the economist believes that fixing the healthcare system is foundational to realizing the Sustainable Development Goals. “If we can’t ensure good health for our people, the rest of the goals become pipe dreams,” he concluded.
