BRAIN DRAIN AMONG PROFESSIONALS AND UNDERDEVELOPMENT IN NIGERIA ( A STUDY OF FEDERAL MEDICAL CENTRE ( FMC) OWERRI
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Background to the Study
Nigeria experiences a significant brain drain in a variety of industries, especially in healthcare. The healthcare system in Nigeria desperately needs repair; this is no longer shocking news because it has been so obvious for a considerable amount of time that the input, process as well as outcome indicators are well below the set targets. It is terrible that the country is losing a significant portion of her highly skilled medical professionals owing to brain drain daily, and it is limited to regard this as a health issue. The country's leadership has harmed the economy by depleting natural resources (oil and gas), which are a source of major revenue and as a result, many citizens have emigrated in order to provide for themselves and their families (Osigbesan, 2021).
In 2020, the global healthcare workforce was 65.1 million healthcare workers (HCW) (29.1 million nurses, 12.7 million medical doctors, 3.7 million pharmacists, 2.5 million dentists, 2.2 million midwives and 14.9 million additional occupations) with a reported shortage of 15 million HCW (Boniol, Kunjumen, Nair, Siyam, Campbell & Diallo, 2022). However, only 1.3% of these HCW are currently working in sub-Saharan African countries despite having 25% of the global burden of disease (Ipinnimo, Ajidahun, & Adedipe, 2022). There is a considerable inequity in the distribution of HCW across the globe, particularly with a low count in the African regions which have been further depleted by brain drain. According to Clemens & Pettersson (2008) about one-fifth of African-born physicians and one-tenth of African-born professional nurses were working overseas in developed countries. They above authors averred that the nine most important destination countries included the United Kingdom, United States, France, Australia, Canada, Portugal, Belgium, Spain, and South Africa.
As it pertains to Nigeria, Tolu-Kolawole (2021) reported that about four thousand five hundred and twenty eight (4,528) Nigerian doctors moved to the United Kingdom between 2015 and 2021. As of November 2021, 8,983 Nigerian trained doctors were working in the United Kingdom, and another 727 licensed in just 5 months between December 2021 and April 2022, bringing the total to 9,710 with at least 12 Nigerian doctors employed in the United Kingdom every week (Tolu-Kolawole, 2022). In addition, about 3,895 Nigerian-educated doctors are licensed to practice medicine in the United State as of 2020, with Nigerians accounting for about 1 in 50 of all licensed physicians who were international medical graduates (Joel, 2021).
The worrisome and pertinent question to come to mind is this, what is the implication of brain drain to national development? The medical brain drain in Nigeria requires a very careful examination due to its negative effects on the nation’s healthcare systems, which indirectly impair population health outcomes and heighten inequality among vulnerable populations. In the case of Nigeria, the movement of medical doctors and other HCW out of the country has been a major problem for public health systems; it exacerbates already brittle healthcare systems, leads to loss of human capital and widens the global gap in health disparities.
Furthermore, Nigeria is one of the nations with the worst results for maternal health globally. Despite making up just 2% of the world's population, it is disproportionately responsible for about 10% of maternal death worldwide (Imafidon, 2018). The shortage of HCW could simply means more loss of lives for many Nigerians especially the poor and vulnerable. This could be as a result of burnout among HCW, work-related stress, and medical negligence, all of which influence negatively on patient experience and health outcomes as well as HCW job satisfaction.
Additionally, the continuous reduction in the number of available medical doctors and other health professionals would lead to economic loss to the nation generally. It is instructive to note that the government put a lot of investment in the education of medical professionals. The overall essence is for these professionals to contribute their quotas to national development. However, this noble ambition is often lost to the receiving countries when these doctors for instance migrate because of better job opportunities abroad. The situation x-rayed above is the stern reality of the Nigerian health sector which the Federal medical Centre is a visible part of. This study is therefore aimed at examining the nexus between brain drain among professionals and underdevelopment in Nigeria using Federal Medical Centre (FMC) Owerri, Imo State.
Statement of the Problem
The problem of shortage of healthcare professionals in sub-Saharan Africa including Nigeria which has about 25% of the global disease burden but less than 2% of the healthcare workforce has been further compounded by the medical brain drain (Ipinnimo, Ajidahun, & Adedipe, 2022). Nigeria is one of the African countries with the worst indices for health; with the second highest number of people living with HIV and the highest number of malaria-related deaths. Although maternal mortality rate has declined steadily since 1990, it still lags behind other nations. This problem to a greater percentage could be attributed to brain drain phenomenon in Nigeria
The medical brain drain in Nigeria could be attributed to the failure of health system leadership in the country that stems from poor insight and neglect of the problem. Nigeria’s healthcare professionals have been migrating in drones to the United Kingdoms, United States, Canada, Australia and other developed nations.
Specifically, the economy of the nation is at risk when HCW leave because what drives the economy is quality human resource capital. It appears that the demand for healthcare professionals in the country currently outweighs our production capacity (without factoring in those who are emigrating). A plan to close the human resources for health (HRH) gap in Nigeria requires clarity of the gaps and clear projections on how to close the gaps. It is quite unfortunate that FMC is losing her best hands of medical professional due to the push and pull factors at play in their everyday work. The best of our surgeons, anesthetics, nurses, gynecologists etc are been poached to seek for professional practice outside the shores of Nigeria. This could result to serious health quagmire to our health sector and national development.
Furthermore, brain drain in FMC Owerri could be deleterious to the patient. The mass exodus of HCW may give rise to health conditions and medical morbidity, an increase in death rates, and an overall deterioration in the health status of the citizens. It is a travesty that the government maintains that there are enough HCW including medical doctors in Nigeria, despite having 4 doctors and 15 nurses to every 10,000 Nigerians. This is in contrast to the World Health Organization (WHO) recommended 1 doctor to 600 populations as well as about 30 HCWs (doctors, nurses and midwives) to 10,000 populations. In FMC Owerri there appears to be a lacuna in the health personnel especially doctors. A cursory observation will show a doctor attending to many patients unlike what obtain in advanced countries in Europe and the USA. A situation where doctors, nurses and other health workers are grossly inadequate, this could result to enormous health crisis situation especially if there is a disease outbreak or pandemic. Besides such HCW may be prone to mistake or error due to work overload which could have fatal consequences on patient’s lives.
Additionally, the emigration of health sector workers could spell huge lost in economic terms in FMC owerri. It is instructive to note that the Federal and State government spend an appreciable amount of their budgets in training medical students especially those in public tertiary education that would help promote a healthy workforce. A cursory observation would show that many of young medical professional are leaving the job to much older health workers whom may not much motivation to emigrate. This also appears to be the situation in FMC Owerri. Basically the government needs to get a return on their investments! But unfortunately, the mass exodus of some of these doctors which is supposed to give back to Nigeria may be seen as a disservice to the nation. The reality is however that these doctors usually seek for greener pastures abroad thereby adding to national development of the foreign country while Nigeria loss out in her investment. To this end this study answers the following research questions.
Research Questions
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What are the main causes of brain drain in FMC owerri
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To what extent does mass exodus of health professional leads to loss of human capital in the FMC Owerri?
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To what extent does shortage of health workers leads to loss of lives the FMC Owerri?
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To what extent does emigration of health sector workers leads to loss of economic investment in health workers in FMC Owerri?
1.4 Objectives of the Study
The general objective of the study is to examine the nexus between brain drain among professionals and underdevelopment in Nigeria using Federal Medical Centre (FMC) Owerri, Imo State as a unit of analysis. The specific objectives however are to:
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To find out the main causes of brain drain in FMC owerri.
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To investigate the extent mass exodus of health professional leads to loss of human capital in the FMC Owerri.
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To examine the extent the shortage of health workers leads to loss of lives the FMC Owerri.
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To determine the extent the emigration of health sector workers leads to loss of economic investment in health workers in FMC Owerri?
1.5 Research Hypotheses
H1: There is a significant relationship between mass exodus of health professional and loss of human capital in the FMC Owerri.
H2: There is a significant relationship between shortage of health workers and loss of lives the FMC Owerri.
H3: There is a significant relationship between emigrations of health sector workers and loss of economic investment in health workers in FMC Owerri.
1.6 Significance of the Study
This study has both theoretical and practical significance.
Theoretical significance
As far as we know till date, there has not been any such study done to examine the nexus between brain drain among professionals and underdevelopment in Nigeria with Federal Medical Centre as a unit of analysis. This study filled this gap by adopting both descriptive and empirical research approaches on the topic under study. Hence, large sample size that is representative of the target population was used in that regard. Thus, the theoretical significance of this study lies in its potential to extend the frontier of knowledge.
Practical significance
This work will be of great benefits to hospital administrators, government and the general public in understanding the huge challenges of brain drain confronting the Nigerian health sector. The benefit of this study will be felt when the report is domiciled in libraries or internet. Besides, the recommendations in the study will be useful to those who engage in similar research area or topic.
1.7 Operational Definition of Terms
Brain Drain: This is the movement of talented people where the outflow of expertise is strongly in one direction. For the purpose of this study, we see it as the migration of highly qualified persons from developing countries to developed countries.
Economic investment: This is an asset or item acquired with the goal of generating income or appreciation. For this study, we see economic investment as the effort put in place to get an accomplished medical professional to optimally do their job.
Human Capital: This refers to the economic value of a worker's experience and skills. Human capital includes assets like education, training, intelligence, skills, health, and other things employers value.
Loss of lives: This means death, including clinical death determined by the local governing medical authorities.
Mass exodus of health professional: This entails the movement of a lot of medical workers from their place of work to other countries due to perceived or real displeasure to their work.
Medical Professional: These are health professionals that maintain health in humans through the application of the principles and procedures of evidence-based medicine and caring. Medical professionals include doctors, nurses, emergency medical technicians, and other trained caregivers.
Shortage of health workers: This is the lack or deficit of medical professionals to carry out their duties.
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