Every year, May 12 is observed as International Nurses Day to commemorate the birth of Florence Nightingale in 1820, the foundational philosopher of modern nursing.
The event, established in 1974 by the International Council of Nurses (ICN), also serves to highlight the important role nurses fulfill in healthcare.
The theme for 2022 International Nurses Day is “A voice to lead-invest in nursing and respect rights to secure global health.”
As part of activities to mark the day in Nigeria, the President of the National Association of Nigerian Nurses and Midwives, Michael Nnachi in an interview with newsmen in Abuja said Nigeria lost over 11,000 nurses to developed countries between 2019 and 2022.
He says the brain drain was a result of the “terrible working conditions and tremendous suffering” of nurses during the COVID-19 pandemic.
Nnachi also says over 5,000 nurses and midwives worldwide lost their lives during the 2020 COVID-19 pandemic and that Nigeria is witnessing a shortage of nurses because of mass migration.
He emphasizes the need to invest in the nursing workforce and consider a special salary package for nurses to address the brain drain.
In Kano, Comrade Ibrahim Maikarfi Muhammad is Chairman, State Chapter, National Association of Nigeria Nurses and Midwives (NANNM), and he agrees with Nnachi.
He says over the years, Nurses face some challenges in executing their job in rural communities and this can be attributed to a lack of adequate equipment, work burden due to a gross shortage of skilled manpower, non-stability of salary, misapplication of resources, and poor community mobilization to access healthcare services.
Muhammad says as a result of these challenges, a large number of the Nurse workforce are moving in large numbers to developed countries.
However, he suggests that with the implementation of a nurse retention strategy, a good or improved salary package with motivational incentives, the brain drain can be stopped.
On salary structure, Comrade Muhammad says the government should stop arbitrary monthly salary deductions from approved packages, to ensure the provision of job security and a decent work environment for quality service delivery.
He also says there should be a reduction of workload by employing more Nurses/Midwives to cater to the needs and demands of the rural communities.
Muhammad says going forward, the government and NANNM should vigorously pursue a professional recognition and empowerment scheme to better the nursing profession.
Government should facilitate the fight against quackery in nursing by stopping the proliferation of mushroom schools that train auxiliary Nurses, and traditional birth attendants, advocate for stiff regulations against unauthorized clinical training and perpetrators, and those who train in unregistered fake clinics and tertiary institutions.
Nurses should be empowered and given leadership roles and management positions or appointments, they should be involved in decision making and policy formulation and increasing diversity in hospital administration.
Comrade Muhammad thinks that most of these issues can be solved by a mixture of strategies that includes the provision of more health facilities at the community level and employing more Nurses and Midwives vis a vis to Basic Health Care Provision Fund, MSP, and Primary Healthcare under-one-roof to reduce maternal and child morbidity and mortality rates in the country.
“Giving Nurses key and gross role with keen attention to indicators and outcomes of programs for mitigating public health menaces like Malaria.
“Job Description for Nurses must be specific to their professional role.
“Ensure proper implementation of policies of sharing tasks with others and should be with clear demarcation and limited goal.
“Employ more Nurses and Midwives across the 3 tiers of health.
He says the theme of this year is very good essentially as it can galvanize the Governments in Nigeria at all levels to focus approach on matching the global trend of health care delivery.
“We still have more lingering issues that should as well be reckoned with, this includes the release of the circular for the approval of proper grading of graduate Nurses from the office of the Head of Service, in Kano
“Creation of Department of Nursing Services in the Federal Ministry of Health (FMOH) to allow expanded professional roles.
“Immediate release of April 2018 withheld salary and commencement of hazard allowance as approved in December 2021
“Provision of insurance coverage for Nigeria Nurses and Midwives due to exposure to hazards.
“The implement the outcome of two (2) days Nurse Leaders and stakeholders’ workshop on the state of the world Nursing Report, a strategic roadmap for the improvement of Nursing and Midwifery Services in Nigeria as directed by World Health Organization (WHO) by the FMOH.
Comrade Muhammad also calls for the inclusion of Nurses in the conduct of research as well as Monitoring and Evaluation of healthcare-related programs and projects.
Nurse Idris Zubairu is the Director of Nursing Services, Kano State Ministry of Health, he says the government has accorded priority attention to the health sector to achieve optimum Universal Health Coverage.
“This was made possible through robust policies and projects targeted at improving the quality of life of the good people of Kano; most notably among these achievements include Healthcare Financing.”
He says the government has introduced the Kano State Health Trust Fund which aims to strengthen the health system through funding Health Training Institutions to meet accreditation requirements for training of frontline health workers which include nurses, midwives, and other cadres of health workers to improve human resources for health in the State.
Nurse Zubairu says in addition vulnerable individuals are being supported through the Kano State Health Trust Fund to attain optimum health.
About 9 Health Training Institutions have been accessing this fund; this has resulted in almost 95% of our Health Training Institutions attaining full accreditation with an increase in the annual intake which translates to an increase in the health workforce.
“The Contributory Health Scheme was introduced to expand access to quality healthcare among formal and informal sectors of the economy and vulnerable groups in the State,” he says.
Recruitment and Retention of Health Workers
Nurse Zubairu says recruitment of health workers including nurses, midwives, and other cadres of health workers is ongoing.
“More than 500 nurses and midwives were screened for recruitment under the Primary Health Care Management Board to augment the minimum service package from the grassroots.
“Already 138 community midwives were recruited and deployed to the facilities in their respective communities which grossly assisted in reducing maternal morbidity and morbidity.
He also says supportive supervision and mentoring of young nurses and midwives are intensified to maintain the quality-of-service delivery.
Training and Manpower Development
On manpower development, he says community nursing and community midwifery programs have been introduced in Schools of Nursing and Midwifery to train 500 lower cadre of nurses and midwives annually to provide skilled birth attendance and nursing services at primary health care facilities in the State.
“Over 300 nurses and midwives were recruited by the Hospital Management Board to work in the secondary facilities.
“Continuing education and capacity building for nurses, midwives, and other cadres of health workers has been intensified.
“About 600 nurses and midwives have been trained on Lifesaving skills. Seminars and workshops have been organized for nurses and midwives.
He says welfare packages in form of staff promotion and appointments are regular and timely and that the government has tried to maintain regular payment of staff salary.
“Despite the economic recession, the government has not relented in its effort to pay staff salaries; the state is up to date with regards to the payment of health workers’ salary.”
Policy and Governance
Nurse Zubairu says there has been a good collaboration with stakeholders to synergize for maximum efficiency and productivity among the health workforce.
And, more than 200 nurses benefitted from training on managerial skills through the Administrative Staff College of Nigeria and other outfits.
Infrastructure and Supplies
To improve the quality of healthcare services, Nurse Zubairu says the government has renovated and equipped over 400 Primary Health Care facilities across the State while over 50 PHC facilities were upgraded to various standards.
“The government has upgraded and equipped 4 facilities with 400 capacity specialist hospitals in the 4 newly created Emirates in the State to reduce the burden on City hospitals.
“These will necessitate the recruitment of more nurses and midwives to provide specialized care.”
Health experts say with adequate funding and respect rights to secure global health, nursing brain-drain and quackery can be reduced to the barest level in the sector.