The Guardian

Curbing frequent strikes by medical professionals | Headline News

The unending industrial action in the health sector, caused by poor employee benefits and salaries and, above all, the government's inability to faithfully implement agreements, is doing more harm to the health of Nigerians than any epidemic. There is. Stakeholders argue that if this incessant behavior is not curbed, the industry's dire situation could worsen. Chukwuma Muanya writes.

Several studies have shown that frequent strikes by health workers lead to the closure of public health institutions, thereby depriving Nigerians of access to quality health services.

Public health agencies in this country are understaffed, underfunded, poorly managed, poor infrastructure, poorly paid and motivated workforces, misconceptions about what medical work entails, brain drain, unfavorable working conditions, It is plagued by a number of issues, including interprofessional collaboration. competition.

Others include disparities in pay, benefits and promotions for workers in the health sector, and the government's failure to honor previous agreements reached with health workers.

The failure of successive governments to effectively resolve these issues has contributed significantly to continued industrial instability in this sector. During the strike in public hospitals, Nigerians will bear the brunt of it and those who cannot afford treatment in private hospitals abroad or within the country will have to endure the disease or resort to traditional and herbal medicines. Some people will definitely lose their lives because of either of these. The most vulnerable in this situation are pregnant women, people with chronic illnesses, and parents of children under the age of five.

The recent strike in the medical sector has turned into a marathon among doctors, supported by the Nigerian Association of Resident Doctors (NARD) and the Joint Health Sector Union (JOHESU), which comprises all non-physician healthcare workers. It has become.

A Guardian investigation found that common causes of health worker strikes were poor staff benefits, pay, management and the government's inability to implement agreements. These strikes have disrupted service delivery and training programs, led to increased patient morbidity and mortality, and a loss of confidence in hospitals and the medical profession.

Stakeholders must respect the federal government's agreements with associations and health care managers to enforce the National Health Service Act and ensure that only formally trained leaders and managers are appointed to health care management positions. We recommend that you do so.

Unfortunately, even in ugly scenarios, there have been a series of strikes in the medical field. NARD on November 29, 2023 launches nationwide strike this month if “one-for-one replacement policy” is not implemented as Enugu State University Teaching Hospital (ESUTH) branch de-tools on December 1, 2023 Then he threatened me.

NARD Chairman Dr. Dele Abdullahi said if the federal government does not meet its demands by January 2024, the union can no longer guarantee industrial harmony in the sector.

On how Nigeria is curbing frequent strikes in the health sector, Abdullahi said: “First of all, we would like to reiterate that the strike by the trade unions is in no way meant to punish the government, but is a last-gasp attempt to get the government's attention and force it to fulfill most of its obligations.” Many times more than I did. We hate to go on strike, but in most cases the government leaves us no other choice. ”

Mr. Abdullahi said the strike was mainly due to the government's failure to ensure that important things were done in the health sector, the government's pervasive attitude towards the welfare of health workers, and the government's insensitivity towards court and health issues. He said it was a thing. Dishonesty in the implementation of written agreements with workers.

He further explained: “To give you a clear example, we all know that our hospitals are understaffed, but last year we paid lip service to that and set up a committee on brain drain. , all opinions have simply been ignored. The committee's recommendations are mainly focused on the blame game, with no practical solutions.”

The doctor said it has been eight months since the current government came to power and NARD is yet to see a realistic approach to solving the problem, adding that a circular to alleviate the manpower shortage was issued on June 5, 2023. It said a memorandum of understanding (MoU) had been issued and signed. However, the government canceled the agreement.

“When government officials have the mindset that “no matter what document is signed, we can always decide not to comply with it,'' it makes negotiations difficult and the unions and government There is a lack of trust between them.'' So in order to get governments to do what they promise and to see the problems that affect their own government agencies, they have to deactivate the tools, which can be very painful. ” he said.

On doctors' key demands, which would ensure industrial harmony and increase their chances of not fleeing to the UK or other developed countries in search of greener pastures, Mr Abdullahi said: stated. If these steps are taken, I assure you that no doctor will ever leave our shores again. Doctors retire for a variety of reasons, but if we're talking about identified drivers of mass exodus, I can tell you. ”

The NARD chairman said the government needs to improve working conditions and significantly increase staffing in all health institutions to make service delivery more efficient and beneficial to staff.

Abdullahi said that the remuneration of health care workers should be commensurate with economic realities, not arbitrary increases like giving candy to a child to stop crying; It should be seen as ensuring basic amenities for people's lives. is guaranteed.

Abdullahi said major upgrades to facilities are needed to work more efficiently and increase job satisfaction, adding: “We cannot train health workers on the spot; They don't even have the basic structures to work and compete with colleagues from other countries.” sphere. The list is endless as it also includes the safety of our community, and everything else above should encompass what my union supports,” he said.

On how to deal with the frequent strikes, the Obstetrician and Gynecologist and Medical Director of Optimal Specialist Hospital, Gbaja Road, Surulere, Lagos State, said: “Strikes are a last resort when governments fail to honor their agreements after repeated negotiations. On our side, this leadership is committed to ensuring that challenges are anticipated, presented, and resolved well in advance through strong collaboration. However, if precedent holds, the most important solution to the incessant strike action in the health sector is to increase funding, especially for the health sector, and to respect promises and agreements with health workers. This will demonstrate the government's commitment.”

Dr Dare Godiya Ishaya, a specialist in internal medicine at the Abubakar Tafawa Balewa University Teaching Hospital (ATBUTH) in Bauchi State, said: “The problem of medical tourism outside this country's shores is very unfortunate. The World Health Organization's latest study ranks Nigeria's health system as the fourth worst in the world, and this is due to lack of funding. This may be due to the fact that Japan's annual budget allocation to the health sector has consistently been below the 15% that African countries agreed to in the Abuja Declaration of April 2001 (20 years ago). A continued lack of investment has left health systems in dire straits in terms of health infrastructure, such as medical equipment and reusable materials, and the compensation of health workers, such as salaries, wages and benefits. Masu.

“Poor healthcare infrastructure makes it impossible for the sector to grow and compete with healthcare standards in other countries. This led to a mass exodus of talented minds to other countries (brain drain).

Dr. Kingsley Chiedu Amibolu, a public health expert, health educator, and former National President of the Association of Hospital and Administrative Pharmacists of Nigeria (AHAPN), believes that in almost every country in the world, physicians are the most He said he was well paid. “Again, given the length and duration of their training, I wouldn't disagree with that. Given the length and duration of pharmacist training programs, pharmacists are supposed to be next to doctors. Since then, the Doctor of Pharmacy (PharmD) degree has become the standard for pharmacy practice in Nigeria and other parts of the world. Now able to fit into the spine pay structure.

“If this happens, you will see a lot less agitation for pay increases by all groups in the field, because once this deal is triggered, future pay increases will be spread across different professional groups. , your question is going to get even bigger.'' For Mr. A, come and increase for me is no longer going to happen.

“In fact, this was the prevailing situation in the Nigerian medical sector until the military regime around 1985 felt opposition and introduced a different salary structure in the once peaceful sector. “This cannot bring about peace, and I am advocating for a return to the status quo as lasting peace in this area,” Amibolu said.

He said health authorities need to address the causes of strikes identified in this sector. Amibor said training personnel in health management, interpersonal and leadership skills will help build capacity and enable interprofessional leadership, which is lacking in most healthcare organizations. .

“Hospitals need to be upgraded and modernized in line with international best practices. State-of-the-art equipment must be available to help in rapid diagnosis. should provide an environment where pharmacists can engage in compounding and full production of medicines within hospitals, which could reduce dependence on foreign medicines and save the country's scarce foreign exchange. Strengthening service delivery requires improvements in working conditions and infrastructure. We strongly believe that if these interventions are implemented, strike action in Nigeria's health sector will be minimized. ,” Amibor said.

The Guardian's research was supported by a study published in Human Resources for Health entitled 'Health worker industrial action in Nigeria: a cross-sectional survey of Nigerian doctors'.

According to the study, health worker strikes were common across the country, but most occurred in the southern region. There was no public health worker in this country who had not taken industrial action with consequences at least once during the period under review. Researchers believe this is destructive and harmful to Nigeria's healthcare system. Furthermore, most of the strike actions were initiated by doctors who were also the leaders of medical facilities, thus indirectly undermining their duty to lead and maintain medical facilities.


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