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One Way Traffic: Nigeria's Medical Brain Drain. A Challenge for Maternal Health and Public Health System in Nigeria?


Background: The migration of health professionals in Africa, medical brain drain, deserves critical attention due to its adverse effects on the healthcare system (HCS) for developing nations, which indirectly impacts population health outcomes and creates greater inequity among vulnerable populations. In the case of Nigeria, the international and internal migration of medical doctors (MDs) has created a great challenge for public health systems; it worsens already weak healthcare systems, which widens the health inequalities gap worldwide. Globally Nigeria ranks among the worst countries in regards to maternal health outcomes. Although it represents 2% of the global population, it disproportionately contributes to nearly 10% of global maternal deaths.

Aims and Objective: The aim of this study is to examine the impact of the brain drain on Nigeria’s HCS from the perspective of Nigerian MDs in the United States (US) versus Nigerian MDs who remained in Nigeria. The social ecologic model was used as a framework to examine push factors out of Nigeria and pull factors into host countries such as the US.

Methods: A thematic analysis of qualitative data (key-informant interviews) obtained from a convenience and snowball sample of 17 MDs residing in Nigeria and the US.

Results: Nearly all participants, 94% (17 out of 18), confirmed that a shortage of Nigerian medical doctors living and working throughout Nigeria exists acknowledging a medical brain drain impacting Nigeria’s HCS. The medical brain drain, which exacerbates the shortage of MDs, indirectly causes adverse effects on all health outcomes especially maternal and child health in rural/low-resource communities.

Conclusion: There are many effects of the health care systems that are both directly and indirectly influenced by the shortage of available MDs such as doctor burnout, work related stress and medical negligence; all negatively impact patient experience, patient health outcomes and job satisfaction of MDs. Despite challenges associated with the shortage of available MDs, the Nigerian government in collaboration with health care administrators and MDs both abroad and at the home front can work towards strengthening Nigeria’s health sector through various development initiatives to regulate, support and sustain the health care system.

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