Doctor-patient ratio worsening in Nigeria, NMA warns

• Deplores decaying health sector, pervasive insecurity
• Threatens indefinite strike if Abia medics remain unpaid in three weeks

The Nigerian Medical Association (NMA) has said the doctor-patient ratio in the country is getting worse, with a physician attending to more than 5,000 patients.

The association, in a communiqué, issued and jointly signed by the President and Secretary-General, Drs. Uche R. Ojinmah and Jide Onyekwelu, yesterday, at the end of its 2022 National Executive Council (NEC) in Gombe, said: “NEC observed that one of the most serious obstacles to the development of effective health services in Nigeria is inadequate supply of skilled human resource. This has led to serious manpower crises in most health facilities in the country with the health workers already being overstretched, leading to serious distortion in the already poor doctor-patient ratio of 1:5,000 in Nigeria as against the World Health Organisation (WHO) recommendation of 1:600.”

The body said the shortage of doctors is currently driving the epidemic of physician burnout in the country, even as it decried pervasive negative effect of the burnout on all aspects of medical care, including lower patient satisfaction and care quality, suicide and higher medical error rates.

The theme of the conference was “Healthcare Delivery in the Face of Insecurity.” The sub-themes were “Health Manpower Planning: The Challenges of Physician Burnout and Brain Drain in Nigeria” and “Re-emerging Health Issues: Monkey Pox Disease and Marburg Virus Disease.”

The doctors also noted that health threats are increasing in every part of Nigeria, citing parlous infrastructure, insufficient and obsolete equipment, human resource shortage, poor remuneration of health workers, medical brain drain, inadequate funding, abuse of referral system, inter-professional rivalry and insecurity as major obstacles to effective healthcare delivery in the country.

They equally observed that the worsening insecurity in the land had led to the inability of both patients and health workers to access health facilities in some parts of the country.

The medics further pointed out the failure of both the Federal and State Governments to effectively check security lapses and rein in kidnappings in Nigeria.

“Health workers have been targeted in some communities with some of them kidnapped during the discharge of their duties, and few of them killed by gunmen,” the communiqué noted.

The NEC, therefore, called on government at all levels and security agencies to urgently address the menace, warning that the already precarious health indices might worsen if the situation is left unattended to.

It reviewed the level of progress in clearing the backlog of salaries of doctors and other health workers in Abia, Ekiti, Ondo and Imo states.

NEC decried the failure of Abia State Government to pay salaries and other allowances of doctors and other health workers for up to 24 months. It considered the action as unfair, irritable and highly provocative to the tenets of civil service and natural justice.

On the other hand, NEC appreciated the level of progress in Ekiti, Ondo and Imo states in clearing their backlogs.

It resolved that Abia NMA should serve the state government a three-week ultimatum to settle the outstanding issues. Failure to do the needful would see doctors in the state embarking on an indefinite strike that “must involve all doctors in federal, state and private hospitals.”

The NEC observed too the slow progress made towards implementation of the new hazard allowance and the attempt to exclude doctors in Ministries, Departments, Agencies (MDAs) and those in basic medical faculties in universities.

The body also submitted that some state governments have always shied away from complying with upward review of salaries and allowances to doctors in state service.

NEC observed with joy the fact that Delta state Government has already started paying the newly approved Hazard allowance.

NEC further resolved to continue the engagement using every lawful means to ensure the payment of the newly approved Hazard Allowance within next two months. NEC also insisted on universal applicability in the implementation of the new Hazard allowance for all doctors working in Federal, State and Local Government establishments.

The NEC decried the action of the Federal Government of Nigeria acting through Federal Ministry of Health (FMoH) in sponsoring a bill on the Establishment of Traditional, Complementary and Alternative Medicine Regulatory Board in the country. The NEC observed that some components of the Bill would be in conflict with the statutory functions of the Medical and Dental Council of Nigeria (MDCN).

The NEC directed the NOC to engage the National Assembly and the FMoH on the need to make amendment to the title of the Bill on Complementary, Alternative and traditional Medicine Board to reflect only African Traditional Medicine matters.

The NEC observed with great pains that eight years after paying the supreme price in the line of duty while protecting Nigerians from the spread of Ebola Viral Haemorrhagic Fever, the Government of Nigeria has not deemed it fit to immortalize our colleague, Dr. Stella Ameyo Adadevoh. NEC noted that this is grave injustice and a disincentive for patriotic Nigerians.

The NEC resolved to name her routine Medical Outreach after the unsung Heroine, Dr. Stella Adadevoh. The NMA Medical Outreach Programme shall henceforth be known as “Dr. Stella Adadevoh Memorial Medical Outreach” – Powered by The Nigerian Medical Association. NEC also directed the National Officers Committee to recommend Dr. Stella Adadevoh to Honours and Awards Committee of NMA for a befitting Post-Humous Award.

The NEC noted the proposed historic installation of Dr. Osahon Enabulele, a Past President of NMA as the substantive President of World Medical Assembly (WMA) during the General Assembly of the Association in Berlin, Germany from October 5 to 8, 2022. The NEC observed that Dr. Osahon Enabulele was the first Nigerian that will occupy this office.