NEWS
Nigeria’s Healthcare System on the Brink as Only 55,000 Doctors Serve Over 220 Million Citizens
..as Massive Brain Drain, Shortage of Psychiatrists, Rising Mental Health Crisis Threaten Access to Quality Healthcare Across the Country
Nigeria’s healthcare sector is facing what medical experts describe as one of its most critical manpower crises in recent history, with only about 55,000 doctors currently available to cater to a population exceeding 220 million people.
The alarming revelation emerged during the Ordinary General Meeting and Scientific Conference of the Association of Resident Doctors (ARD), Federal Neuropsychiatric Hospital (FNPH), Yaba, Lagos. The conference, themed “Too Few Doctors, Too Many Patients: The Consequences of Manpower Shortage on the Mental Well-being of Nigerians,” brought together leading healthcare professionals and mental health experts who painted a troubling picture of the nation’s struggling healthcare system.
Experts warned that the worsening shortage of doctors is severely limiting access to healthcare services, particularly psychiatric and mental health care, leaving millions of Nigerians without the treatment they desperately need.
The crisis has been compounded by the increasing migration of healthcare professionals under the popular “Japa” phenomenon. According to medical professionals, no fewer than 16,000 Nigerian doctors have emigrated over the last five years, further weakening an already overstretched healthcare workforce.
Healthcare stakeholders at the conference noted that the continuous exodus of doctors, nurses, and other medical professionals has significantly depleted Nigeria’s mental health workforce, widened treatment gaps, increased healthcare costs, and intensified pressure on the few specialists still practicing within the country.
Only 55,000 Doctors Actively Practicing in Nigeria:
Confirming the development, President of the Nigerian Medical Association (NMA), Prof. Omoti Ernest, disclosed that although the Medical and Dental Council of Nigeria (MDCN) has registered more than 130,000 doctors, only about 55,000 remain actively engaged in medical practice within Nigeria.
With the country’s population now surpassing 220 million people, he noted that the doctor-to-patient ratio remains dangerously inadequate.
“This ratio is far below the World Health Organisation’s recommended threshold of one doctor to about 600 people, highlighting the significant shortage of medical personnel and the strain on healthcare delivery.
“Many Nigerian-trained doctors have emigrated or are no longer engaged in active clinical practice, contributing to the country’s healthcare workforce shortage,” the NMA President said.
Prof. Ernest explained that the migration of skilled healthcare professionals in search of better opportunities abroad has had devastating consequences for Nigeria’s hospitals and healthcare institutions.
“Thousands of doctors and other healthcare professionals have left the country in recent years, leading to severe staff shortages, increased workload for those who remain with many suffering from burnout, longer waiting times for patients, and declining quality of care in many public hospitals.
“Rural and under-served communities have been particularly affected, as they already struggle with limited access to healthcare services.
‘’The reasons behind this migration include poor remuneration, inadequate working conditions, insecurity, limited opportunities for career advancement, and insufficient investment in healthcare infrastructure, among others.
“Many professionals are attracted by better pay, improved facilities, and more stable environments in countries such as the United Kingdom, Canada, and the United States.”
Mental Healthcare Facing Severe Setback:
Speaking at the conference, Consultant Psychiatrist at the Neuropsychiatric Hospital, Aro, Dr. Yesir Kareem, highlighted the devastating impact of the manpower shortage on mental healthcare delivery.
He disclosed that Nigeria’s doctor-to-patient ratio has deteriorated even further in some areas, reaching approximately one doctor to more than 10,000 patients.
According to him, the implications are especially severe for mental health services, where treatment gaps continue to widen.
“Only about 55,000 doctors remain to serve a population of over 220 million Nigerians. More than 40 million Nigerians suffer from mental health disorders, yet about 85 per cent of them do not have access to mental healthcare services,” Kareem said.
Dr. Kareem warned that the shortage of psychiatrists and mental health specialists has reached dangerous levels, contributing to increased family breakdowns, substance abuse, unemployment, delayed diagnosis of mental illnesses, and preventable deaths.
“The economic consequences are equally devastating, with billions of dollars lost annually due to untreated mental health conditions,” he added.
He further revealed that approximately 94,000 doctors and nurses have left Nigeria since the onset of the Japa wave, citing poor remuneration, delayed salaries, overwhelming workloads, inadequate facilities, lack of career advancement opportunities, insecurity, and unstable socioeconomic conditions as major drivers of migration.
Less Than 150 Psychiatrists Left in Nigeria:
Adding her voice to the growing concern, President of the Association of Psychiatrists in Nigeria (APN), Dr. Veronica Nyamali, described the manpower shortage as a national emergency that is affecting every level of mental healthcare delivery.
According to her, consultants are increasingly abandoning research and specialist duties to fill staffing gaps left by departing doctors.
“There are gaps everywhere. Work that should be done by four psychiatrists is now being handled by one or two people. Consultants are increasingly forced to work at lower levels because the doctors they are supposed to supervise are no longer there,” she said.
Nyamali lamented that many doctors undergoing specialist training now leave the country before completing their professional careers locally.
“Those we train are leaving. Junior registrars, senior registrars, many complete their examinations and return abroad. The result is that we have shortages at every level of care,” she stated.
She disclosed that Nigeria currently has fewer than 150 psychiatrists serving millions of people living with mental health conditions, warning that access to specialist mental healthcare is becoming increasingly difficult and expensive, especially in rural communities.
Specialists Becoming Scarce, Treatment Costs Rising:
Nyamali noted that the dwindling number of specialists is directly impacting affordability and accessibility of mental healthcare services.
“When specialists become scarce, services become more expensive. Access becomes difficult because patients must travel long distances to find care. This is contrary to the principle of universal health coverage, where mental health services should be available, affordable and accessible to everyone,” Nyamali said.
She also linked the healthcare workforce crisis to the shrinking presence of pharmaceutical companies in Nigeria.
“We now have fewer treatment options. Some of the newer drugs that offer better outcomes are no longer readily available. At the same time, the market is being flooded with fake medicines, making treatment even more challenging,” she warned.
The APN President noted that shortages in mental health personnel have increased dependence on traditional and faith-based healers, many of whom serve as first points of contact for people experiencing mental illness.
While acknowledging their influence, she said psychiatrists are increasingly collaborating with traditional and religious healers to eliminate harmful practices and encourage appropriate referrals.
“We recognise that people go to them first because they are available, accessible and affordable. Rather than confront them, we are engaging them and providing basic mental health education so that harmful practices can be eliminated and patients referred appropriately,” she explained.
Economic Hardship Fueling Mental Health Challenges:
Nyamali further linked the rising burden of mental illness across Nigeria to worsening economic conditions, insecurity, unemployment, kidnappings, substance abuse, and other traumatic experiences affecting citizens daily.
“People are being traumatised daily. Poverty, joblessness, violence and insecurity are all social determinants of mental illness. Those already living with mental health conditions are relapsing more frequently, while many others are developing new mental health challenges because of the pressures of daily living,” she said.
She also expressed concern over the poor coverage of mental health treatment under existing health insurance schemes.
“Mental illness is not properly covered under health insurance. Many of the newer medications are not included in insurance drug lists, leaving families to bear enormous treatment costs. The burden on care-givers is huge,” she added.
Resident Doctors Call for Urgent Government Intervention:
President of ARD, FNPH Yaba, Dr. Okuwoga Temitope, described the shortage of doctors as a major threat to quality mental healthcare delivery in Nigeria.
“As mental health professionals, we witness first hand the widening treatment gap, the burden on already stretched healthcare workers and the impact these shortages have on access to quality mental healthcare for Nigerians,” he said.
Temitope noted that many resident doctors are increasingly battling burnout, anxiety, stress, and depression due to overwhelming workloads caused by inadequate manpower.
At the conclusion of the conference, participants urged both federal and state governments to urgently improve remuneration packages, strengthen healthcare worker welfare, expand specialist training opportunities, improve working conditions, and increase investment in healthcare infrastructure and mental health services.
They also advocated the integration of mental healthcare into primary healthcare centres nationwide, broader deployment of telepsychiatry services, and intensified public awareness campaigns aimed at reducing stigma and encouraging early treatment.
In a communiqué issued after the conference, the association reaffirmed its commitment to promoting the welfare of resident doctors and improving access to quality mental healthcare services across Nigeria.
The doctors also called on the management of the Federal Neuropsychiatric Hospital, Yaba, to fast-track the enrolment of newly recruited resident doctors on the Integrated Payroll and Personnel Information System (IPPIS) to prevent salary delays and financial hardship.
They, however, commended the Medical Director of the hospital, Dr. Olugbenga Owoeye, for restoring public electricity supply to the Yaba and Oshodi arms of the institution after a prolonged outage, while urging authorities to ensure more stable power supply to support patient care, training, and healthcare service delivery.
The conference ended with a unanimous warning that unless urgent measures are taken to halt the mass migration of healthcare professionals and strengthen Nigeria’s healthcare infrastructure, the country’s already fragile health system could face even greater challenges in the years ahead.