Health workforce and governance: the crisis in Nigeria

Abstract

BackgroundIn Nigeria, several challenges have been reported within the health sector, especially in training, funding, employment, and deployment of the health workforce. We aimed to review recent health workforce crises in the Nigerian health sector to identify key underlying causes and provide recommendations toward preventing and/or managing potential future crises in Nigeria.MethodsWe conducted a scoping literature search of PubMed to identify studies on health workforce and health governance in Nigeria. A critical analysis, with extended commentary, on recent health workforce crises (2010–2016) and the health system in Nigeria was conducted.ResultsThe Nigerian health system is relatively weak, and there is yet a coordinated response across the country. A number of health workforce crises have been reported in recent times due to several months’ salaries owed, poor welfare, lack of appropriate health facilities and emerging factions among health workers. Poor administration and response across different levels of government have played contributory roles to further internal crises among health workers, with different factions engaged in protracted supremacy challenge. These crises have consequently prevented optimal healthcare delivery to the Nigerian population.ConclusionsAn encompassing stakeholders’ forum in the Nigerian health sector remain essential. The national health system needs a solid administrative policy foundation that allows coordination of priorities and partnerships in the health workforce and among various stakeholders. It is hoped that this paper may prompt relevant reforms in health workforce and governance in Nigeria toward better health service delivery in the country.

Perceptions and predictors of organizational justice among healthcare professionals in academic hospitals in South-Eastern Nigeria

“…The moderate level of distributive justice might be due to perception by all health professionals that salaries, promotional opportunities and hospital resources are generally insufficient. Inadequate pay and hospital resources have been reasons for industrial actions in Nigeria [13,[15][16][17]28]. However, our findings that nurses and AHPs had significantly lower perception of distributive justice than doctors validate findings of a previous Nigerian study [11].…”

“…In Nigeria, evidence of organizational injustice, deriving from studies on industrial actions, inter-professional conflict, and health workforce governance highlight the huge organizational challenges in managing and motivating healthcare professionals for effective performance in Nigeria especially importance of rewards, professional dominance and work climate [13,[15][16][17]28]. Although there are growing concerns about whether rewards and hospital resources are allocated to healthcare professionals equitably and whether such allocation decisions are made according to fair methods and guidelines, studies on perceptions of organizational justice among health workers in Nigeria are scarce [11].…”

Exploring Issues and Challenges of Leadership among Early Career Doctors in Nigeria Using a Mixed-Method Approach: CHARTING Study

“…Effective clinical leadership is closely associated with a wide range of hospital functions, and it forms an integral component of the health care system. Unfortunately, poor administration and leadership has been persistently bedevilling the Nigerian health care system for many years, and it is the root cause of numerous industrial actions and unrest [14]. Developing clinical leadership skills among ECDs and other health professionals is of critical importance in changing the current trend.…”

Assessment of impediments affecting health systems response to neurocysticercosis in two districts (Gulu and Amuru) of Northern Uganda: A cross sectional study

“…African Development Bank Report (2016) indicates that young people continues to be a powerful work force for development. Additionally, Adeloye et al (2017) reported that shortage of human resources for health has been the main barrier to scale-up health systems and health specific interventions. Previous studies have shown direct links between efficient health system governance and promising health workers outputs, which ultimately have positive effects on overall health outcomes (Adeloye et al, 2017).…”