Nigeria’s Public Hospitals In Crisis: Japa, Underfunding & Inefficiency

Nigerian Healthcare at Risk: Japa, Poor Funding, and Inefficiency Crippling Public Hospitals

Alarming Shortage of Medical Professionals

Nigeria’s healthcare system is on the brink of collapse as public hospitals battle severe shortages of medical professionals. The widespread emigration of doctors, nurses, and healthcare workers, known as the “Japa” phenomenon, has created a vacuum in the already fragile sector. In 2017, Nigeria had approximately 300,000 healthcare professionals, but by 2024, that number has dwindled to just 90,000.

This crisis has left hospitals struggling to cope with patient demand. The World Health Organization (WHO) recommends a doctor-to-patient ratio of 1:600, but in Nigeria, it has worsened to 1:2,000. The nurse-to-patient ratio is equally alarming, averaging 1:1,160 instead of the global standard of 1:4. This shortage means longer wait times, overworked staff, and a decline in the quality of healthcare services.

Impact of the Japa Exodus on Public Healthcare

Medical professionals are leaving Nigeria in droves due to poor working conditions, inadequate salaries, and security concerns. Between 2019 and 2024, over 16,000 doctors migrated abroad, while 17,000 switched jobs locally. As a result, hospitals are overwhelmed, with emergency cases facing severe delays due to insufficient resources and personnel.

Patients often wait for hours or even days to receive basic medical attention. In urban centers, it is common to see overcrowded wards, under-equipped emergency units, and stretched-out medical staff working beyond capacity.

Patient Struggles: Long Waits, Lack of Beds, and Inadequate Resources

The current healthcare crisis has led to heartbreaking patient experiences. Many Nigerians face unnecessary suffering due to delays in medical procedures, lack of basic drugs, and unhygienic hospital environments.

For instance, Yetunde Adebayo, a Lagos resident, lost her husband to a stroke after multiple public hospitals turned them away due to unavailable beds. Similarly, Janet, a mother of four, endured months of excruciating pain before finally undergoing hernia surgery in a government hospital that lacked the required surgical tools.

Poor hospital hygiene and maintenance also threaten patient safety. Facilities frequently experience water shortages, power outages, and unsanitary conditions, increasing the risk of infections.

Underfunding and Infrastructure Deficits

One of the biggest challenges facing Nigeria’s public hospitals is chronic underfunding. The 2025 health budget is N2.48 trillion, which is only 5.18% of the total national budget, far below the 15% target set by the 2001 Abuja Declaration. The consequences of this financial neglect are evident in outdated medical equipment, insufficient medical supplies, and dilapidated hospital buildings.

A recent independent evaluation by the National Tertiary Health Institutions Standards Committee (NTHISC) exposed severe deficiencies across 20 tertiary hospitals, including staffing shortages, poor service delivery, and lack of essential medical equipment. The findings underscore the urgent need for reforms to improve Nigeria’s healthcare system.

Experts Call for Privatization and Innovative Solutions

Healthcare experts argue that privatizing specialist hospitals could improve efficiency and service delivery. Dr. Paul Faduola, CEO of Androcare Fertility Centre, suggests that Nigeria should follow India’s model, where private hospitals handle specialized treatments while the government focuses on primary healthcare. Lowering tariffs on medical supplies, he argues, could make healthcare more affordable for Nigerians.

Additionally, healthcare professionals advocate for improved welfare packages to retain talent and prevent further brain drain. Investing in better salaries, working conditions, and continuous training for medical staff could help stabilize the system.

Government’s Response and the Way Forward

The Federal Government has acknowledged the crisis and initiated efforts to address the challenges. Dr. Iziaq Salako, Minister of State for Health, revealed plans to expand healthcare infrastructure, including establishing eight new Federal Medical Centres and teaching hospitals across the country. These measures aim to relieve the pressure on existing facilities and increase bed capacity.

However, experts insist that Nigeria needs a sustainable healthcare financing model to bridge the funding gap. Raising the healthcare budget to at least 15% of the national budget and implementing innovative funding strategies, such as public-private partnerships (PPPs) and national health insurance schemes, could significantly improve healthcare delivery.

Conclusion: The Urgent Need for Healthcare Reform

The crisis in Nigeria’s public hospitals demands urgent intervention. The mass exodus of healthcare professionals, inadequate infrastructure, and chronic underfunding have left the system on the brink of collapse. Without substantial government investment and policy reforms, millions of Nigerians will continue to suffer from poor healthcare services.

To reverse this trend, Nigeria must prioritize funding, infrastructure development, and human resource retention in the health sector. Strengthening primary healthcare, incentivizing medical professionals to stay, and adopting global best practices will be critical steps toward rebuilding a functional and efficient healthcare system.

Source: WHO on Doctor-to-Patient Ratios