Finding lasting solutions to doctors’ strike in Nigeria

Despite various reforms to address the extensive issues in the health care system, the country’s healthcare space remains weak due to lack of sufficient health personnel, poor health infrastructure, and inadequate remuneration of healthcare workers among others.

Also, over the years, the incessant strike actions by health care workers across the country have cast a lot of doubt on the care system, hence lack of public trust in the healthcare space. Frequent healthcare workers’ strikes result in the closure of public healthcare institutions preventing Nigerians’ access to quality health services

However, according to a study titled ‘Healthcare Workers’ Industrial Action in Nigeria: A Cross-Sectional Survey of Nigerian Physicians,’ poor staff welfare, salary, leadership/management and governmental inability to implement agreements were the common causes of healthcare worker strikes in the country.

Also, these strikes resulted in disruption to service delivery and training programmes increased morbidity and mortality of patients and loss of confidence in the hospitals and the healthcare professions.

However, proffering solutions to the unending strike actions ravaging the health sector, Publicity Secretary, National Association of Resident Doctors (NARD), Dr. Stanley Egbogu, said that lack of political will to implement policies and insincerity from the government were major reasons for the industrials actions in the country.

He also faulted the slashing of the health and education budgets amid the pandemic, alleging the insensitivity of the government towards the health challenges of the country.

Recall, NARD was protesting non-payment of inducement allowances for the doctors, deplorable state of the hospital, and lack of protective equipment for members treating COVID-19 patients, implementation of the Medical Residency Training Act in all Federal and State Hospitals and pay parity among doctors of equal cadre among others.

Nevertheless, Egbogu said that the Residency Training Act was an act of the Federal Government (FG) that was passed into law in 2017 and it defines the role of FG that sponsors the programme and also the responsibility of the resident doctors.

He, however, stated that since inception of the Act, the government has not funded it until they went on strike and the Speaker of the House of Representative, Femi Gbajabiamila was able to allocate N4 billion for the residency training funding for 2020 in the revised budget. He also lamented that state governments were yet to adopt the act.

The obstetrician and gynaecologist added that the association was totally against the slashing of the health and education at this moment of the pandemic, which means the government is insensitive to health challenges in the country and they are not serious about getting the problem solved.

“In as much as the general health budget was cut. There was an inclusion of N4 billion to carter for that Residency Training funding, the budget was cut by about 43 per cent but there was inclusion to carter for the training. Regards the residency training fund, efforts are been made now to see if the money would be released to the doctors,” he noted.

Egbogu lamented on the insincerity of the government on the payment of inducement allowance. His words: “Recall when we went on strike, they promised to pay April, May and June in the first instance and July, August September in the second instance pending when the COVID-19 would abate, then they will now determine final hazard allowance for doctors.

“Subsequently, after paying the first two months, April and May, they stopped and we weren’t happy with that. As we speak now, June has not even been paid that was one of the reasons we gave them the 21days ultimatum, which would end on August 17.

“Also, look at the Primary Health Care (PHC), they are meant to have a doctor, but very few PHC are functional. Nobody is seeing the role of the Local Government. They do not have any impact at all. I do not even know what the Local Government chairmen are doing as regards health. I cannot see any project but that are being given money. The state too, they do not pay much attention expect few.

“Look at the COVID-19 inducement allowance FG encouraged to pay as I speak now only Nasarawa and Enugu has paid. How are doctors to be motivated? The government does not want to take health serious and COVID-19 has shown us that health affects everything. At the peak of COVID-19, everything was grounded that was to show you how important health is; yet the government does not want to take it seriously. Health should be properly funded. Good leaders should also be elected. With what I have seen so far, we have not learnt anything at all,” he stated.

Among other issues the doctors are protesting for include: inadequate Personal Protective Equipment (PPE), poor remuneration, shortage of doctors, lack of adequate infrastructure, consumables and non-payment of life insurance for the doctors.

He also advocated for the revitalisation of the primary healthcare centres across the nation for easy access to healthcare.

Similarly, a former, Chief Medical Director, Lagos University Teaching Hospital (LUTH) and a Consultant Public Health Physician Prof Akin Osibogun said that staff welfare and work environment are major reasons for strike action across the country.

The public health expert explained that workers are not satisfied if the work environment is not conducive and also if their take home do not take them home.

He maintained that is paramount for the doctors to get professional satisfaction to be able to perform optimally.

Osibogu continued: “To address the issue, the government has to explore a different mechanism to improve the work environment. If we pull more resources in the health sector through mandatory health insurance, even if every Nigeria pay N2000 per month that would be additional fund and then once they pay we guarantee them access to care. Right now we cannot guarantee them access to health service that is what we mean by the universal health care coverage. If we can ensure that, there would be more funds to be able to improve in the infrastructure, equipment and therefore improve on the work climate and more likely, give the workers’ job satisfaction.”