Northern Nigeria is facing a critical shortage of doctors and other critical healthcare workers as persisting insecurity worsens the exodus of professionals.

The situation, public health experts note, is dire and deteriorating health outcomes for a region already grappling with high incidences of disease burdens and mortality, warning that the crisis will only worsen following spikes in insecurity.

Nigeria already struggles with insufficient doctors, yet the distribution is significantly skewed toward the south. According to the Joint Annual Review Health Sector Statistical Book 2025, states like Yobe, Kebbi, Zamfara, and Jigawa have 0.5 doctors per 10,000 population. This means there is half a doctor for 10,000 people, and approximately one doctor for every 20,000 people.

For Adamawa, Bauchi, Taraba, and Katsina, the density is 0.7 doctors per 10,000, while the state with the highest ratio in the North-East and North-West is Kaduna with 1.8 per 10,000 population. Across southern states, densities are significantly higher, often above 3 per 10,000, with states like Lagos, Enugu, and Edo exceeding 5 per 10,000 persons.

For context, the World Health Organisation (WHO) recommends a minimum density of 2.5 doctors per 1,000 people. While no Nigerian state meets this threshold, the north faces the most critical shortage.

The shortage extends to specialist care, which is almost non-existent in much of the north. Specialists such as dentists, optometrists, radiographers, and medical laboratory scientists are concentrated in southern states, leaving millions in the north without access to preventive or diagnostic services.

For dentists per 10,000 population, Taraba (0.2), Jigawa (0.1), Zamfara (0.3), and Katsina (0.3) record the lowest densities, with the highest in the north being Kaduna at 0.6. In comparison, southern states such as Edo (4.7), Lagos (over 4), Enugu (over 3), and Osun (3.1) record figures times higher than northern counterparts.

Optometrist densities are extremely low in the north (0.03–0.09 per 10,000). Sokoto, Zamfara, and Katsina are among the lowest at 0.05, meaning one optometrist per 200,000 people or more. Southern states like Imo (5.56), Lagos (over 5), and Abia (over 3), with others averaging 2–3 per 10,000 persons, show that access to eye care in the south is hundreds of times better.

Radiographers, who are essential for diagnostic imaging, are virtually absent in some northern states. Kebbi, Sokoto, Zamfara, and Katsina report 0 per 10,000, indicating no radiographers at all for that population. Others like Jigawa, Kano, Kaduna, Yobe, and Borno have only 1 per 10,000. Meanwhile, southern states like Enugu and Lagos record greater than 3 per 10,000.

Medical Laboratory Scientists, crucial for diagnostics and disease surveillance, are similarly concentrated in the south. Northern states record low densities ranging between 1.1 and 3.3 per 10,000, with Borno (2.7) and Gombe (3.3) having the highest. However, southern states are significantly higher, with Enugu (14.3), Ebonyi (10.5), Edo (14.9), and Rivers (13.7).

Overall, the total number of licensed healthcare professionals highlights the scale of the problem: 60,551 licensed doctors, 7,008 medical laboratory scientists, 2,156 optometrists, 3,559 dentists, and 2,810 radiographers serve the country’s population of over 220 million.

While southern states concentrate most of these professionals, northern states, particularly rural and conflict-affected areas, are left severely underserved.

Doctors and healthcare experts point to insecurity as the primary factor driving the exodus from the north. Other factors include poor infrastructure and inadequate incentives.

Zenith Osundare, immediate past president of the National Association of Resident Doctors (NARD), said insecurity is the chief reason why many doctors avoid postings to the north.

“Many northern states like Katsina are ready to employ doctors and pay well, but they can’t secure doctors,” he said.

He added that poor incentives, underdeveloped states, lack of social amenities, and no accommodation make life and work difficult, prompting professionals to migrate to the south.

“No doctor wants to go there because one is first looking out for his life before other matters. The doctors there are those who were born and brought up in the north and already understand the terrain,” he said.

Another resident doctor in the Federal Capital Territory said, “I dreaded going to the north because of insecurity. I will never feel safe doing my job. The insecurity terrifies me. Also, there is a more advanced medical system in the south in terms of equipment and facilities. The working conditions are much better.”

Available data also highlight security as a primary push factor. A 15-year retrospective cohort study on the pattern and determinants of migration among Nigerian doctors and dentists, published in 2024 on the National Library of Medicine, found that the leading push factor was insecurity of lives and property, as highlighted by 57.8% respondents.

Similarly, a 2022 cross-sectional survey of 913 physicians from 37 states across Nigeria, published on Springer Nature, reported that rising insecurity was cited by 79.8% of respondents as a primary motivation for emigration, alongside poor pay and inadequate diagnostic facilities.

Adaobi Onyechi, a public health expert, expressed concerns that persisting insecurity will worsen outcomes. She said northern Nigeria, already reporting higher incidences of disease, may experience higher maternal and infant mortality, worse outcomes for infectious diseases, and untreated chronic conditions as hospitals run dry of health professionals.

Onyechi warned that this adds strain on existing healthcare workers.

She urged urgent investment in retention incentives, rural posting policies, and security improvements to ensure equitable access to healthcare across regions. (Business Day)

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