Research Article – Pandemic and brain-drain in Africa: Assessing the impact of the COVID-19 outbreak on ‘capital flight’ of Nigeria’s health workers

[This is an excerpt from an article in The Round Table: The Commonwealth Journal of International Affairs and Policy Studies.]

Possible solution to mitigate the effect of brain drain

The effect of brain drain on African healthcare systems has been made clear by the COVID-19 pandemic, and Nigeria is no exception. Given Nigeria’s young population, prevention should be the main focus of health policy. This will necessitate both community involvement and a whole-of-government strategy. Priority should be given to explicitly taking equity into account while implementing programmes and offering social welfare, educational, and career opportunities. In order to strengthen the healthcare system and enhance health outcomes in Nigeria and Africa, immediate action must be done to prevent or lessen the brain drain effect. No one has the right to make healthcare workers feel guilty for leaving the nation. To keep healthcare professionals, the government must show that it is committed to raising both the standard of living and the working conditions for them. Some suggestions for addressing Nigeria’s brain drain are briefly outlined below.

Improved working conditions

Better welfare benefits would stem Nigerian doctors from leaving for other nations. The healthcare professionals would not feel the need to relocate in quest of better opportunities if the government makes the working conditions of healthcare practitioners, particularly doctors, nurses, and midwives, competitive with those in other areas of the world. The Nigerian government needs to improve the healthcare system and increase funding for the sector to make the healthcare professions more rewarding, reducing the need for workers to leave the country.

Improved production capabilities for medications

There is need to conduct a comprehensive system analysis of the investments required to ensure Nigeria’s health security. The COVID-19 outbreak has highlighted and exposed Nigeria’s health security system’s flaws. Nigeria has to improve its production capabilities for medication, vaccines, and other important medical supplies. It also needs to provide diagnostic services, public health surveillance, and other preventive and curative measures in hospitals and other settings.

Investment in local healthcare systems and healthcare education and training

Healthcare professions can be more fulfilling and the brain drain can be lessened by the government making investments in local healthcare systems and improving access to medical resources and equipment. There is a need for the system to support innovation. In order to ensure that currently implemented nationally driven programmes have local buy-in and are sustainable, future health system reform should involve communities. Also, investing in healthcare education and training can improve retention rates of healthcare workers, reducing the brain drain effect.

Fixing infrastructural facilities

Healthcare professionals form a vital part of society and their choice to stay in or leave the country will be influenced by the quality of life for the people they care about. The choice to stay will be challenging if, among other infrastructural deficiencies, the power supply remains erratic, there is no access to broadband internet, and the potholes on the roads represent a threat to life. Although mending them may take years, the government must show leadership and commitment by investing in the nation’s infrastructure before the people are willing to accept the sacrifices involved in the short term.

Public-private partnerships

There is a need for public–private partnerships in accessing health insurance. Neither the government nor individual citizens can fully cover the cost of healthcare. Nigeria can gain from several effective types of health insurance. The country must expand access to health insurance for the uninsured in order to pay for healthcare costs and fairly compensate medical staff. The government should encourage public–private partnerships to improve healthcare infrastructure, increase the capacity of medical professionals and provide better working conditions for healthcare workforce, which in turn will reduce the trend of brain drain.

International cooperation and digitization of health records

Developed nations may assist African, and by extension Nigerian, healthcare systems by funding educational initiatives, exchanging knowledge and resources, and fostering domestic employment possibilities. More so, the Nigerian Federal Government should support and take the lead in developing standards for the digitisation of health records and better data collection, registration, and quality assurance systems in collaboration with state and local governments. The adoption of electronic data gathering tools for Nigerian healthcare workforce overseas and the creation of a global skill collaboration with industrialised nations are also necessary to turn a brain-drain into a brain-gain.

Concluding remarks

The COVID-19 pandemic exposed how overburdened and susceptible to disruption Nigeria’s essential health services are and highlighted the burden health workers often face. Nigeria’s socioeconomic and developmental agendas are impacted by the problem of brain drain chiefly in the post-COVID-19 pandemic period. In addition to a high level of insecurity and a deteriorating working environment, the push factors for brain-drain on the workforce of Nigeria’s health workers during the pandemic include insufficient provision of personal protective equipment, meagre monthly salary and hazard allowances and inconsistent payment of COVID-19 inducement allowances, among others. On the other hand, the pull factors include higher salaries and wages as well as a secure and healthy workplace with modern facilities in the destination countries. While there may not be easy ways comprehensively to mitigate the impact of brain drain on the country’s healthcare delivery and developmental aspirations, there are a number of strategies and legislative choices that could help the situation.

To reduce the negative consequences of human capital flight in the health sector, for example, qualified and professional health workers must be hired and adequately incentivised for retention.

Michael B. Aleyomi, Department of Political Science, Federal University Oye-Ekiti, Oye-Ekiti, Nigeria.

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