Nigeria’s healthcare system is facing a worsening crisis driven by a severe shortage of doctors, with ratios as high as one doctor to 9,000 patients, far below global standards, as experts attribute the gap largely to a variety of factors, writes PRINCESS ETUK
Across Nigeria, a growing healthcare crisis is quietly unfolding, one defined not by a sudden outbreak but by a persistent and widening gap between the number of doctors available and the millions of patients who depend on them.
The situation is epitomised by patients waiting for hours, sometimes days, to see a doctor, surgeries delayed for years, and emergencies turned away. In some extreme cases, lives are lost not because treatment is impossible, but because no doctor is available to provide it.
Generally, the situation is that of overcrowded public hospitals, under-resourced private facilities, and underserved rural communities.
At the centre of this crisis is a dangerously low doctor-to-patient ratio that has steadily worsened over the years, raising serious concerns among healthcare professionals, policymakers, and ordinary Nigerians about the future of medical care in the country.
A salary comparison report sourced from NHS Pay Structure (2025/2026) and CONMESS Nigeria reveals one of the underlying drivers of the crisis: a stark disparity in remuneration between Nigerian doctors and their counterparts abroad.
According to the report, a House Officer in Nigeria earns between $124 and $161 monthly, compared to a House Officer in the United Kingdom who earns $4,303. A Medical Officer earns between $168 and $220 in Nigeria, compared to $4,924 in the UK. Senior Medical Officers earn between $227 and $308, while their UK counterparts earn between $5,834 and $7,207.
For consultants and specialists, the gap widens further, with Nigerian doctors earning between $329 and $476 monthly, compared to between $12,156 and $16,118 in the UK. At the highest level, Chief Consultants or Directors in Nigeria earn between $513 and $732, while those in the UK earn between $14,209 and $17,663.
These figures, experts say, are not just numbers; they represent a powerful push factor driving Nigerian doctors out of the country in search of better pay, improved working conditions, and a more structured healthcare system.
According to the National President of the Association of Nigerian Private Medical Practitioners, Kay Adesola, the standard should be one doctor to 600 patients, but it’s a 9,000 patients to one doctor ratio in Nigeria.
“The way Nigerians are treating doctors is scary enough. Some of us predicted this problem of not having enough doctors as far back as ten to fifteen years ago. And it’s just that it’s getting worse.”
He stressed that the country has moved far beyond globally acceptable standards.
Adesola said, “Standard thing would be one doctor to 600 patients. Not 9,000 patients to one doctor. 600 to one doctor. That’s what the WHO targets.”
“In Nigeria, we have crossed beyond 9,000 to one doctor. The implication of this ratio is far-reaching. A system designed to allow doctors to provide careful, attentive care has become one where a single doctor must attend to thousands, often under intense pressure and within a limited time.
Adesola further noted that the problem is not evenly distributed across the country.
“And then, the distribution is also not uniform. The majority of the doctors are in Lagos, Abuja, and Port Harcourt. In most of the world, which is a larger part of the society, we have very little or no doctors at all.”
“This uneven distribution means that while urban centres struggle with overcrowded facilities, rural communities face a different but equally dangerous reality, little to no access to qualified doctors,” he said.
He warned that the situation is likely to worsen due to Nigeria’s growing population. He said, “We don’t have a static population. We have a population that is growing.”
“With the population that is ever increasing, and the number of doctors available getting fewer and fewer every day, definitely the ratio of patients to doctors is increasing every day. And it’s worsening.”
He also noted the importance of good remuneration to keep doctors in the country.
“The remuneration is one of the key things that can keep the doctors. Has this government or any other government deliberately tried to empower the private sector?
“In some other countries, the health sector should be deliberately taken care of, with certain packages, in the form of relief, empowerment, grants, or tax relief.
“There are places where schools, accommodation, and cars are guaranteed, and all you need to do is focus on your work. The opposite is the case here in Nigeria. A lot of people want to go to those places where at least certain things are provided to make their work easier and reduce the chances of making mistakes.
“If ideally, I am meant to see 10 patients a day, but I have to see 50 patients. By the time I go home, I am so tired. Yet, I could still be called. For doctors practising in Nigeria, the impact of this imbalance is grave. We have seen doctors dropping dead, due to overwork.”
Dr Jane Orizu-Chiedu, a Principal Medical Officer at Gwarimpa General Hospital, described a system pushed to its limits by understaffing and poor welfare.
“To be fair, I think the very foundation is the fact that doctors are not well taken care of. So, because doctors are not well taken care of, most of them are looking for greener pastures where they can be appreciated and taken care of. It doesn’t make sense that you dedicate your life literally to work that doesn’t give you time to do anything else, yet you don’t have a reasonable pay to go home,” Orizu-Chinedu said.
She explained that the departure of many doctors has left the remaining workforce overwhelmed.
“A large number of people are leaving, yet they are not being replaced. Unfortunately, those of us left behind are the people bearing the brunt of the work. We are seriously short-staffed.”
“We are grossly short-staffed. I get to do calls two to three times a week. So, just imagine having to sleep in a hospital two to three times a week.”
“After the call, you don’t leave the next morning, you have to stay till the end of work the next day. And, the day that you are not on call, you still come to work. The result is chronic fatigue that affects performance and decision-making,” she said.
She also laments the exhaustion faced by doctors. “I try to pull everything within me together to be able to give the patient the best results at that time. Sometimes when I am breastfed, I think about it, and I realise there are areas I could have done better, but my brain was tired at that point.”
Beyond workload, she highlighted the poor state of infrastructure in many hospitals.
“If you get to see where we consult, while consulting, you are sweating. Sometimes you are consulting in the dark, with your phone light. It’s ridiculous,” she said.
She added that even critical procedures are affected by an unstable power supply.
“I’m not in a department where there is no stable power for surgery. The strain is not only physical but also emotional, as doctors struggle to balance work and personal life.
“Sometimes you feel dizzy in the evening because you have not had anything to eat the entire day.”
“You also barely have time to even take care of your family because we are grossly short-staffed. So you are more in the hospital than you spend time with your children and your husband,” she said.
A doctor who works in the surgery department, Dr Alex Nnadozie, said the current crisis is the result of both “push” and “pull” factors that have made migration increasingly attractive.
He said, “You find a lot of people who are studying now just to go abroad. You find a lot of people who are going into nursing school to do nursing as a second degree or third degree because they want to leave.”
“You find people in medical school who are not even planning to write primaries or to do residency in Nigeria; they just want to finish and write the foreign exams.”
He explained that even those who initially choose to stay eventually become discouraged.
“There are some people who say they love the country, and, no matter what, will hang on. However, the person eventually gets tired and wants to leave.”
He cited a dramatic reduction in staffing levels within his department.
“About five years ago, we were about ten to twelve in the department. But now, we are not more than three. It’s the same department to handle the same level of work. So pressure is even on you to deliver better than the earlier 10 people. This tells about the mental health of the healthcare professionals. People break down, people drop dead here and there.”
He recounted tragic incidents involving colleagues.
“Two weeks ago, we lost a doctor in one of our hospitals. He just dropped dead. Two years ago, we lost one in our hospital. He died in the sitting room. He was a young man,” Nnadozie said.
He added that financial stress compounds the problem.
“Our people are not just relocating to the USA, UK, Saudi Arabia, but also leaving for smaller African countries like Guinea-Bissau,” he said.
A doctor anonymously recounted a distressing experience during a call duty.
“There was a time I was on call, and I had two emergencies coming. So I was trying to resuscitate both of them… but I was the only doctor.”
He described the impossible choice he faced. I already collected the two patients, and another emergency came in. I knew that there was no way I could take that emergency. If not, I stood a chance of losing all three of them.”
“So I had to tell them my hands are busy and asked them to go to another hospital. I can remember the man just sitting there with his ailing baby for a while. By the time he realised that there was really no hope, he left,” he said.
Similar tales also abound on social media.
A content creator, Njideka Achilonu, popularly known as Deka George, recounted on Instagram how she lost her pregnant sister in a hospital, blaming inadequate medical attention.
According to her, the hospital had only a corps-member doctor on duty, who reportedly said it was not his responsibility to attend to the patient.
The content creator attributed her sister’s death to alleged negligence by the hospital.
Deka further stated that Bwari General Hospital appeared unusually quiet compared to other general hospitals at the time her sister was admitted.
She added that her sister had called her three times, but by the time she responded, it was already too late.
Her account triggered widespread reactions online, with many Nigerians sharing similar experiences.
One Instagram user, @donaldtalka, wrote: “As a doctor still practising in Nigeria, I’ll let you know Nigeria is now short of experienced doctors, and it will get worse.
“There are not enough doctors left to man the general hospitals, so when you get access to a doctor, see it as a privilege.”
Another user, @heggansstar, described a near-death experience. “I almost died in January because of this same negligence. That hospital is one of the most equipped hospitals in Kaduna State; the government provided everything. But trust Nigerians, doctors only come for ward rounds once in 3 days.”
“I went into cardiac shock, and the nurse told my mum. In the middle of the night, they couldn’t give me anything; they left me to God.”
Medical experts warn that these experiences are not isolated but are symptoms of a system under severe strain.
Chairperson of the National Committee on Gender and Sexuality of the NMA and Vice President of the Nigerian Association of Resident Doctors, Dr Ebidimie Irole, said the shortage is already affecting the quality of care.
“The rate at which doctors are leaving Nigeria is worrisome. This has really overburdened our already very fragile health system.”
“WHO recommends one doctor to about 600 patients. In Nigeria, what we have currently is one doctor to six to nine thousand patients. And this has been worsened by the increased rate of migration of doctors and other health care workers out of the country.”
As a result, she said doctors face burnout and an increased risk of medical errors.
“Inadequate rest and poor readiness have contributed to burnout. Medical errors are reducing patient safety,” she said.
She warned that the situation could worsen if urgent action is not taken.
He made reference to statistics by the National Prescription Medical College of Nigeria in 2025 that, in the last 10 years, about 50 per cent of doctors have left the country. That’s about 8,000 doctors, and the patients are increasing.
“This is really no good for the healthcare system. The doctor is burnt out, so there would be increasing medical errors. This is apart from low productivity.
“We had a doctor who died from excess work. He was on a weekend call. By Monday, he was found dead. I know a lot of doctors who have died like that.”
“If this migration of doctors among other healthcare workers is not mitigated, a tsunami is going to occur,” Ebidimie said.
Similarly, former Chairman, NMA Lagos State, Dr Saheed Kehinde, said the shortage is already affecting access to care.
“The issue of shortage of doctors is a critical issue that needs an urgent solution.”
He explained that patients now face significant delays.
“You come to the hospital, there will be a long queue, the appointments can be elongated, and surgeries are being postponed for years.
“If you go to some hospitals in Lagos, some people booked for surgery have been scheduled for 2027 or 2028,” he said.
He warned that the situation is pushing Nigerians towards unsafe alternatives.
“Some people are frustrated, so they opt for traditional medicine, or self-medication, or quacks. At the end of the day, the mortality rate of Nigeria increases.”
“In some private hospitals, we might have one doctor. It might even be the Managing Director, an elderly person who is 60 or 70 years old, seeing patients from morning to night. There is a tendency towards medical negligence because there are no doctors. At the end of the day, there is increased mortality and a poor health index.
“Nigeria has become the second-largest exporter of doctors in the world after India. Therefore, the solution is to stop japa.
To stop doctors’ exits, he called for an increase in remuneration, car loans at a very low rate, and housing loans at a very low rate.
“If we have better welfare packages, people will stay, and people will come back. Unfortunately, we don’t have a minister trying to solve the Japa issue,” he said.
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