By Adaobi Rhema Oguejiofor
Nigeria’s healthcare system is under serious strain and at the heart of this crisis is the steady loss of its most vital resource: its people. The continuous migration of doctors, nurses, and other health professionals, widely referred to as “japa,”is no longer a passing trend. It has become a big challenge for a system that is already struggling with limited funding, weak infrastructure, and uneven access to adequate healthcare.
Japa used to be a gradual move but it has rapidly evolved into a sustained outflow, with far-reaching implications for healthcare delivery across Nigeria. Speaking during the 2026 Global Health Summit at the Royal College of Physicians in London, the Minister of State for Health and Social Welfare, Iziaq Salako, described the situation in urgent terms.
He noted that the health workforce crisis is not a distant concern but a present and escalating emergency, one that is already reshaping the realities of healthcare in Nigeria.
In his own words, “at the heart of the issue is a stark numerical imbalance. In Nigeria, out of every 10,000 people, there are roughly only four doctors. This is less than half of the minimum benchmark recommended by the World Health Organization (WHO). In practical terms, this translates to overstretched facilities, longer waiting times, and reduced capacity for both routine and emergency care.”
Data from the United Kingdom shows that more than 13,000 Nigerian health workers relocated there between 2021 and 2022 alone. At the same time, a 2023 survey by NOI Polls and Nigeria Health Watch found that 57 percent of Nigerian doctors had already taken concrete steps toward leaving the country.
These figures point to more than a workforce gap, they reflect a system struggling to retain its trained professionals. Training a single doctor in Nigeria requires significant public investment, often estimated at over $200,000. When these professionals leave, the loss is double. It results in a depletion of skilled manpower and a quiet transfer of scarce national resources to wealthier health systems that are better positioned to attract and absorb them. This dynamic has placed Nigeria within a broader global imbalance.
As highlighted by Salako, Africa carries a substantial share of the world’s disease burden yet accounts for only a small fraction of the global health workforce. The result is a widening disparity between need and capacity, with countries like Nigeria bearing the heaviest consequences.
Domestically, the effects are increasingly visible. Public hospitals are operating under pressure, with fewer professionals managing the increasing patient loads. The strain contributes to burnout, limits the time available for patient care, and raises concerns about the overall quality and safety of medical services.
In rural and underserved areas, the situation is even more acute. Limited access to healthcare personnel adds to the already existing barriers including distance, cost, and infrastructure. This leaves many communities with minimal or very inconsistent medical support.
In response, according to Salako, the Federal Government under the administration of Bola Tinubu has introduced a series of reforms aimed at strengthening the sector. Central to these efforts is the Nigeria Health Sector Renewal Investment Initiative, a framework designed to improve coordination, streamline funding, and enhance accountability through its “One Plan, One Budget, One Conversation” approach.
There has also been a notable expansion in training capacity. Between 2023 and 2025, medical school admissions increased significantly, alongside similar efforts in the training of nurses, pharmacists, and laboratory scientists. Complementary strategies, including task-shifting and the strengthening of community health worker programmes, are intended to extend care to underserved populations.
Beyond domestic reforms, attention is increasingly turning to Nigeria’s health diaspora. With an estimated 150,000 Nigerian healthcare professionals working abroad, many occupying senior roles, the diaspora represents both a loss and an opportunity. Planned medical missions and knowledge exchange initiatives aim to leverage this global network to support local capacity, particularly in specialized areas of care.
However, while these measures may help ease immediate pressures, they do not fully address the underlying drivers of migration. These drivers include persistent challenges including inadequate remuneration, limited career progression, and suboptimal working conditions. These conditions continue to push professionals to seek opportunities elsewhere.
At the same time, global trends are intensifying the competition for health workers. Ageing populations in developed countries, coupled with their own workforce shortages, have increased demand for foreign-trained professionals. Economic uncertainty and evolving health risks are further reshaping labour dynamics within the sector.
Environmental factors are also emerging as an additional layer of strain. According to the Lancet Countdown on Health and Climate Change, climate-related health risks, from rising temperatures to food insecurity, are placing new demands on already stretched systems. In Nigeria, challenges such as flooding, desertification, and pollution are contributing to disease patterns that require sustained medical attention.
Addressing the crisis, therefore, requires a response that extends beyond national borders. Salako has called for stronger international cooperation, including adherence to ethical recruitment practices outlined by the WHO Global Code of Practice on the International Recruitment of Health Personnel. He has also advocated for bilateral arrangements that allow healthcare workers to gain experience abroad while ensuring that skills and knowledge are transferred back to their home countries.
Ultimately, the migration of healthcare professionals is not simply a labour issue, it is a defining factor in the future of Nigeria’s health system. Without deliberate efforts to retain talent, improve working conditions, and align global recruitment practices with principles of equity, the gap between healthcare demand and available expertise will continue to widen.
What is at stake is not only the stability of the system, but the quality of care accessible to millions of Nigerians. In that sense, the health workforce crisis is more than a sectorial challenge, it is a national imperative that seeks urgent attention.
