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Health Workforce for 2016-2030: Will Nigeria have enough?
Abstract
Health workforce is made up of health workers which include all people engaged in the promotion,
protection or improvement of the health of the population and they play a critical role in achieving effective health care delivery.
We sought to estimate the health workforce in Nigeria for 2016-2030 using the population growth rate from censuses and health workforce growth rate from data from the World health organization, World Health
Organisation recommended doctors and nurses critical density and the Africa health workforce observatory database to estimate the potential supply gap. Nigeria’s population will increase from 178.5 million in 2014 to 272.5 million by 2030. We found the range of estimated doctors (physicians) and nurses & midwives required for 2016-2030 to be between 422,018 and 621,205 with mean of 515,668. The range for doctors is 101,803 to 149,862 with mean of 124,394. The range of estimated Nurses and Midwives requirement is
320,216 to 471,353 with a mean of 391,274. We found the range of deficit for doctors and nurses &
midwifes to be 30.86-33.45% (average- 32.16%.) and 26.09-29.5% (average- 27.68%) respectively during
the study period with actual figure for doctors ranging from 31,413-50,120 while nurses is estimated to be 83,548-137,859 if no effort is made to upscale the present supply. Nigeria needs to improve on the health workforce supply to tackle the supply deficit in order to solve the heavy disease burden and turn the tide of health indicators in the positive direction.
... This is worrisome considering that some of these third world countries like Nigeria already has insufficient supply of critical health workforce to cope with its rapidly increasing population. 1 Nigeria has only a doctor for about 6000 persons, well below the World Health Organisation's recommended ratio of 1:1000. 1,2 The migration of doctors especially early career doctors (ECDs) from Nigeria to countries like the United States, United Kingdom, Canada and the Arabian Gulf has become enormous in recent time due to economic and professional factors with wide-ranging consequences on both the economic and social systems. 1 As much as a quarter of doctors in countries such as the United States, Canada and United Kingdom are International Medical Graduates (IMGs) with strain on the inadequate numbers in countries such as Nigeria. 2,3 Furthermore, Nigerian doctors form a significant proportion of IMGs from sub-Saharan Africa. ...
... 1,2 The migration of doctors especially early career doctors (ECDs) from Nigeria to countries like the United States, United Kingdom, Canada and the Arabian Gulf has become enormous in recent time due to economic and professional factors with wide-ranging consequences on both the economic and social systems. 1 As much as a quarter of doctors in countries such as the United States, Canada and United Kingdom are International Medical Graduates (IMGs) with strain on the inadequate numbers in countries such as Nigeria. 2,3 Furthermore, Nigerian doctors form a significant proportion of IMGs from sub-Saharan Africa. 4 This pattern appears not likely to abate soon with a relative perennial shortage in developed countries. ...
... 1 This study suggests that emigration of medical practitioner would not abate in the nearest future if these intentions are follow through. 1 The tendency is likely to be aided by a younger age. 1,2,16 Our cohort had four of every five participants less than 40 years of age. 1,2,16 Interestingly, the topmost designation follows the earlier established observed pattern among the Nigerian doctors with leading destination being countries with a high proportion of Nigerian medical practitioners. ...
Introduction:
Recently, there has been an upsurge in the migration of medical personnel, especially early career doctors (ECDs) from low- and middle-income countries, Nigeria inclusive, to high-income countries with wide-ranging consequences on the social and economic systems of the donor countries. This study assessed the profile and determinants of intention to emigrate by ECDs in Nigeria.
Methods:
A cross-sectional study conducted among Nigerian ECDs from nine tertiary hospitals. Socio-demographic characteristics, intention & reasons to emigrate and willingness to return were collected using a self-administered semi-structured questionnaire. Data were analysed using Statistical Package for Social Sciences (SPSS) version 23.
Results:
A total number of 763 ECDs participated in the study. The majority (88.2%) were less than 40 years of age and the male to female ratio was 2:1. Majority of the participants (69.4%) received monthly income ≤833 US Dollar. About two-thirds of ECDs had plans to emigrate and most to developed countries. Common reasons for intention to migrate were better quality of postgraduate training, improved quality of life and better remuneration.
Conclusion:
High proportion of Nigerian ECDs has intention to emigrate out with potential adverse effect on the fragile health system in the country.
... The health workforce is an integral part of every health care system in the world. 60,61 It is a universal truth that there is no health without a health workforce. 62 1.1 pharmaceutical personnel per 10,000 population. ...
... 63 Based on geometric projection, Nigeria will require at least 149,852 doctors and 471,353 nurses by 2030. 61 However, Nigeria will only be able to produce 99,120 doctors and 333,494 nurses based on its annual growth rate. 61 Therefore, there will be a shortage of about 50,120 doctors and 137,859 nurses by 2030. ...
... 61 However, Nigeria will only be able to produce 99,120 doctors and 333,494 nurses based on its annual growth rate. 61 Therefore, there will be a shortage of about 50,120 doctors and 137,859 nurses by 2030. 61 While physician emigration has always occurred, the rate accelerated in the 1980's when the financial crises occurred, leading to the Structural Adjustment Programme (SAP). ...
The Nigerian health care system is weak and has been evolving over the years with misplaced priorities and a focus on health inputs rather than outputs. The design and adoption of several policies have contributed little to strengthening the health care system towards improvement in health outcomes. Available evidence on the Nigerian health care system from 1960–2019 was reviewed. Decentralization and fragmentation of the health care system, with duplication of responsibilities among the three tiers of government, have affected effective health care service delivery and accountability. The national health insurance scheme has provided health insurance coverage to less than five percent of the population. Nigeria is also faced with a health workforce crisis with no end in sight. While some modest gains and improvements have been recorded over the decades, maternal mortality, child mortality, immunization coverage, access to basic health services, and life expectancy remain poor. Nigeria needs to strengthen its health care system.
... According to a research paper on the health workforce estimated between 2016 and 2030 to understand if Nigeria will have enough workforce, [22] the estimated number of HCWs was 621,205. This was used as a proxy for HCWs caring for chronic illness patients. ...
... Furthermore, age appeared to influence HCWs' perceptions of Smart Lockers' benefits. Younger HCWs (aged [18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34][35] tended to rate the benefits of reducing stigmatization and discrimination of patients living with chronic diseases more positively, with statistically significant differences observed (Mean = 3.75, p < 0.05) compared to participants aged 36 -60 (Mean = 3.68) and Above 60 years (Mean = 1.80). Moreover, marital status emerged as another influential factor. ...
Chronic diseases present a significant public health challenge globally, particularly in resource-limited settings like Nigeria. Effective management of chronic diseases often requires regular access to medications and adherence to treatment regimens. Smart Lockers, serving as Virtual Dispensing Units (VDU), offer a potential solution to improve medication access and adherence among individuals with chronic illnesses. However, little is known about the perceptions of healthcare workers (HCWs) and patients regarding using Smart Lockers in Nigeria. This study assessed the perceived benefits of Smart Lockers as VDU among HCWs and patients for chronic disease medications. It explored how demographic factors influence these perceptions. A descriptive cross-sectional research design was employed. Data were collected from 405 HCWs and 728 patients via a structured questionnaire. Descriptive statistics were used to analyze demographic characteristics and perceived benefits, including means, standard deviations, and percentages. Additionally, One-way Analysis of Variance (ANOVA) and t-test were conducted to explore relationships between demographics and perceptions, with significance set at p < 0.05. The results revealed that among HCWs, the perceived benefits of Smart Lockers included reduced workload (Mean = 4.40), facility decongestion (Mean = 4.50), and decreased patient waiting time (Mean = 4.57). Patients perceived benefits such as minimization of time spent waiting at healthcare facilities (Mean = 4.26) and reduced transportation costs associated with accessing care (Mean = 3.84) most positively. Significant variations in perceptions among HCWs and patients were observed based on demographic factors such as gender, age, marital status, employment status, and educational qualification. Male HCWs and patients, as well as employed patients, tended to perceive the benefits of Smart Lockers more positively compared to their female counterparts and unemployed patients, respectively (p < 0.05). Additionally, patients with higher educational qualifications expressed more favourable perceptions of Smart Locker's benefits than those with lower educational levels (p < 0.05). Understanding these perceptions and demographic influences is crucial for effectively implementing and utilizing Smart Lockers technology in healthcare settings. Tailored interventions based on these findings can help address disparities in perceptions and enhance the acceptance and utilization of Smart Lockers for chronic disease management in Nigeria. This study provides significant perspectives into healthcare technology and chronic disease management, ultimately aiming to improve healthcare delivery and patient outcomes in Nigeria.
... Moreso, Nigeria according to Uneke et al. (2007) is known to be one of the foremost health-worker exporting nation in Africa due to insufficient health amenities and pitiable compensation packages which makes a sizeable number of healthcare workers migrate to advanced nations in search of sustaining and worthwhile jobs. Adebayo, Labiran, Emerenini and Omoruyi (2016) assert that the consequences of inadequate health workforce cannot be overemphasised as it would negatively impact the health status in the society in terms of ineffectual tackling of infectious endemics, the emergence of noncommunicable diseases (NCDs), increase maternal mortality and non-achievement of Millennium Development Goals (MDGs). In addition, Adebayo et al., (2016) assert that out of forty-nine nations identified by WHO to be having insufficient healthcare workers, Nigeria is in the sixth position. ...
... Adebayo, Labiran, Emerenini and Omoruyi (2016) assert that the consequences of inadequate health workforce cannot be overemphasised as it would negatively impact the health status in the society in terms of ineffectual tackling of infectious endemics, the emergence of noncommunicable diseases (NCDs), increase maternal mortality and non-achievement of Millennium Development Goals (MDGs). In addition, Adebayo et al., (2016) assert that out of forty-nine nations identified by WHO to be having insufficient healthcare workers, Nigeria is in the sixth position. This challenge of the dearth of health workers might also contribute to the present high infant mortality rate in Nigeria (Adetoro and Amoo, 2014). ...
Medical practitioners’ migration to other countries of the world has a considerable effect on the appropriate health care delivery of the affected countries. Funding, training, work overload, capacity building is some of the contemporary issues confronting Nigeria health sector. All these have contributed to migration intention of many Nigerian health professionals to the developed nations.
... While that study was questionnaire-based, this study design is qualitative and by nature allows hidden themes to be explored. Although, our respondents are from tertiary centres which are relatively better staffed than other levels of care in Nigeria notwithstanding the general doctor-patient ratio in Nigeria and may not be bothered with a staff-patient ratio in respect to the confl ict in the workplace [23]. Confl ict in health workplace poses a negative effect on the health system and the quality of services, particularly the patients whether in confl icts between the health worker and the doctor or cases of an industrial dispute with the ECDs. ...
... It is imperative for the managers in the Nigerian Health system while realizing that confl icts are unavoidable since there is regular human interaction in the clinical workplace; to institute institutional confl ict resolution mechanism. Furthermore, suffi cient confl ict resolution may help to prevent the attrition of the insuffi cient health workforce in Nigeria [23,24]. Strategies that can be used to minimize confl ict are attractive remuneration, professional laws, mutual respect, among others. ...
Background. Conflicts across professional workgroup and hierarchies inundate the clinical workplace. Early Career Doctors (ECDs) are also affected either as victims or as a provocateur/perpetrator. The effects of conflict at their workplaces have both significant positive and negative dimensions and impacts on ECDs. Little has been reported about conflict among ECDs in Nigeria.
Thus, this study explored the issue of conflict and conflict resolution among ECDs in Nigeria, in a bid to elicit information on the causes, consequences, perpetrators and victims.
Method. This was a qualitative study, using Focus Group Discussions (FGD) to explore information on conflict and conflict management among purposively selected key respondents (n = 14) from seven tertiary hospitals in Nigeria. The respondents are ECDs who were leaders and representatives of other ECDs in their various hospitals. Two FGDs were conducted.
Results. The result showed that conflict is inescapable in clinical settings and occurred at different levels. The perpetrators are varieties of health workers, and most are task-related conflicts, although there are relational ones. The conflicts with the government on labour-related issues are also frequent. The lack of job description and specification and power struggle among others were highlighted as the drivers of conflicts between ECDs and other health-workers. Conclusion. The findings of the study were discussed, and suggestions were made to reduce its effect, which would require structural solutions to mitigate at different levels and the diverse players in the health sectors.
... The benefits of reliable rapid screening tools for migraine headache diagnosis towards mitigating the prevalent under-recognition and consequent mistreatment of migraine headache has been widely acknowledged 17,21,22 . Such benefits are pronounced in resource-poor settings like ours, faced with daunting manpower and resource constraints 17,23,24 . ...
... Adopting the outcome of such comparative studies would be of huge benefit to tackling the prevalent under-recognition and inadequate treatment of migraine headaches 12 . The benefits are more obvious in regions grappling with the challenges of resource constraints, as obtained in Nigeria, with an unfavorably skewed doctor to patient ratios and the added disadvantage of limited availability of neurologists and other specialist healthcare providers trained in the management of headaches 24,30 . ...
Under-recognition and consequent mismanagement of migraine highlight the importance of quick and easier tools for migraine diagnosis. The ID-migraine, a 3-item migraine diagnosis tool, fits the description of such a rapid tool. This study tested the accuracy of the ID-migraine tool in migraine without aura diagnosis, to determine its usefulness in our setting. This cross-sectional accuracy study was done in Calabar, Nigeria. We compared the ID-migraine tool with the International Headache Society criteria in migraine without aura diagnosis on persons with recurrent headaches, within the previous three months, recruited from a pool of 220 clinical students in Calabar, Nigeria. Data analysis was done with Statistical Package for the Social Sciences software version 20, and we set the level of significance at p < 0.05. Fifty-one persons who had recurrent headaches from the pool of students, comprising 25 (49%) males and 26 (51%) females, completed the study. The mean age of the participants was 24.2 years±4.6. The derived sensitivity, specificity, accuracy, positive predictive and negative predictive values of the 3-item migraine diagnosis tool were 69.2%, 63.1%, 64.7%, 39.1% and 85.7%, respectively (kappa=0.26; p=0.043). The ID-migraine tool had moderate sensitivity and specificity in our study and a low level of agreement with the reference standard. Its usefulness may be more in excluding migraine in persons with recurrent headaches. [J Med Allied Sci 2020; 10(2.000): 91-97]
... These are pay, promotion, supervision, benefits, contingent rewards, operating procedures, co-workers, nature of work and communication. 17 Batura et al studied the validity and reliability of the JSS in assessing job satisfaction among health workers in Nepal (a Low/middle-income country) and found it a reliable tool. 6 He added the caveat that' the work environment dimension of the tool be tailored to reflect the interests of the specific population being evaluated'. ...
... Furthermore, it is necessary to examine this in the background of the chronic inadequate physician workforce in Nigeria and continuous brain drain and the high burden of other mental health and psychosocial issues. 17,21,30 ...
This commentary examines job satisfaction among early-career doctors (ECDs) in Nigeria. This group of professionals constitutes a significant portion of the physician workforce, and their satisfaction or otherwise can have indirect effects on patient care. Various theories and models relating to job satisfaction – such as those proposed by Locke and Herzberg; including the job-demand-control model, effort-reward-imbalance and job-demand-resource models- were discussed. Also, the various tools used to assess job satisfaction in the literature were evaluated. Moreover, a review of studies on job satisfaction among doctors in different regions of the world was done, suggesting that more doctors in Europe and Australia appeared to have a somewhat better satisfaction on their job than their counterparts in Africa. Intrinsic (like personal passion and motivation) and extrinsic factors (remuneration, working conditions) were identified. This was further dissected, and certain factors, including socio-demographics, issues bordering on autonomy, remuneration, working environment and training/skill acquisition were shown to influence job satisfaction. Lastly, this commentary establishes the benefits of overall improved job satisfaction on the doctor (improved mental and physical wellbeing), the patients (fewer errors in judgement, more efficient patient care), the overall health sector (reduction in brain-drain, expansion of health care delivery points), as well as the future of healthcare in our country, with the potential generation of efficient future healthcare leaders.
... These are pay, promotion, supervision, benefits, contingent rewards, operating procedures, co-workers, nature of work and communication. 17 Batura et al studied the validity and reliability of the JSS in assessing job satisfaction among health workers in Nepal (a Low/middle-income country) and found it a reliable tool. 6 He added the caveat that' the work environment dimension of the tool be tailored to reflect the interests of the specific population being evaluated'. ...
... Furthermore, it is necessary to examine this in the background of the chronic inadequate physician workforce in Nigeria and continuous brain drain and the high burden of other mental health and psychosocial issues. 17,21,30 ...
... Programmes to address this challenge have been proposed, including focusing global a en on on human resources for health (HRH), par cularly in rela on to the cri cal shortages of skilled health professionals in 57 countries and the centrality of health workers for accelera ng progress in achieving the health-related Sustainable Development Goals (WHO, 2006). Doctor-to-popula on ra os in many low-and middle-income countries (LMICs) are already cri cally low, and the con nuous wave of migra on of the healthcare workforce is only worsening the situa on (Adebayo et al., 2016). There have been different waves of doctor migra on out of Nigeria over the years, and the na on may be presently witnessing one of the largest waves, with different cadres of doctors, Currently, in Nigeria, there is a perennial low budgetary alloca on to the health sector in milieu of insufficient manpower. ...
... At the same me, Nigeria is also a source and des na on country for migrants in West Africa (Adepoju, 2004). Unfortunately, Nigeria is also confronted with the nega ve dimensions of emigra on in milieu of chronic shortage of health professionals in Nigeria, which is unlikely to abate soon (Adebayo et al., 2016;Muyibi, 2008). Nigerian medical doctors, especially early career doctors, are emigra ng to other countries and leaving significant gaps in an already fragile infrastructure. ...
... However, the massive exodus of health workers, as identi ed in this study implies an impending detrimental de cit of health workforce that would compromise the quality of healthcare in the country. This aligns with the predictions of a 2016 study, that by 2030, there will be a de cit of doctors and nurses by 33.45% and 29.25% respectively [24]. Similarly, a survey conducted by the Medical and Dental Consultants Association of Nigeria on its members in 2022 revealed that more than 500 medical consultants have left Nigeria to practice in developed countries, and 1 out of 10 consultants with fewer than ve years had plans for emigration [9]. ...
Background Health workers are an integral part of any functioning health system. Over the years, there has been an increasing migration of health workers, especially from low- and middle-income countries, such as Nigeria, to developed regions in the quest for further education, higher remuneration, and an overall improvement in their quality of life. This study explored the patterns of health worker emigration, also known as Japa, from Nigeria and explores the driving factors and associated barriers from multi-disciplinary stakeholder perspectives. Methods This study adopted an exploratory mixed-method design, comprising of desk review of health workers migration data from 2013 - 2023, policy documents, and in-depth interviews of 20 multidisciplinary stakeholders in health, using semi-structured interviews as the data collection tool. The leaders of the health regulatory agencies and corresponding professional associations, most impacted by migration were interviewed. Data from desk and document reviews were presented in tables, while transcripts from the qualitative interviews were thematically analyzed. Results The year 2023 demonstrated the peak of health worker migration in all the professions, with the United Kingdom as the most common destination country. The in-depth interview of 20 stakeholders revealed three themes and thirteen subthemes. The themes were the push factors, pull factors, and barriers. The subthemes were characterized as economic factors, workplace conditions, poorly regulated practice environment, insecurity of all types, including job insecurity, and lack of job satisfaction, limited career growth, higher remuneration, better working conditions, job security and welfare benefits, research and training opportunities, financial constraints, system and regulatory factors, family and personal factors, overseas country policies, restrictions and discrimination. Conclusion This study identified the United Kingdom as the most common destination country. The key drivers of migration(japa) were economic factors, workplace conditions, a poorly regulated practice environment, insecurity of all types, lack of job satisfaction, limited career growth, and higher remuneration. Associated barriers from the multidisciplinary stakeholders included financial constraints, system and regulatory factors, family and personal factors, overseas country policies, restrictions, and discrimination. Evidence from this study can inform urgent and strategic actions toward practical migration and workforce retention policies of the Nigerian government.
... Nigeria's healthcare system is composed of primary, secondary, and tertiary facilities. In 2018, the estimated population of Nigeria was 195,606,286; however, there was a 26.55% nursing deficit among nurses [13]. ...
Background
Malaria is a major public health problem in Nigeria. This study set out to ascertain Nigerian nurses' knowledge and willingness to recommend malaria vaccination to caregivers of under-5 children.
Methods
This was a cross-sectional study carried out among nurses from all six geopolitical zones of Nigeria. A pretested semi-structured questionnaire was used to collect data on participants' demographics, their knowledge of the RTS S/AS01 and R21 Matrix M malaria vaccines, how they obtain malaria vaccine-related information, and the factors that the nurses consider when recommending any malaria vaccine. Univariate association between each of the demographics characteristics and the key research variables: knowledge of the vaccine and willingness to recommend was used. This was examined using the Chi-Square test and multiple logistic regression.
Results
The study found that nearly two out of every three nurses had poor knowledge and perception of the vaccines (p < 0.05). Awareness of the malaria vaccine was the only factor that was found to be associated with their knowledge (p <0.05). The odds of willingness to promote the vaccine were about 21 times higher among nurses with high perceptions of efficacy than their counterparts who have low perceptions.
Conclusions
The findings highlight major gaps in Nigerian nursing's knowledge and awareness of malaria vaccinations, as well as their willingness to recommend the vaccine to parents. Addressing these gaps will enable nurses to play a critical role in the successful implementation of malaria immunization campaigns, lowering the illness burden among vulnerable populations.
... Baye et al. (2020) found that nurses' occupational stress increased as a result of heavy workload. Worldwide, it is acknowledged that having insufficient resources, limited capabilities, and a low nurse-to-patient ratio is stressful and has a negative impact on nurses' physical and mental well-being (Adebayo et al., 2016). Nigeria had fewer than 150,000 registered nurses, or one nurse for every 1066 people, to serve its estimated 160 million inhabitants (Faremi et al., 2019). ...
This study determined the effectiveness of a nurse-led education on coping strategies in reducing occupational stress among nurses in two selected tertiary hospitals in Ekiti State. The quasi-experimental method was used. One hundred eighteen (118) nurses were selected and allocated into intervention and control groups using a simple balloting technique. The nurses in the intervention groups had three sessions of educational workshops within a month, while those in the control groups had none. Data were collected pre and post-intervention and analysed using Chi-square, Fisher’s exact test, and Paired t-tests. The majority (79%) of the nurses were female; the prevalent type of stress experience was due to workload, with a mean stress score of almost three across all groups. There were no differences between the pre and post-intervention stress levels for all types of stress apart from stressful situations due to conflict among nurses. Most participants reported physical symptoms of stress, and multiple coping strategies improved significantly among the intervention groups. The study suggests that nurse-led education could improve the use of coping strategies among nurses.
... Currently, Nigeria is facing a severe shortage of qualified healthcare professionals. This crisis is exacerbated by the mass emigration of healthcare workers to more developed countries, which has significantly undermined the quality of patient care in Nigeria (Adebayo et al., 2016;Odebiyi, 2021;Osibanjo et al., 2020;Ugwu et al., 2018). For instance, data from the Nigerian Medical Association (NMA) and the General Medical Council (GMC) in the UK indicate that between 2021 and 2024, 8,560 Nigerian doctors registered with the GMC, accounting for 39% of all international registrations. ...
Nigeria is currently facing a significant shortage of qualified healthcare professionals. With forecasts suggesting that the population could reach 263 million by 2030 and a growing trend of medical practitioners leaving the country, this challenge is expected to worsen unless addressed effectively. Utilizing social exchange theory, this study explored the relationship between psychological contract breach, abusive supervision, and the turnover intentions of healthcare workers in Nigeria, as well as, investigating the mediating effect of organizational cynicism in these relationships. A cross-sectional survey design was employed to collect data from a sample of 200 healthcare professionals in tertiary and secondary public hospitals across the three senatorial districts in Ondo State, Nigeria. The findings revealed that both psychological contract breach and abusive supervision were positively correlated with turnover intentions among this group. Furthermore, organizational cynicism was found to fully mediate these relationships. This study implies the need for the government and healthcare management commitments against abusive supervision in the healthcare system. ABSTRAK Nigeria saat ini menghadapi kekurangan tenaga kesehatan profesional yang berkualitas. Dengan perkiraan yang menunjukkan bahwa populasi dapat mencapai 263 juta pada tahun 2030 dan tren meningkatnya praktisi medis yang meninggalkan negara tersebut, tantangan ini diperkirakan akan semakin memburuk jika tidak ditangani secara efektif. Dengan menggunakan teori pertukaran sosial, penelitian ini mengeksplorasi hubungan antara pelanggaran kontrak psikologis, pengawasan yang kejam, dan niat pergantian pekerja kesehatan di Nigeria, serta, menyelidiki efek mediasi sinisme organisasi dalam hubungan ini. Desain survei cross-sectional
... While Ghana has prioritized and implemented specific workforce policies, the policy response in Nigeria has lagged. In Nigeria, health workforce shortage is expected to worsen due to ongoing brain drain and inadequate infrastructure and financing to attract, train, motivate and retain health professionals (Adebayo et al., 2016;WHO, 2022a,b) These issues have persisted due to factors such as the governance structure in Nigeria, and the political factors at play which have impeded the development of concrete policies to address health service delivery issues (Aregbeshola, 2016;Onwujekwe et al., 2020). ...
... Healthcare workers (HCWs). According to a research paper on the health workforce estimated between 2016 to 2030 to understand if Nigeria will have enough workforce [13], the estimated number of HCWs was 621,205. This was used as a proxy for HCWs providing care to chronic illness patients. ...
The use of smart locker technology has been beneficial for patients with chronic diseases who require regular medication and face challenges accessing healthcare facilities due to distance, time, or mobility issues. This study aimed to assess preferences for utilizing Smart Lockers in accessing and dispensing chronic disease medication among healthcare workers (HCWs) and patients in Nigeria. A descriptive cross-sectional survey was conducted between November 8th and December 4th, 2021, across secondary healthcare facilities in five states of Adamawa, Akwa Ibom, Cross River, Benue, and Niger. Among 1,133 participants included in the analysis, 405 were HCWs and 728 were patients with chronic illnesses. Descriptive statistics, including frequencies and percentages, were used to summarize the data, while chi-square tests were employed to assess significant differences between healthcare workers (HCWs) and patients. Results indicated a strong preference among both HCWs and patients for one-on-one counseling as the preferred method for orientating patients on using Smart Lockers, with 53.8% of HCWs and 58.1% of patients expressing this preference (p = 0.25). Additionally, there was a shared preference for hospitals or clinics as secure locations for Smart Lockers, with 68.9% of HCWs and 71.6% of patients preferring this option (p < 0.05). The majority of participants favored receiving notification of drug delivery via phone call, with 49.1% of HCWs and 48.8% of patients expressing this preference (p = 0.63). There was a significant difference in preferences for access hours, the majority (HCWs: 65.4% and patients: 52.6%) favored 24-hour access (p < 0.05). Participants identified patients with HIV within the age range of 18–40 as the most suitable population to benefit from using Smart Lockers for medication dispensing. These findings offer insights into healthcare policies aimed at enhancing medication access and adherence among patients with chronic diseases in Nigeria. The development of models for using smart lockers to dispense chronic disease medications to chronically ill persons in Nigeria and other populations is recommended.
... In the last decade, substantial workforce shortages have been reported across SSA. [52] Improving malaria vaccination coverage in Africa would be problematic even with an available, adequate, and competent health workforce. It may be challenging to administer vaccines to inform and educate the public due to the lack of skilled healthcare workers, particularly in rural and isolated locations. ...
Malaria remains an endemic public health concern in Africa, significantly contributing to morbidity and mortality rates. The inadequacies of traditional prevention measures, like integrated vector management and antimalarial drugs, have spurred efforts to strengthen the development and deployment of malaria vaccines. In addition to existing interventions like insecticide-treated bed nets and artemisinin-based combination therapies, malaria vaccine introduction and implementation in Africa could drastically reduce the disease burden and hasten steps toward malaria elimination. The malaria vaccine rollout is imminent as optimistic results from final clinical trials are anticipated. Thus, determining potential hurdles to malaria vaccine delivery and uptake in malaria-endemic regions of sub-Saharan Africa will enhance decisions and policymakers' preparedness to facilitate efficient and equitable vaccine delivery. A multisectoral approach is recommended to increase funding and resources, active community engagement and participation, and the involvement of healthcare providers.
... Push factors are the low standard of living, political instability, insecurity, excessive workload and stress, low income, inadequate facilities, irregular payment of allowances and salaries, inadequate funding, preferential treatment among health workers, and irregularities during recruitment to mention but a few as asserted by Refs. [15][16][17][18]. According to Ref. [19], the outflow of doctors from sub-Saharan Africa, and specifically Nigeria, started to rise alarmingly over time. ...
The high turnover rate of medical personnel in Nigeria is becoming alarming as many of them are leaving the country for developed nations for better job opportunities. This has contributed to the shortage of doctors and nurses in the Nigeria health sector. The study’s objective is to crystallise the challenges of health worker retention in Nigeria through a critical literature review. The study used data from previously published peer-reviewed articles published in recognised and credible scientific journals. Relevant information was obtained from these sources, conceptualised, and discussed alongside existing literature. Key findings from the research are attributed to a lack of competitive pay, state-of-the-heart medical equipment deficiency, security, and lack of political will by the government. To this end, there is a need for restructuring of the health sector in Nigeria to address issues relating to poor remuneration, infrastructure, training opportunities, and the well-being of the health workers.
... The typical doctor-to-patient ratio is 1:600, while Nigeria's doctor-topatient ratio is 4:10 000 in 2021, which is lower than the recommended level worldwide. 63 This has caused the medical brain to drain, leaving many people in Nigeria without access to medical care. ...
This comprehensive analysis examines the multifaceted impacts of population growth on public health in Nigeria. Drawing parallels with Omran’s epidemiological transition model (that focuses on the intricate means that patterns of health and illness are changing, as well as the relationships that exist between these patterns and the sociological, demographic, and economic factors that influence them) and referencing experiences from Chile and Ceylon. The study highlights a substantial rise in Nigeria’s population causing a double burden of infectious and non-communicable diseases, leading to higher morbidity, and mortality rates, increased healthcare costs, decreased productivity, and health inequalities, posing significant challenges to the country’s healthcare system. Furthermore, the correlation between low education levels and health outcomes underscores the importance of addressing systemic deficiencies in Nigeria’s educational sector. The article emphasizes the urgent need for strategic interventions to mitigate the adverse effects of population growth on health. Recommendations include revitalizing primary healthcare centers, fostering public-private partnerships to enhance healthcare accessibility, leveraging technological advancements like telemedicine, and promoting initiatives to improve nutrition and environmental sustainability. Moreover, prioritizing education on reproductive health and family planning emerges as a crucial strategy to manage population growth sustainably. In conclusion, the article underscores the imperative for collaborative efforts across sectors to navigate Nigeria’s evolving health landscape amidst increasing population growth. By implementing targeted policies and interventions, Nigeria can strive toward achieving universal health coverage, enhancing health outcomes, and ultimately raising the standard of living for its populace.
... According to a research paper on health work force estimated between 2016 to 2030 to understand if Nigeria will have enough workforce. [6], the estimated number of HCWs was 621,205. This was used as a proxy for HCWs providing care to chronic illness patients. ...
Smart lockers are automated delivery machines. They have been used in dispensing ARVs and Tuberculosis medication to chronically ill patients in South Africa, Kenya, and Eswatini. However, there is no evidence of smart lockers in dispensing chronic disease medication in Nigeria. This study aimed to assess the acceptability of smart lockers in dispensing chronic disease medication and to describe the barriers to accessing care among patients with chronic diseases medication in 5 states in Nigeria. We conducted a cross-sectional study among healthcare workers and patients living with chronic diseases in five Nigerian states of Adamawa, Akwa Ibom, Cross River, Benue, and Niger between November and December 2021. A total of 1,133 participants were recruited (728 patients and 405 healthcare workers). The results revealed that most patients and healthcare workers agreed that using smart lockers for drug dispensing will lead to reduced transportation costs, hospital waiting times, the workload of healthcare workers, and decongestion of health facilities. The majority of the patients living with chronic diseases (43%) and healthcare workers (51%) showed high acceptability for the use of smart lockers. The use of smart lockers in dispensing chronic disease medication in Nigeria is feasible, and patients and healthcare workers are willing to accept the smart lockers, provided that a patient-centred implementation strategy is developed.
... In contrast, many African countries including Nigeria have in recent times experienced a consistent and enormous exodus of their health human resources. [7] Brain drain is currently a significant challenge of human resources for health in Nigeria. Nigeria has about 70,000 registered medical doctors, half of whom currently practice outside its shores. ...
... Inequalities in the geographical distribution of healthcare facilities are a crucial constraint on access to healthcare services. The distance between the location of the health facility, its high demand, and the shortage of personnel contributes to the difficulty of using the healthcare services [32,33]. Uwala (2020) and Welcome (2011) [34,35] also stated that health facilities (health centers, workers, and medical equipment) are insufficient, particularly in rural regions. ...
Background:
Nigeria is considering making Universal Health Coverage (UHC) a common policy goal to ensure that citizens have access to high-quality healthcare services without crippling debt. Globally, there is an acute shortage of human resources for Health (HRH), and the most significant burden is borne by low-income countries, especially in sub-Saharan Africa. This shortage has considerably constrained the achievement of health-related development goals and impeded accelerated progress towards universal health coverage. We examine the existing human resource capacity and the distribution of health facilities in Lagos state in this study, discussing the implications of our findings.
Methods:
The study is descriptive using secondary data analysis. We leverage census-based primary data collected by NOIPoll on health facility assessments in Lagos state. The collected data was analyzed using counts, ratios, rates, and percentages.
Results:
We observe a ratio of 5,014 people to 1 general medical doctor, 2,942 people to 1 specialist, 2,165 people to 1 nurse, and 5,117 people to 1 midwife, which are far higher than the WHO recommendation. We also observe that the ratio of nurses to general medical practitioners is 2.2:1 in urban areas and 2.7:1 in rural. In contrast, the ratio of nurses to specialist medical doctors is 1.3:1 in the urban area and 1.5:1 in the rural areas of Lagos state. The overall nurse per general medical practitioner ratio is 2.3:1 and 1.4:1 for specialist medical doctors. 77.2% of the health facilities surveyed were in the urban areas, with private-for-profit facilities accounting for 82.9%, government facilities accounting for 15.4%, and NGOs/faith clinics accounting for 1.7%. Primary healthcare facilities account for 75.3% of the facilities surveyed, secondary and tertiary facilities account for 24.6% and 0.08%, respectively. Alimosho LGA has the most health facilities (77.38% PHCs, and 22.62% SHCs) and staff strength specifically for general medical practitioners, specialists, nurses, and midwives (16.9%, 19.9%, 16.7%, 17.1%, respectively). Eti-Osa LGA has the best density ratio for generalist doctors, specialist doctors, and nurses per 10,000 (4.42, 12.96, and 11.34 respectively), while Ikeja has the best midwife population density ratio 5.46 per 10,000 population.
Conclusion:
: The distribution of health personnel and facilities in Lagos State is not equitable, with evident variation between rural and urban areas. This inequitable distribution could affect the physical distance of health facilities to residents, leading to decreased utilization, ultimately poor health outcomes, and impaired access. Much like child mortality, maternal mortality also exhibits a correlation with healthcare worker density. As the physician density increases linearly, the maternal mortality rate decreases exponentially. However, due to the low number of healthcare workers in Lagos state, doctors, nurses, and midwives are frequently unavailable during childbirth, resulting in increasing infant, neonatal, and maternal death. As such, the government should adopt the UHC strategy in its distribution of facilities and personnel in the state for adequate coverage and optimal performance of the facilities. Also, additional investments are needed in some parts of the state to improve access to tertiary health facilities and leverage private sector capacity.
... To curb the ugly trend and prevent projected physician deficit in Nigeria [18], the need for national actions cannot be overemphasized. An indispensable step to effective national actions is a determination of factors promoting the trend and a reliable projection of the pattern of outflow from the country. ...
Background
Adequate Human Resources for Health is indispensable to achieving Universal Health Coverage and physicians play a leading role. Nigeria with low physician–population ratio, is experiencing massive exodus of physicians. This study investigated emigration intention of physicians, the factors influencing it and discussed the implications to guide policy formulation and reforms, curtail the trend and safeguard the country’s health system.
Methods
Through cross-sectional survey, 913 physicians from 37 States were interviewed with semi-structured questionnaire using Google form shared via WhatsApp and Telegram forums of Nigeria Medical Association. Data were analysed with IBM-SPSS version-25 and charts were created with Microsoft-Excel. Chi-square and multiple regression tests were done with p -value set at 0.05.
Results
The mean age of respondents is 37.6 ± 7.9 years; majority of them are males (63.2%), married (75.5%) with postgraduate qualifications (54.1%) and working in public health facilities (85.4%). Whereas 13% and 19.3% are, respectively, satisfied with their work and willing to continue practice in Nigeria, 43.9% want to emigrate and 36.8% are undecided about future location of their practice. The commonest reasons for emigration are poor remuneration (91.3%), rising insecurity (79.8%) and inadequate diagnostic facilities (61.8%). Physicians working in public health facilities are 2.5 times less satisfied than their counterparts in non-public sector (AOR = 0.4; 95% CI = 0.3–0.8). Physicians in their thirties, forties and fifties are 3.5 (95% CI = 1.5–8.0), 5.5 (95% CI = 2.1–14.5) and 13.8 (95% CI = 3.9–49.3) times, respectively, more willing to retain practice in Nigeria than those younger and those satisfied with their work are 4.7 (AOR = 4.7, 95% CI = 2.9–7.4) times more willing to practice in Nigeria than those not satisfied.
Conclusion
Majority of Nigerian physicians want to emigrate for professional practice and top among the push factors are poor remuneration, rising insecurity and inadequate diagnostic facilities. The observed trend portends danger to the country’s health system due to the foreseeable negative consequences of physician deficit to the system. We recommend upward review of physician remuneration, a root cause analysis of insecurity to determine workable preventive measures and increased funding of the health sector to improve the diagnostic infrastructure, retain physicians and save the health system from imminent collapse.
... According to Adebayo, Labiru, Emerenini, Omoruyi [5] the estimated population of nurses in Nigeria is 248,553. It is interesting to note that a few percentage of these nurses have attained university degree. ...
Introduction: Nursing is a profession that keeps evolving in order to improve care for persons, families and communities as a whole. Education is an important tool of training and retraining these professionals in order to make them keep up with the pace of practice and consequently improve outcome of the healthcare system. Thus, a need to understudy advanced nursing education motivators and barriers in Nigeria. Study Aim: This study was aimed at finding motivators and barriers to the pursuit of advanced nursing education in a teaching hospital in Nigeria. Methodology: This is a descriptive correlation study conducted to identify factors that promote and deter nurses from the pursuit of advanced nursing education in Nigeria. The population was made up of nurses from a teaching hospital in Nigeria. Stratified random sampling technique was used to select 180 elements from the population. Data was analysed using Statistical Package for Social Sciences version 18(SPSS 18). Results: Findings showed that majority of nurses were interested in advanced nursing education. However, the tuition fees for such education was high. The findings also showed that job security, increased salary, and promotion were motivators for the pursuit of advanced nursing education. Review Article Aina et al.; AJRNH, 4(4): 109-115, 2021; Article no.AJRNH.73992 110 Conclusion: The study concluded that job incentives, job security, increased salary, and promotion are motivators for the pursuit of advanced nursing education while cost of tuition, work life balance and family commitment are barriers to the pursuit of advanced nursing education. The study therefore recommended that policy makers should make efforts to provide adequate job incentives for nurses and reduce the cost of tuition for advance nursing education to an affordable level.
... Adebayo (9) explained that workforce crisis manifest as shortage acute and demographic imbalance in distribution doctors' in a nation. Data in table 1, illustrates links population, required minimum density and extant density from 2005 to 2020 Correspondence demand for trainees into Nigeria's medical schools indicate that over 120,000 applicants sought admission and 3000 students were admitted with 2.5% acceptance rate in past decade (11). ...
Background: This paper assessed availability of physicians, supply and demand gap of medical workforce comparatively with the internationally established requisite minimum physicians’ density for Nigeria (2022-2042). It also evaluates the propensity of medical education programme and capability of the Nigerian medical schools to produce sufficient mint medical doctors for effective medical services to population. It also provides projection of estimates of government financing requirement for achieving the targeted number of physicians in the medium to long term.
Methods: Ex-post ‘facto’ quantitative research design and method is employed in the study. Data sets obtained from the relevant Nigerian government’s organisations. Analytical techniques adopted include simple numerical analysis, descriptive statistics, moving average system, demographic estimation methods and projections of future budgetary resource allocation procedures.
Main Finding / Results: Results show that there was a significant deficit in physicians’ density in Nigeria with average annual shortage of 31000. At this range, represents one doctor per 2591 persons as against one-doctor-to-1818 people and shortage of 33000 doctors. Second, the current student enrolment in the range of 3300 to 3600 requires a minimum of 2000300 percent increase in annual students’ enrolment in order to be recording reasonable annual out-turns. With the adoption of a flexible optimum enrolment policy, the result reveals there would be a downward decline in the range of 9%-to-5% in physicians’ shortages which is linked to increase of 250-312%. Thus, Nigeria will be able to produce enough medical doctors and injection to the pool to effectively eliminate physicians’ density deficit in next two decades. Therefore should be replaced with a flexible system. Nigeria would make about one trillion naira savings from medical tourism if Nigeria implements the medical education acceleration strategy as envisage in this paper. Nigeria needs to spend about an average of N313 million annually in next 20 years as against N360 million current spending on foreign medical care (tourism) and with such medical programme funding,
Conclusion: This study provided evidence-based results indicating sub-optimal students’ enrolments and inadequate funding are the root cause of physicians’ density deficit in Nigeria and not necessarily the wage pricing medical labour force. Nigeria is under-producing doctors with about 15000-20000 currently working outside the country. It is illogical that Nigeria’s medical schools have continued to enrol fewer trainees despite a huge deficit of 33000 physicians which implies that about a minimum of 8000-to-10000 for the next two decades in order to clear the shortage or the country will continue to grapple with physicians’ deficit continuously.
... postgraduate degrees among resident doctors in the present study can be explained by several factors. Residency programme is quite intense and involvingchallenging clinical service, poor staffing, and other structural challenges of early career doctors in Nigeria (Akinyemi and Atilola 2013;Adebayo et al. 2016Adebayo et al. , 2020Ogunsuji et al. 2019). The hospitals' management, who are the primary employers of resident doctors, demand full commitment to clinical services from the resident doctors with practically no allowance for extra-training in academic pursuits. ...
The study examined the characteristics and factors driving the acquisition of postgraduate academic degrees among resident doctors in Nigeria. About 10% of the respondents had a form of university postgraduate degree with the majority being master’s degree. Having more than seven years of professional practice was the only factor predicting the acquisition of postgraduate academic degrees amongst the respondents [AOR: 0.243 (95% CI: 0.069,0.856; p = 0.028)]. The acquisition of a postgraduate degree is not common among the surveyed resident doctors; and those that will acquire it do so in the latter part of their career.
... Health workforce is an integral part of the health system and plays a critical role in achieving effective healthcare delivery. According to the World Health Organization (WHO), they are people "primarily engaged in action with the intent of enhancing health" diagnosing illnesses, healing, caring for people, monitoring health outcomes, supporting treatment adherence, providing medical information, and preventing diseases [4,5]. They consist of physicians, nurses, midwives, dentists, pharmacists, laboratory workers, environment and public health workers, community health workers, other health workers, and health management, and support staff [6,7]. ...
Background
In 2014, Nigeria issued the task-shifting/sharing policy for essential health services, which aimed to fill the human resource gap and improve the delivery of health services across the country. This study focuses on the characteristics, spread, and family planning (FP) stocking practices of medicine vendors in Lagos and Kaduna, assessing the influence of medical training on the provision and stocking of FP services and commodities by vendors.
Methods
We conducted a census of all Patent Medicines stores (PMS) followed up with a facility assessment among 10% of the mapped shops, utilizing an interviewer-administered questionnaire. Bivariate analysis was conducted using the Chi-square test, and multiple logistic regression was used to estimate the adjusted odds ratio (OR) and confidence intervals (CI) for the test of significance in the study.
Results
A total of 8318 medicine shops were enumerated (76.2% urban). There were 39 shops per 100,000 population in both states on average. About half (50.9%) were manned by a medicine vendor without assistance, 25.7% claimed to provide FP services to > 2 clients per week, and 11.4% were not registered with the regulatory body or any professional association. Also, 28.2% of vendors reported formal medical training, with 56.3% of these medically trained vendors relatively new in the business, opening within the last 5 years. Vendors utilized open drug markets as the major source of supply for FP products. Medical training significantly increased the stocking of FP products and inhibited utilization of open drug markets.
Conclusion
Patent and Proprietary Medicines Vendor (PPMVs) have continued to grow progressively in the last 5 years, becoming the most proximal health facility for potential clients for different health services (especially FP services) across both Northern and Southern Nigeria, now comprising a considerable mass of medically trained personnel, able to deliver high-quality health services and complement existing healthcare infrastructure, if trained. However, restrictions on services within the PPMV premise and lack of access to quality drugs and commodities have resulted in poor practices among PPMVs. There is therefore a need to identify, train, and provide innovative means of improving access to quality-assured products for this group of health workers.
... Healthcare is the service or care directed towards ensuring the health of individuals and population through morbidity and mortality reduction (Atrash and Richard, 2012). It involves prevention, diagnosis and treatment of disease, illness, injury and other physical and mental impairments in humans (Adebayo, Labiran, and Emerenini, 2016). Every healthcare system aims to employ healthcare, social and other resources to meet people's health needs within a particular geographical region. ...
Quality healthcare delivery is imperative for sustainable socio-economic development and poverty reduction in any nation. It is a function of timely access to relevant and accurate patient health information by physicians, error-free prescription and medication, and the seamless transfer of patients from one level of care to another. However, the quality of healthcare delivery by physicians in Nigerian hospitals falls short of international best practices. The study investigated the influence of Electronic Health Records (EHRs) use on quality healthcare delivery by physicians in tertiary hospitals in Federal Capital Territory (FCT), Nigeria. The survey research design was adopted for the study. The population consisted of 610 physicians from the level of Registrar to that of Consultant in the three Federal Tertiary Hospitals located within the FCT. A stratified random sampling technique was used to select a sample of 390 physicians (Registrars-Consultants) across all departments. A validated questionnaire was used for data collection. The Cronbach’s Alpha reliability coefficients for the constructs ranged from 0.89 to 0.98. The response rate was 99.5%. Data were analyzed using inferential (correlation, simple and multiple regression) statistics. Findings showed weak but significant relationships between quality healthcare delivery and Health Information Exchange (r(388)=.240, p<0.05), Computerized Physician Order Entry (r(388)=.173, p<0.05) and Clinical Decision Support (r(388)=.277, p<0.05). The study concluded that EHRs use contributes to quality healthcare delivery by physicians in tertiary hospitals in FCT, Nigeria. Therefore, the legislative arm of the government should enact a law on the adoption, implementation and use of electronic health records in the nation’s tertiary hospitals.
... [5] There was also an issue of heavy work burden [6] and a high tendency for migration among them, with serious implications for Nigeria meeting her already low workforce adequacy in the health system. [4,7,8] While these issues are revealing in a one-time cross-sectional survey, they would probably provide more insight when there is regular data acquisition with the attendant exploration of the data to generate useful information on ECDs and the trends and relevant outcomes in Nigeria. These outputs would serve as the barometer on crucial issues affecting ECDs in Nigeria and the necessary information to guide relevant policies and guidelines related to this category of workers. ...
... These compulsory requirements are applaudable considering the unique flavor it provides to the program compared to other countries; producing ready human resources for academic and clinical setting for a third world country such as Nigeria, where there is a dearth of health-care workforce. [4,5] Such an approach avoids the luxury of a separate pathway for postgraduate academic medicine and clinical medicine which may have a dire consequence on meeting the critical specialist workforce need of the Nigerian health system. The current residency training program is unique and has produced specialists, who are as competitive as a clinical physician-scientist as obtainable in other climes and provide an effective alternative to the commoner physician-scientist pathway in duration, and less likelihood of certain proportion of the needed physician workforce restricted to pure academic medicine. ...
... Health workforce is an integral part of the health system and plays a critical role in achieving effective healthcare delivery. According to the World Health Organization (WHO), they are people "primarily engaged in action with the intent of enhancing health" diagnosing illnesses, healing, caring for people, monitoring health outcomes, supporting treatment adherence, providing medical information, and preventing diseases [4][5]. They consist of physicians, nurses, midwives, dentists, pharmacists, laboratory workers, environment & public health workers, community health workers, other health workers, and health management, and support staff [6][7]. ...
Background
In 2014, Nigeria issued the task-shifting/sharing policy for essential health services, which aimed to fill the human resource gap and improve the delivery of health services across the country. This study focuses on the characteristics, spread, and Family planning (FP) stocking practices of medicine vendors in Lagos and Kaduna, assessing the influence of health training on the provision and stocking of FP services and commodities by vendors.
Methods
We conducted a census of all patent and proprietary medicine vendor (PPMV) shops and followed up with a facility assessment among 10% of the mapped shops; utilizing an interviewer-administered questionnaire. Bivariate analysis was conducted using the chi-square test, and multiple logistic regression was used to estimate the adjusted odds ratio (OR) and confidence intervals (C.I) for the test of significance in the study.
Results
8,318 medicine shops were censused (76.2% Urban). There were 39 shops per 100,000 population in both states on average. About half (50.9%) were manned by a medicine vendor without assistance, 25.7% claimed to provide FP services to > 2 clients per week, and 11.4% were not registered with the regulatory body or any trade association. Also, 28.2% of vendors reported formal health training; with 56.3% of these health trained vendors relatively new in the business, opening within the last five years. Vendors utilized open drug markets as the major source of supply for FP products. Health training significantly increased the stocking of FP products and inhibited the utilization of open drug markets.
Conclusion
PPMVs have continued to grow progressively in the last five years, becoming the most proximal health facility for potential clients for different health services (especially FP services) across both Northern and Southern Nigeria. Now comprised of a considerable mass of health trained personnel, able to deliver high-quality health services and complement existing healthcare infrastructure, if trained. However, restrictions on services within the PPMV shop and lack of access to quality health commodities and consumables have resulted in poor practices among PPMVs. There is therefore a need to identify, train, and provide innovative means of improving access to quality-assured products for this group of health workers.
... Currently, Nigeria is densely populated, and a projected 420 million population in 2030 may pose a potential risk for the overwhelming burden of mental illnesses if evidence-based preventive measures are not put in place among present youths who represent future generation. [15,16] This is key, towards attainment and sustenance of optimal mental health in tune with current sustainable development goals. [2] This study was, therefore, aimed at assessing patterns and mental health effects of addiction to internet/use of social media among undergraduate students in Calabar, Southern Nigeria. ...
Context:
Access to social network sites (SNS) is commonplace, especially among young people globally. Cumulatively, long duration of daily exposure may be having effects on psychological health outcomes, including increased and in some cases, decreased risk of depression and anxiety. Despite these potential effects, there is a paucity of literature on patterns and effects of exposure to social media, especially in developing countries where regular mental health screening is generally unavailable.
Aim:
This study aims to assess the psychological effects of Internet/social media usage among undergraduates in Calabar.
Settings and design:
A descriptive cross-sectional study conducted in the University of Calabar, Nigeria.
Methodology:
Multi-staged sampling technique was used to recruit equal proportions of the undergraduate students from five selected Faculties in the University. Internet Addiction Test and General Health Questionnaire-28 were used to measure addiction to Internet and psychological health status of the respondents, respectively. Socio-demographic questionnaire was used to obtain information on demographic and social media characteristics of the respondents.
Statistical analysis:
Chi-square and independent t-test were used as inferential statistics, with P value set at 0.05.
Results:
Four hundred and eighteen (418) respondents completed the questionnaires. The mean age was 21.5 ± 3.6 years. Male:female ratio was 1:0.99. WhatsApp (59.8%) was the most commonly visited social media platform, whereas entertainment (52.2%) was the most common reason for social media use. About one-fifth (20.1%) had moderate-to-severe forms of Internet addiction, whereas one-third (33.1%) were psychologically distressed. Psychological distress was found to be significantly more common among respondents with mild/none, compared with those with moderate-to-severe forms of Internet addiction (P = 0.00). Respondents with moderate-to-severe forms of Internet addiction had significantly lower mean depression and anxiety scores compared with those with mild or no form of addiction (P = 0.00).
Conclusions:
There is high degree of psychological distress among students, and this was found to be more common among those that were less/not addicted to SNS. Specifically, high degree of Internet addiction may be protecting against the increased risk of depression and anxiety. The implications of these findings on youth counselling and the prevention of mental illnesses in developing countries are discussed in this article.
... There is a nursing shortage in Nigeria, which is a huge burden to the Nigerian healthcare system, population health, and nurses' health and wellbeing. International and urban migration of nurses further contributes to acute nursing shortages and inequity in the distribution of nurses countrywide [22,23]. In recognition of the increasing demand for healthcare and nursing services as a result of an increase in the aging population and continuous increase in Nigeria's population, Nigerian nurses' HPBs are a primary concern for this study. ...
Nurses make up the single largest healthcare professional group in the Nigerian healthcare system. As frontline healthcare providers, they promote healthy lifestyles to patients and families. However, the determinants of Nigerian nurses’ personal health promoting behaviors (HPBs) remain unknown. Utilizing the socio-ecological model (SEM) approach, this study aimed to explore the perceived facilitators and barriers to Nigerian nurses’ engagement in HPBs. HPBs were operationalized to comprise of healthy dietary behaviors, engagement in physical activity, low-risk alcohol consumption, and non-smoking behaviors. Our study was carried out in a large sub-urban tertiary health facility in Nigeria. Data collection was via face-to-face semi-structured interviews and participants were registered nurses (n = 18). Interview data were transcribed verbatim and analyzed thematically to produce nine themes that were mapped onto corresponding levels of influence on the SEM. Findings show that in Nigeria, nurses perceive there to be a lack of organizational and policy level initiatives and interventions to facilitate their engagement in HPBs. The determinants of Nigerian nurses’ HPBs span across all five levels of the SEM. Nurses perceived more barriers to healthy lifestyle behaviors than facilitators. Engagement in healthy behaviors was heavily influenced by: societal and organizational infrastructure and perceived value for public health; job-related factors such as occupational stress, high workload, lack of protected breaks, and shift-work; cultural and religious beliefs; financial issues; and health-related knowledge. Organizations should provide facilities and services to support healthy lifestyle choices in Nigeria nurses. Government policies should prioritize the promotion of health through the workplace setting, by advocating the development, implementation, regulation, and monitoring of healthy lifestyle policies.
... Although the emerging evidence from this review showed that burnout rate in Nigeria might be comparable to what is obtainable in the developed world, the low doctor to patient ratio in Nigeria may make the implication more serious. (24) This is because burnout is associated with factors such as absenteeism, reduced effectiveness at work, and impaired productivity, which will further reduce the capacity of the doctors to deliver optimally. Aside from that, other health challenges such as poor mental health and physical morbidity, which comes with burnout (17) can inadvertently further reduce the effective doctor to patient ratio in the country. ...
Burnout among physicians is a global phenomenon which has been under-reported in middle and low-income economies. The importance of burn-out on the physicians' well-being, patient care and overall health care system cannot be overemphasized. In Nigeria, few studies are specific to burnout, with most of the available studies exploring psychosocial issues at physicians' workplace stress and job dissatisfaction. This present review of literature is assessing burnout among Nigerian Physicians. This review is designed using the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) guidelines. The review identified observational, review, longitudinal and experimental studies on Nigerian physicians between 1970- 2017, which have the full text in the English language. The articles were searched from online databases such as PUBMED, Directory of Open Access Journals (DOAJ), African Journals Online (AJOL) and Google Scholar by researchers. The keywords used include “Physician”, “Nigeria”, “burn-out” syndrome. The prevalence of 23.6% to 51.7% burnout was reported among physicians in the selected studies, with young age being a strong predictor for burnout. High burden of emotional exhaustion, depersonalization and personal accomplishment were reported in the study carried out among resident doctors who are early career doctors. The prevalence of burnout reported from these studies in Nigeria is very high, although they are within the globally reported range of physician burnout. Nevertheless, there is a dearth of information on the subject matter among Nigerian Physicians. There is a need to carry out more studies on burnout among Nigerian Physicians.
Backgound
White Army, "They are doctors and nurses and all health care workers in the world." They are crucial for human lives and well-being over the world. Health worker are diverse and has standards regarding loud, demographical characteristics and distribution. Therefore, this paper aimed to identify the size and distribution of the health workforce in governmental hospitals in Hajjah governorate of Yemen.
Method
The descriptive approach was used for the health workforce data set in governmental hospitals in Hajjah Governorate, Yemen. The data was obtained from the Human Resources Department of the Public Health and Population Office. The data was used to determine the workforce size, distribution and most prominent demographic characteristics (hospital, district, qualification, specialization and gender).
Results
The study showed that the total health workforce in governmental hospitals in Hajjah governorate are 431 employees, including 29 doctors and specialists, 15 dentists, 81 nurses, 61 midwives, and 245 medical and health service providers. In percentage (0.07, 0.03, 0.19, 0.14, 0.57), respectively.
The study showed that the majority of health workforce are male, with 294 (68%) male health workers, and with 137 (32%) female health workers.
Most of them have a health diploma above secondary or intermediate, which reached 365 with an average of 85% at the expense of bachelors and specialists, and they are concentrated in central hospitals with 73%, especially in urban areas 63%.
It also reveals the gap in specialists, doctors, midwives and nurses (90%, 38%, 39, 58), respectively. Not to mention the others. This confirms the existence of shortage of health manpower in governmental hospitals in Hajjah Governorate in most specialties, especially women's cadres.
Conclusion
The results showed that the level of the gap in the health workforce in governmental hospitals in Hajjah Governorate was high, and the largest percentage was among females. Therefore, Ministry of Health is recommended to develop a plan to qualify and attract the health workforce, including women, to reduce this gap, especially in rural hospitals.
Introduction
The internship period is a peculiar time in a doctor's career, and some have described it as a "nuisance year" during which the junior doctor assumes many roles at the same time.
Junior doctors especially house officers are faced with many unique challenges; this is even more pronounced in poor resource settings like Nigeria. This study aimed to unravel and improve understanding of the challenges faced by medical and dental interns in Nigeria.
Methodology
A nine-member House officers Research and Statistics Committee (HRSC) was immediately set up to include three senior colleagues - Senior Registrars and Registrar. To carry out her responsibility efficiently the committee created the House Officers Research Collaboration Network (HRCN), a 103- member team comprising medical and dental interns from across Nigeria under a collaborative - Medical INternship Training in Nigeria (MINTING) study.
Results
Out of a total of the 103 House Officers Research Collaboration Network, 80 of them participated in this survey giving a 78% response rate.
Ten of the intern Collaborators had additional qualification and seven of them had BSc as an initial degree. About 66 % of the Collaborators have never authored any publication. Of the 27 that have published an article; three collaborators are said to have published 15, 13, 16 articles respectively.
Male collaborators where more likely to have published at least one article in the past.
Thirty one of the 80 Collaborators have never been in a research collaborative group prior to this MINTING collaborative.
Conclusion
This commentary is set out to describe in detail Nigerian House Officers initiative in terms of the structure, functions, operational modalities, and to investigate the demographics of the HRCN collaborators which showed that over two third of collaborators have never authored any publication and about a third of them have never been involved in collaborative research. We also believe the findings will serve as policy guide and benchmark in training the critical medical health force.
This study examines the impact of HEXACO characteristics and emotional intelligence on nurses' in-role performance in public health facilities in Lagos. Descriptive design was utilized to collect data from 200 Nurses from two public health facilities in Lagos. HEXACO qualities (honesty-humility, emotionality, extraversion, agreeableness, conscientiousness, and openness to experience) were assessed, as were four domains of emotional intelligence (other's emotion appraisal, self-emotion appraisal, regulation of emotion, and use of emotion) using structured instruments. The study's data were analyzed using Pearson correlation and stepwise regression. Two HEXACO qualities (emotionality and extraversion) correlated significantly with in-role performance. Emotional intelligence has a significant association with in-role performance of Nurses, except for one component (other's emotional appraisal). The study recommends employers invest in strategies to boost nurses' HEXACO qualities (emotionality and extraversion in particular) and emotional intelligence to improve their in-role performances.
She was born at 28 weeks of gestation and weighed 800g. Following delivery, her mother suffered wound dehiscence and was re-admitted for a prolonged period. For the care of the little baby, the father had preferred a public health facility where the cost is less prohibitive. Incidentally, Nigerian resident doctors were 23 days into a nationwide industrial action at the time; health workers were on strike during the two previous births. With no one available to help out with household chores, the father alone combined the care of two children and the logistics of two hospitals. Having to pay hospital bills out of pocket, the financial burden became unbearable, and the baby's siblings soon dropped out of school. Though the prolonged stay in the hospitals eventually ended on a happy note, it came at a huge social and economic cost that may linger for some time.
Context:
After thirty years of ratifying the child rights convention and nineteen years of the Child Rights Act, implementing child rights instruments remains challenging in Nigeria. Healthcare providers are well positioned to change the current paradigm.
Aim:
To examine the knowledge, perception, and practice of child rights and the influence of demographics among Nigerian doctors and nurses.
Materials and methods:
A descriptive, cross-sectional online survey was done using nonprobability sampling. Pretested multiple-choice questionnaire was disseminated across Nigeria's six geopolitical zones. Performance was measured on the frequency and ratio scales. Mean scores were compared with 50% and 75% thresholds.
Results:
A total of 821 practitioners were analyzed (doctors, 49.8%; nurses, 50.2%). Female-to-male ratio was 2:1 (doctors, 1.2:1; nurses, 3.6:1). Overall, knowledge score was 45.1%; both groups of health workers had similar scores. Most knowledgeable were holders of fellowship qualification (53.2%, P = 0.000) and pediatric practitioners (50.6%, P = 0.000). Perception score was 58.4% overall, and performances were also similar in both groups; females and southerners performed better (59.2%, P = 0.014 and 59.6%, P = 0.000, respectively). Practice score was 67.0% overall; nurses performed better (68.3% vs. 65.6%, P = 0.005) and postbasic nurses had the best score (70.9%, P = 0.000).
Conclusions:
Overall, our respondents' knowledge of child rights was poor. Their performances in perception and practice were good but not sufficient. Even though our findings may not apply to all health workers in Nigeria, we believe teaching child rights at various levels of medical and nursing education will be beneficial. Stakeholder engagements involving medical practitioners are crucial.
Background: Adequate Human Resources for Health is indispensable to achieving Universal Health Coverage and physicians play a leading role. Nigeria, with low physician-population ratio, is experiencing massive exodus of physicians. This study investigated emigration intention of physicians, the factors influencing it and discussed the implications to guide policy formulation and reforms to curtail the trend and safeguard the country’s health system.
Methods: Through cross-sectional survey, 913 physicians from 37 States were interviewed with semi-structured questionnaire using online Google form with link shared via WhatsApp and Telegram forums of Nigeria Medical Association and her affiliate bodies. Data was analyzed with IBM-SPSS version-25 and charts were created with Microsoft Excel Spread Sheet version 2019. Chi-square and binary logistic regression tests were done with p-value set at 0.05 for statistical significance.
Results: The mean age of respondents is 37.6±7.9 years; majority of them are males (63.2%), married (75.5%) with postgraduate qualifications (54.1%) and working in public health facilities (85.4%) located in urban areas (64.2%). Whereas only 13% and 19.3% of the physicians are respectively satisfied with their work and willing to continue practice in Nigeria, 43.9% want to emigrate and 36.8% are undecided about future location of their practice. The commonest reasons for emigration are poor remuneration (91.3%), rising insecurity (79.8%) and inadequate diagnostic facilities (61.8%). Physicians working in public health facilities are 2.5 times less satisfied than their counterparts in non-public sector and those in their thirties, forties and fifties are 3.5, 5.5 and 13.8 times respectively more willing to retain practice in Nigeria than those younger.
Conclusion: Majority of Nigerian physicians want to emigrate for professional practice and top among the push factors are poor remuneration, rising insecurity and inadequate diagnostic facilities. The observed trend portends danger to the country’s health system due to the foreseeable negative consequences of physician deficit to the health system. We recommend upward review of physician remuneration, a root cause analysis of insecurity to determine workable preventive measures and increased funding of the health sector to improve the diagnostic infrastructure in order to retain physicians and save the health system from imminent collapse.
Sağlık hizmetleri emek teknoloji yoğun sektörler arasında yer almaktadır. Bu bağlamda hizmetlerin sürdürülebilirliğinde sağlık işgücünün önemli bir yeri bulunmaktadır. Sağlık işgücünün ülke ya da global düzeyde sağlıklı bir dağılımının yapılabilmesi hizmetlere erişim ve hakkaniyet bakımından önemli sorunlardan biridir. Sağlık işgücünün dengeli dağılımı ve nitel ve nicel olarak yeterli düzeyde bulunabilmesi için eğitim aşamasından başlanılarak planlaması, işe alınması, elde tutulmasının yanı sıra, sağlık çalışanlarının beceri karması ve ileriye dönük arz ve talep projeksiyonları önemli tartışma konuları arasında yer almaktadır. Bu çalışmada yukarıda kısaca özetlenen konular hizmetlerin sürdürülebilirliği bağlamında ele alınmakta ve tartışılmaktadır.
Bibliometric Analysis of Graduate Dissertations Written Based on Quality Function Deployment (QFD) Method: An Overview of Health Management Profile
This chapter identifies the primary healthcare professions in Nigeria and apprises the readers of their central roles and clinical specialties. The chapter also analyzes the professionalization milestones of the major health disciplines, the capacity, and distribution of the healthcare workforce, including gender inequity and working conditions.
This chapter apprises the readers of the causes and adverse impacts of the ongoing interprofessional conflict and industrial action within the Nigerian healthcare system. The chapter proposes using the interdisciplinary team concept as a panacea to curtail interprofessional scuffle and industrial action activities in Nigeria. The chapter also discusses other synergistic effects that the implementation of the team strategy would have within the healthcare system. The likely impacts include improved communication among HCPs, reduced medical errors and mortality rates, improved patient outcomes, and healthcare quality.
6. International Health Sciences and Management Conference Sonuç Bildirgesi
USSAM tarafından düzenlenen 6. Uluslararası Sağlık Bilimleri ve Yönetimi Kongresi, “Sağlıkta Değişen Paradigmalar” teması ile Süleyman Demirel Üniversitesi İktisadi ve İdari Bilimler Fakültesi’nin ev sahipliğinde 20-22 Mayıs 2021 tarihleri arasında tamamlandı.
20 Mayıs 2021 Saat 09.30’da şehitlerimiz, sağlık şehitlerimiz ve yakın zamanda kaybettiğimiz kongremizin Bilimsel Danışma Kurulu üyesi Prof. Dr. Yunus TAŞ hocamız anılarak saygı duruşu ve İstiklal Marşıyla kongremiz başladı. Açılış konuşmasını yapan Kongre Başkanı Prof. Dr. Ramazan ERDEM, Covid-19 salgın sürecinin tüm alanlarda olduğu gibi sağlık yönetimi ve diğer sağlık disiplinleri için de paradigma değişimine yol açtığını, dijital ağırlıklı planlanan ancak fizikî katılıma da imkân sunan kongrede bildiri sunumları, paneller ve kurslarla bu değişimin yansımalarının tartışılacağını ifade etti.
USSAM Başkanı ve Kongre Eş Başkanı Prof. Dr. Sedat BOSTAN, kongrenin gelişim hikâyesini özetleyerek Uluslararası Stratejik Sağlık Araştırmaları Merkezi (USSAM) ve bu kapsamda yürütülen bilimsel faaliyetler hakkında bilgi verdi. Kongrenin salgın şartlarına rağmen yoğun ilgi gördüğünü ve bu ilgiyi genç akademisyen adaylarının ve lisansüstü öğrencilerin faydasına olacak şekilde yönlendirdiklerini vurgulayan Prof. Dr. Sedat BOSTAN, kongrenin alana faydalı olmasını temenni ederek konuşmasını sonlandırdı.
Süleyman Demirel Üniversitesi Rektör Yardımcısı Prof. Dr. Murat Ali DULUPÇU, böyle bir kongreye ev sahipliği yapmaktan çok memnun olduklarını ve sağlık yönetimi camiasının dayanışma anlayışının diğer disiplinler için de örnek olması gerektiğini belirterek “İlerlediğiniz yoldan vazgeçmeyin, ülkemizin dayanışmaya ihtiyacı var” dedi. Prof. Dr. Murat Ali DULUPÇU pandemi sürecinde insanlığın bir sınav verdiğini, ancak sınavı kaybettiğini belirterek sürecin metalaşmasına dikkat çekti.
Açılış konuşmalarının ardından Süleyman Demirel Üniversitesi İktisadi ve İdari Bilimleri Fakültesi Kongre Salonunda fizikî oturumlar icra edildi, Sağlık Yönetimi Bölümü ofislerinde ise dijital oturumlar yönetildi.
Kongrenin 1. Paneli’nde “Sağlıkta Değişen Paradigmalar” konusu Prof. Dr. Musa ÖZATA başkanlığında, Sağlık Bakanlığı Bilim Kurulu Üyesi Prof. Dr. Tevfiz ÖZLÜ “Sağlıkta Değişen Paradigmalarla ilgili sağlık bilişimi ve tele-tıp konularında yeni sağlık mesleklerine ihtiyaç olduğunu ifade etti:” Dünya Sağlık Örgütü Türkiye ofisinden Prof. Dr. Toker ERGÜDER “Uzaktan sağlık hizmeti sunum modeli” üzerine çalışmalar hakkında görüşlerini açıkladı ve “Dünya Sağlık Örgütüyle birlikte tele-tıp konusunda çalışmaların yapıldığını ifade etti. Türkiye Sağlık Politikaları Enstitüsünden Yonca Özatakan’ın katılımlarıyla tamamlandı. Panelde konuşmacılar tarafından, sağlık eğitimi ve sisteminin bu değişimlere paralel olarak dönüşümünün gerekli olduğu vurgulandı.
Kongredeki 2. Panelde “New Approaches in Cancer Treatment” başlığı Tayvan’dan Chung-Shan Medical University School of Medical Informatics öğretim üyesi Prof. Dr. Chi-CHang Chang başkanlığında tartışıldı. Konuşmacı olarak katılan Ssu-Han Chen, Yi-Ju Tseng ve Chi-Jie Lu tarafından Tayvan’daki kanser çalışmaları ve kanser tedavisinde yapay zekâ kullanımı konuları tartışıldı.
Kongrenin 3. Panelinde “Yönetimde Değişen Paradigmalar” teması tartışıldı. Oturum Başkanı Prof. Dr. Sedat BOSTAN özellikle uygulama açısından anlamlı olacak yönetim aforizmalarını “İyi Yönetim Pratiklerin” üzerinden formülüze etti. Konuşmacılardan Prof. Dr. Ramazan ERDEM informalitenin yönetim süreçlerine etkisi ve süreçleri yönlendirmesini tartıştı. Prof. Dr. Mahmut AKBOLAT yönetim yaklaşımlarında değişen paradigmaları ve Doç. Dr. Erdal EKE ise yönetimde dijitalleşmenin doğurduğu paradigma değişikliklerini tartışmaya açtı.
Kongrenin 4. Paneli “Current Issues in Health Economics” başlığı, University College London’dan Dr. Tuba SAYGIN AVŞAR’ın oturum başkanlığı, Philip Kinghorn (PhD), Naijie Guan (MSc) ve Zainab Al-Abdali (MSc) katılımları ile icra edildi. Panelde sağlık hizmetlerinde ekonomik değerlendirme yöntemleri ile ilgili yeni yaklaşımlar ortaya konuldu.
Kongrenin 5. ve son paneli ise “Changing Paradigms in Health” başlığı ve Doç. Dr. Taşkın KILIÇ’ın oturum başkanlığı ile icra edildi. Avusturya’dan Assoc. Prof. Marion S. Rauner, Pakistan’dan Prof. Dr. Farzand Ali Jan, ABD’den Prof. Dr. Neşet Hikmet ve Malezya’dan Assoc. Prof. Dr. Ng Yee Guan tarafından küresel ölçekte değişen sağlık paradigmalarını tartıştılar. Panellere katılımcılar yoğun ilgi gösterdi ve aktif katıldılar.
Kongrede dördü fiziki, 17’si dijital olmak üzere her biri en az 90 dakika süren 21 oturumda 180’den fazla bildiriyle “Sağlık Hizmetleri Yönetimi”, “Covid-19 Çalışmaları”, “Sağlık Kurumlarında Örgütsel Davranış”, “Sağlık Kurumları Yönetimi”, “Covid-19 Aşı Çalışmaları”, “Sağlık Teknolojileri ve Dijital Sağlık”, “Sağlık Eğitimi”, “Sağlık Turizmi”, “Sağlık Ekonomisi”, “Klinik ve Tıbbi Hizmetler Yönetimi” konuları özgün bilimsel çalışmalarla detaylı bir şekilde tartışılarak gelecek perspektifi ortaya kondu. Bildiri oturumlarının bilimsel münazaralarla zenginleşti. Kongreye özellikle genç akademisyenlerin yoğun ilgi gösterdiği gözlemlendi.
Kongrenin fiziksel katılımcıları için düzenlenen sosyal programda Süleyman Demirel Üniversitesi’nden “Keşif Isparta” ekibinin rehberliğinde gül bahçeleri ziyaret edildi, Eğirdir ve Gölcük gölleri ile Süleyman Demirel Demokrasi Müzesi ziyaret edildi.
22 Mayıs’ta İstanbul Sağlık Bilimleri Üniversitesi’nden Dr. Öğr. Üyesi Hasan Giray ANKARA tarafından “Sağlık Ekonomisinde Regresyon Modellemeleri”, Süleyman Demirel Üniversitesi’nden Prof. Dr. Ramazan ERDEM, Dr. Öğr. Üyesi Necla YILMAZ ve Dr. Öğr. Üyesi Elif KAYA ile Burdur Mehmet Akif Ersoy Üniversitesi’nden Dr. Öğr. Üyesi İzzet ERDEM tarafından “Sağlık Yönetiminde Nitel Araştırma Yöntemleri” konusunda kurslar verilerek kongre tamamlanmış oldu. Paralel oturumlar şekilde tam gün süren her iki kongre kursuna alandan 70 civarında lisansüstü öğrenci ve akademisyen katıldı.
Kongre sürecinde, kongrede sunulan bilimsel bilgilerden derlenen bilgiler ve görseller yeni medya araçlarıyla paylaşıldı. Kongrede sağlık bilimleri ve yönetimi alanında teorik ve pratik bilgi açısından önemli tartışmalar ortaya konuldu. Kongrede sunulan 180 civarındaki yeni bilimsel araştırmanın önümüzdeki süreçte bilimsel dergilerde makaleye dönüşerek yayınlanması beklenmektedir.
Kongrede sunulan bildiler değerlendirilerek hocamız Prof. Dr. Yunus TAŞ adına en iyi bildiri ödülleri verildi.
21 Mayıs 2021, saat 18-19:30 arasında dijital olarak gerçekleşen kapanış oturumunda sürece katkı sunan bütün ekip üyeleri ve katılımcılar dilek ve temennilerini paylaştı.
Kongre düzenleme kurulu olarak, bu bilimsel şölenin altıncısına ev sahipliği yaparak bizlerin yanında olan SDÜ Rektörü, Sayın Prof. Dr. İlker Hüseyin ÇARIKÇI Beyefendiye ve bütün emeği geçen, içinde bulunan ve katkı verenlere teşekkür edildi.
Prof. Dr. Sedat BOSTAN Prof. Dr. Ramazan ERDEM
Kongre Başkanı Kongre Başkanı
The study investigate human resource for health management practices on training and development between secondary and tertiary healthcare facilities. The study adopted a descriptive research design. The independent t-test analysis showed that the calculated t-value of 2.412 was greater than the critical t-value of 1.96 at 0.05 alpha level of significance. Specifically, on in-service training, 35.7% and 19.7% of secondary healthcare respondents reported not practiced and practiced to a little extent respectively. This shows significant differences from responses in the tertiary healthcare facilities with only 17.6% and 21.3% respectively reported corresponding responses (that is, negative responses of 55.4% and 38.9% for secondary and tertiary respectively). This observed trend in the secondary healthcare facilities was affirmed by qualitative responses where secondary level respondents verbalized non provision for in-service training. However, in both States, secondary healthcare facilities key informants affirmed the assistance and role of development partners in staff training and development but that such trainings are in their (partners') area of interest/interventions. It was recommended that biannual training, retraining and development of the health workforce should be made an area of utmost priority particularly at the secondary level of care. This is important considering the paucity in stock of HRH and emerging challenges emanating from the trend of disease outbreaks and occurrence. KEYWORDS: human resource, health management practices, training and development, secondary and tertiary healthcare facilities, cross river state and Ebonyi state.
The study investigate human resource for health management practices on training and development between secondary and tertiary healthcare facilities. The study adopted a descriptive research design. The independent t-test analysis showed that the calculated t-value of 2.412 was greater than the critical t-value of 1.96 at 0.05 alpha level of significance. Specifically, on in-service training, 35.7% and 19.7% of secondary healthcare respondents reported not practiced and practiced to a little extent respectively. This shows significant differences from responses in the tertiary healthcare facilities with only 17.6% and 21.3% respectively reported corresponding responses (that is, negative responses of 55.4% and 38.9% for secondary and tertiary respectively). This observed trend in the secondary healthcare facilities was affirmed by qualitative responses where secondary level respondents verbalized non provision for in-service training. However, in both States, secondary healthcare facilities key informants affirmed the assistance and role of development partners in staff training and development but that such trainings are in their (partners') area of interest/interventions. It was recommended that biannual training, retraining and development of the health workforce should be made an area of utmost priority particularly at the secondary level of care. This is important considering the paucity in stock of HRH and emerging challenges emanating from the trend of disease outbreaks and occurrence. KEYWORDS: human resource, health management practices, training and development, secondary and tertiary healthcare facilities, cross river state and Ebonyi state.
Background: The availability of skilled manpower at service locations is an important indicator of the strength of the healthcare system and is critical for effective healthcare service delivery in developing countries. The emigration of doctors reported in Africa over the years has tremendously increased in recent times. The health sector in this low-income region has registered a great setback in their health indices following a severe shortage of manpower.
Objective: This study was undertaken to assess the willingness of medical students to practice in Nigeria after the completion of their medical education.
Methods: This was a cross-sectional study performed among medical students in Enugu State University Teaching Hospital, Parklane, Enugu, Nigeria. A pretested self-administered questionnaire was used for data collection. Information was analyzed using the Statistical Package for Social Sciences version 22 software. Descriptive statistics were used to summarize and present data. The degree of bivariate associations was measured using the Pearson Chi-Square test at a significance level of p < 0.05.
Results: The mean age of the respondents was 23.9 ± 3.4 years.The majority were males (58.0%) and a greater proportion of the respondents (83.5%) did not desire to practice in Nigeria after their studies with the USA (29.3%) and Canada (17.8%), being the most preferred countries of migration. Advancement in technology and better remuneration were the most compelling factors for emigration.
Conclusion To ensure adequacy and efficiency in the health sector as recommended by the World Health Organization, governments of low-income countries should put measures in place to make medical practice in their countries more attractive to young doctors. Such measures include improved remuneration for services rendered and incorporation of more modern technology into the health care delivery system.
Background
Early career doctors (ECDs) are faced with many challenges due to their transition from undergraduate medical/dental studentship to being postgraduate doctors and being in an early phase of their career. The specific factors that affect ECDs in their careers and endeavors at the workplace range from poor remuneration, particularly in developing countries, to psychosocial problems (such as burnout [BO] syndrome). There is a dearth of information on BO among ECDs in Nigeria. This qualitative study aims to explore the opinions of ECDs in Nigeria on the causal/predisposing factors of BO, effects of BO, and strategies for mitigating BO among ECDs in Nigeria.
Method
Using purposive sampling method, two sessions of focus group discussions (FGDs) involving 14 ECDs (key informants) holding key leadership positions and who were delegates of other ECDs in Nigeria were conducted to explore their experiences on psychological issues among ECDs. Data collected were transcribed and analyzed thematically.
Results
BO is an issue of serious concern among ECDs in Nigeria. The causes of BO are diverse, some of which include low staff strength, prolonged work hours, wrong counseling, lack of job description and specification, and abuse of powers by trainers. In order to mitigate the issue of BO among ECDs, the respondents recommended that work policy review, medical workforce strengthening, stakeholder dialog on ECDs’ welfare, regular psychological review of ECDs, and provision of free yearly medicals need to be looked into. Conclusion: Our findings revealed that the participants considered BO issues among ECDs to be common, and it affected their performance and the overall quality of care in Nigeria health system. Based on our findings, there is an urgent need to mitigate the problem of emotional exhaustion among ECDs in Nigeria.
Nigerian health professionals are impacted by several global forces bearing down on them, one of which is the positive economic prospects associated with emigrating to work abroad. This emigration is an aspect of increased global mobility which has had an adverse effect on the Nigerian health economy. This is important globally because countries with the smallest healthcare workforce capacities such as Nigeria have the poorest health outcomes. The emigration of health professionals from Nigeria will continue until domestic structures such as improved healthcare infrastructures, job security, and financial rewards change for the better. Thus, it is important that measures aimed at supporting the Nigerian health workforce be implemented with a focus on building and managing for sustainability within the context of international interdependency. Accordingly, this chapter is aimed at creating a theoretical framework for building capacities and managing the challenges of the Nigerian health workforce vis-à-vis the opportunities offered by globalization.
Background paper prepared for The world health report 2006 -working together for health © World Health Organization 2006 The designations employed and the presentation of the material in this background paper do not imply the expression of any opinion whatsoever on the part of the World Health Organization concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries. Dotted lines on maps represent approximate border lines for which there may not yet be full agreement. The mention of specific companies or of certain manufacturers' products does not imply that they are endorsed or recommended by the World Health Organization in preference to others of a similar nature that are not mentioned. Errors and omissions excepted, the names of proprietary products are distinguished by initial capital letters. All reasonable precautions have been taken by the World Health Organization to verify the information contained in this background paper. However, the published material is being distributed without warranty of any kind, either expressed or implied. The responsibility for the interpretation and use of the material lies with the reader. In no event shall the World Health Organization be liable for damages arising from its use.
With increased globalization and interdependence among countries, sustained health worker migration and the complex threats of rapidly spreading infectious diseases, as well as changing lifestyles, a strong health workforce is essential. Building the human resources for health should not only include healthcare professionals like physicians and nurses, but must take into consideration community health workers, mid-level workers and strengthened primary healthcare systems to increase coverage and address the basic health needs of societies. This is especially true in low and middle-income countries where healthcare access is a critical challenge.
There is a global crisis in the health workforce, expressed in acute shortages and maldistribution of health workers, geographically and professionally. This massive global shortage, though imprecise quantitatively, is estimated at more than 4 million workers. To respond to this crisis, policies and actions are needed to address the dynamics of the health labour market and the production and management of the health workforce, and to strengthen the performance of existing health systems. Schools of public health need to develop the range of capacity and leadership in addition to the traditional training of healthcare managers and researchers. Countries should first identify their health problems in order to properly address their health worker needs, retention, recruitment and training, if they are to come close to reaching the Millennium Development Goals (MDGs) for health.
Global achievements in health may be limited by critical shortages of health-care workers. To help guide workforce policy, we estimate the future demand for, need for and supply of physicians, by WHO region, to determine where likely shortages will occur by 2015, the target date of the Millennium Development Goals.
Using World Bank and WHO data on physicians per capita from 1980 to 2001 for 158 countries, we employ two modelling approaches for estimating the future global requirement for physicians. A needs-based model determines the number of physicians per capita required to achieve 80% coverage of live births by a skilled health-care attendant. In contrast, our economic model identifies the number of physicians per capita that are likely to be demanded, given each country's economic growth. These estimates are compared to the future supply of physicians projected by extrapolating the historical rate of increase in physicians per capita for each country.
By 2015, the global supply of physicians appears to be in balance with projected economic demand. Because our measure of need reflects the minimum level of workforce density required to provide a basic health service that is met in all but the least developed countries, the needs-based estimates predict a global surplus of physicians. However, on a regional basis, both models predict shortages for many countries in the WHO African Region in 2015, with some countries experiencing a needs-based shortage, a demand-based shortage, or both.
The type of policy intervention needed to alleviate projected shortages, such as increasing health-care training or adopting measures to discourage migration, depends on the type of shortage projected.
Background
Despite the undoubted importance of human resources to the functions of health systems, there is little consistency between countries in how human resource strategies are monitored and evaluated. This paper presents an integrated approach for developing an evidence base on human resources for health (HRH) to support decision-making, drawing on a framework for health systems performance assessment.
Methods
Conceptual and methodological issues for selecting indicators for HRH monitoring and evaluation are discussed, and a range of primary and secondary data sources that might be used to generate indicators are reviewed. Descriptive analyses are conducted drawing primarily on one type of source, namely routinely reported data on the numbers of health personnel and medical schools as covered by national reporting systems and compiled by the World Health Organization. Regression techniques are used to triangulate a given HRH indicator calculated from different data sources across multiple countries.
Results
Major variations in the supply of health personnel and training opportunities are found to occur by region. However, certain discrepancies are also observed in measuring the same indicator from different sources, possibly related to the occupational classification or to the sources' representation.
Conclusion
Evidence-based information is needed to better understand trends in HRH. Although a range of sources exist that can potentially be used for HRH assessment, the information that can be derived from many of these individual sources precludes refined analysis. A variety of data sources and analytical approaches, each with its own strengths and limitations, is required to reflect the complexity of HRH issues. In order to enhance cross-national comparability, data collection efforts should be processed through the use of internationally standardized classifications (in particular, for occupation, industry and education) at the greatest level of detail possible.
Background
In this analysis of the global workforce, the Joint Learning Initiative—a consortium of more than 100 health leaders—proposes that mobilisation and strengthening of human resources for health, neglected yet critical, is central to combating health crises in some of the world's poorest countries and for building sustainable health systems in all countries. Nearly all countries are challenged by worker shortage, skill mix imbalance, maldistribution, negative work environment, and weak knowledge base. Especially in the poorest countries, the workforce is under assault by HIV/AIDS, out-migration, and inadequate investment. Effective country strategies should be backed by international reinforcement. Ultimately, the crisis in human resources is a shared problem requiring shared responsibility for cooperative action. Alliances for action are recommended to strengthen the performance of all existing actors while expanding space and energy for fresh actors.
Recent studies have shown evidence of a direct and positive causal link between the number of health workers and health outcomes. Several studies have identified an adequate health workforce as one of the key ingredients to achieving improved health outcomes. Global health initiatives are faced with human resources issues as a major, system-wide constraint. This article explores how the Global Fund addresses the challenges of a health workforce bottleneck to the successful implementation of priority disease programmes.
Possibilities for investment in human resources in the Global Fund's policy documents and guidelines are reviewed. This is followed by an in-depth study of 35 Global Fund proposals from five African countries: Ethiopia, Ghana, Kenya, Malawi and Tanzania. The discussion presents specific human resources interventions that can be found in proposals. Finally, the comments on human resources interventions in the Global Fund's Technical Review Panel and the budget allocation for human resources for health were examined.
Policy documents and guidelines of the Global Fund foster taking account of human resources constraints in recipient countries and interventions to address them. However, the review of actual proposals clearly shows that countries do not often take advantage of their opportunities and focus mainly on short-term, in-service training in their human resources components.
The comments of the Technical Review Panel on proposed health system-strengthening interventions reveal a struggle between the Global Fund's goal to fight the three targeted diseases, on the one hand, and the need to strengthen health systems as a prerequisite for success, on the other. In realizing the opportunities the Global Fund provides for human resources interventions, countries should go beyond short-term objectives and link their activities to a long-term development of their human resources for health.
Health systems played a key role in the dramatic rise in global life expectancy that occurred during the 20th century, and have continued to contribute enormously to the improvement of the health of most of the world's population. The health workforce is the backbone of each health system, the lubricant that facilitates the smooth implementation of health action for sustainable socio-economic development. It has been proved beyond reasonable doubt that the density of the health workforce is directly correlated with positive health outcomes. In other words, health workers save lives and improve health. About 59 million people make up the health workforce of paid full-time health workers world-wide. However, enormous gaps remain between the potential of health systems and their actual performance, and there are far too many inequities in the distribution of health workers between countries and within countries. The Americas (mainly USA and Canada) are home to 14% of the world's population, bear only 10% of the world's disease burden, have 37% of the global health workforce and spend about 50% of the world's financial resources for health. Conversely, sub-Saharan Africa, with about 11% of the world's population bears over 24% of the global disease burden, is home to only 3% of the global health workforce, and spends less than 1% of the world's financial resources on health. In most developing countries, the health workforce is concentrated in the major towns and cities, while rural areas can only boast of about 23% and 38% of the country's doctors and nurses respectively. The imbalances exist not only in the total numbers and geographical distribution of health workers, but also in the skills mix of available health workers. WHO estimates that 57 countries world wide have a critical shortage of health workers, equivalent to a global deficit of about 2.4 million doctors, nurses and midwives. Thirty six of these countries are in sub- Saharan Africa. They would need to increase their health workforce by about 140% to achieve enough coverage for essential health interventions to make a positive difference in the health and life expectancy of their populations. The extent causes and consequences of the health workforce crisis in Sub-Saharan Africa, and the various factors that influence and are related to it are well known and described. Although there is no "magic bullet" solution to the problem, there are several documented, tested and tried best practices from various countries. The global health workforce crisis can be tackled if there is global responsibility, political will, financial commitment and public-private partnership for country-led and country-specific interventions that seek solutions beyond the health sector. Only when enough health workers can be trained, sustained and retained in sub-Saharan African countries will there be meaningful socio-economic development and the faintest hope of attaining the Millennium Development Goals in the sub-continent.
OBJECTIVE: Global achievements in health may be limited by critical shortages of health-care workers. To help guide workforce policy, we estimate the future demand for, need for and supply of physicians, by WHO region, to determine where likely shortages will occur by 2015, the target date of the Millennium Development Goals. METHODS: Using World Bank and WHO data on physicians per capita from 1980 to 2001 for 158 countries, we employ two modelling approaches for estimating the future global requirement for physicians. A needs-based model determines the number of physicians per capita required to achieve 80% coverage of live births by a skilled health-care attendant. In contrast, our economic model identifies the number of physicians per capita that are likely to be demanded, given each country's economic growth. These estimates are compared to the future supply of physicians projected by extrapolating the historical rate of increase in physicians per capita for each country. FINDINGS: By 2015, the global supply of physicians appears to be in balance with projected economic demand. Because our measure of need reflects the minimum level of workforce density required to provide a basic health service that is met in all but the least developed countries, the needs-based estimates predict a global surplus of physicians. However, on a regional basis, both models predict shortages for many countries in the WHO African Region in 2015, with some countries experiencing a needs-based shortage, a demand-based shortage, or both. CONCLUSION: The type of policy intervention needed to alleviate projected shortages, such as increasing health-care training or adopting measures to discourage migration, depends on the type of shortage projected.
The pattern of spread of medical schools in Nigeria has an effect on the general availability of doctors nationwide and their retention in their primary areas of training. Using statistics from the National Population Commission and the medical and dental council of Nigeria, we determined the pattern of distribution across the geopolitical zones in Nigeria.
There were 25 fully accredited and 6 partially accredited medical schools. There were 15 federally owned, 12 state owned and four privately owned medical schools - nine in the south-south zone, seven in the south-east zone, and seven in the south-west zone with a population of 21,044,081, 16,395,555, and 27,722,432 respectively. In the north-central zone, there were four medical schools with a population of 20,369,956, three in the north-west with 35,915,467, and only one in the north-east with a population of 18,984,299. In each geo-political zone, the mean distribution was 5 medical schools - 3 federally owned and 2 state owned.
Medical schools are not evenly distributed in Nigeria. While the north-east, north-west and north-central zones have below the national average of total medical schools, the south-east, south-west and south-south zones have above the national average. Also, the number of medical schools in each zone had a linear relationship with the percentage population that completed secondary school education. Governments (especially states) should develop more medical training institutions especially in the geopolitical zones that have below the national average of medical schools (northern part of the country). In addition, secondary school completion rate should be improved, and there should be expansion of the capacity of existing medical schools to increase doctors in the north-east, north-west, and north-central geopolitical zones
Why do health systems matter? -- How well do health systems perform? -- Health services: well chosen, well organizad? -- What resources are needed? -- Who pays for health system? -- How is the public interest protected?
Effective interventions exist for many priority health problems in low income countries; prices are falling, and funds are increasing. However, progress towards agreed health goals remains slow. There is increasing consensus that stronger health systems are key to achieving improved health outcomes. There is much less agreement on quite how to strengthen them. Part of the challenge is to get existing and emerging knowledge about more (and less) effective strategies into practice. The evidence base also remains remarkably weak, partly because health-systems research has an image problem. The forthcoming Ministerial Summit on Health Research seeks to help define a learning agenda for health systems, so that by 2015, substantial progress will have been made to reducing the system constraints to achieving the MDGs.
Human resources are the crucial core of a health system, but they have been a neglected component of health-system development. The demands on health systems have escalated in low income countries, in the form of the Millennium Development Goals and new targets for more access to HIV/AIDS treatment. Human resources are in very short supply in health systems in low and middle income countries compared with high income countries or with the skill requirements of a minimum package of health interventions. Equally serious concerns exist about the quality and productivity of the health workforce in low income countries. Among available strategies to address the problems, expansion of the numbers of doctors and nurses through training is highly constrained. This is a difficult issue involving the interplay of multiple factors and forces.
Only a few studies have investigated the link between human resources for health and health outcomes, and they arrive at different conclusions. We tested the strength and significance of density of human resources for health with improved methods and a new WHO dataset.
We did cross-country multiple regression analyses with maternal mortality rate, infant mortality rate, and under-five mortality rate as dependent variables. Aggregate density of human resources for health was an independent variable in one set of regressions; doctor and nurse densities separately were used in another set. We controlled for the effects of income, female adult literacy, and absolute income poverty.
Density of human resources for health is significant in accounting for maternal mortality rate, infant mortality rate, and under-five mortality rate (with elasticities ranging from -0.474 to -0.212, all p values < or = 0.0036). The elasticities of the three mortality rates with respect to doctor density ranged from -0.386 to -0.174 (all p values < or = 0.0029). Nurse density was not associated except in the maternal mortality rate regression without income poverty (p=0.0443).
In addition to other determinants, the density of human resources for health is important in accounting for the variation in rates of maternal mortality, infant mortality, and under-five mortality across countries. The effect of this density in reducing maternal mortality is greater than in reducing child mortality, possibly because qualified medical personnel can better address the illnesses that put mothers at risk. Investment in human resources for health must be considered as part of a strategy to achieve the Millennium Development Goals of improving maternal health and reducing child mortality.
Vaccine-preventable diseases cause more than 1 million deaths among children in developing countries every year. Although health workers are needed to do vaccinations, the role of human resources for health as a determinant of vaccination coverage at the population level has not been investigated. Our aim was to test whether health worker density was positively associated with childhood vaccination coverage in developing countries.
We did cross-country multiple regression analyses with coverage of three vaccinations--measles-containing vaccine (MCV); diphtheria, tetanus, and pertussis (DTP3); and poliomyelitis (polio3)--as dependent variables. Aggregate health worker density was an independent variable in one set of regressions; doctor and nurse densities were used separately in another set. We controlled for national income per person, female adult literacy, and land area.
Health worker density was significantly associated with coverage of all three vaccinations (MCV p=0.0024; DTP3 p=0.0004; polio3 p=0.0008). However, when the effects of doctors and nurses were assessed separately, we found that nurse density was significantly associated with coverage of all three vaccinations (MCV p=0.0097; DTP3 p=0.0083; polio3 p=0.0089), but doctor density was not (MCV p=0.7953; DTP3 p=0.7971; polio3 p=0.7885). Female adult literacy was positively associated, and land area negatively associated, with vaccination coverage. National income per person had no effect on coverage.
A higher density of health workers (nurses) increases the availability of vaccination services over time and space, making it more likely that children will be vaccinated. After controlling for other determinants, the level of income does not contribute to improved immunisation coverage. Health workers can be a major constraining factor on vaccination coverage in developing countries.
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