Nigerian nurses are
currently agitated over the new circular by the Nursing and Midwifery Council
of Nigeria, NMCN, which revised the guidelines for requesting verification of
certificates for nurses and midwives to foreign nursing boards or councils.
They are demanding a review of
the circular’s contents to avoid a situation where nurses’ progress and
development are subjected to other professionals’ determination.
The development is coming amid
poor healthcare infrastructure, funding, welfare, and working conditions in the
health sector.
The revised
guidelines for requesting verification of certificates for nurses and midwives
come amid the mass exodus of healthcare professionals, especially doctors,
pharmacists, and nurses, which has been a burning issue in the country.
Recently, brain drain has
become a serious challenge in Nigeria’s health sector, with the nation losing
healthcare workers in droves to other countries.
This imminent crisis has
overwhelmed government authorities, with no plan to tackle it wholesomely.
The NMCN on Tuesday
disclosed that over 42,000 nurses have left the country in the last three years
to seek greener pastures in foreign countries. According to the council, over
15,000 nurses left Nigeria in 2023 alone.
Recall that earlier last year,
the MDCAN disclosed that more than 100 members left the country within 24
months.
In addition, health officials
say at least 5,600 Nigerian medical doctors have migrated to the United Kingdom
(UK) in the last eight years.
Though complex and
multifaceted, some factors, including low salaries, poor working conditions,
lack of career opportunities, inadequate resources and infrastructure,
political instability, and insecurity, have been attributed as the underlying
causes.
Many have also blamed poor
health sector funding as one of the reasons professionals are leaving the
country, noting that the Nigerian government allocated less than five per cent
of its annual budget to the health sector.
Seemingly worried by the
imminent threat of brain drain in the nation’s health sector, the NMCN
introduced revised guidelines for verifying nursing certificates to address the
crisis.
The NMCN had, in a
recent memo dated February 7, 2024, outlined the revised guidelines and
requirements to be met by all applicants seeking the verification of
certificate(s) to foreign nursing boards/councils.
It said that applicants seeking
verification of certificates to foreign nursing boards and councils must have
two years of qualification experience and pay a non-refundable application fee.
The memo signed by the
Registrar/Secretary General of NMCN, Dr. Faruk Umar Abubakar, was sent to the
Commissioners/Secretary of Health Services; Chief Medical Directors/ Medical
Directors; National President; Directors of Nursing Services; Heads of Department;
Provosts & Principals; Coordinators; Zonal Officers; All States Ministry of
Health & Federal Capital Territory, Abuja; University Teaching
Hospitals/Specialist & Federal Medical Centre and National Association of
Nigerian Nurses and Midwives, National Headquarters, Abuja.
The circular was also sent to
the Ministries of Health, Hospitals Management Boards, All States & Federal
Capital Territory; All Universities Offering Nursing Programmes; Colleges of
Nursing Sciences, Schools of Nursing & Midwifery, All Post-Basic Nursing
Programmes; All Nursing and Midwifery Council of Nigeria Zonal Offices.
It provided that, “Eligible
applicants must have a minimum of two (2) years post qualification experience
from the date of issuance of the permanent practising licence. Any application
with a provisional licence shall be rejected outrightly.
“The Council shall request a
letter of Good Standing from the Chief Executive Officer of the applicant’s
place(s) of work and the last nursing training institution attended, and
responses on these shall be addressed directly to the Registrar/CEO, Nursing
and Midwifery Council of Nigeria. Please note that the Council shall not accept
such letter(s) through the applicant.
“Applicants must have an active
practising licence with a minimum of six months to the expiration date.
Applicants must upload Certificate(s) of Registration only. Notification of
Registration is not acceptable.
“The applicant shall receive
prompt notice via his/her email and dashboard on the status of the verification
application.
“Please note: Processing of
verification application takes a minimum of six (6) months. All applicants
shall ensure that complete requirements are met before initiating verification
application as incomplete documentation shall not be processed.”
The NMCN is the only
legal, administrative, corporate and statutory body charged with performing
specific functions on behalf of the Federal Government to ensure the delivery
of safe and effective Nursing and Midwifery care to the public through quality
education and best practices.
The council was mandated by law
to regulate the standards of Nursing and Midwifery education and practice in
Nigeria and to review such standards from time to time to meet the changing
health needs of the society.
However, there are indications
that nurses and other health workers have kicked against the new development,
insisting the guidelines and requirements are typical of a denial of human
rights.
The health workers stressed
that there had never been any occasion where regulatory bodies asked for work
experience or mandated years of service as a condition for verification.
As a protest against the
policy, the nurses, under the aegis of the National Association of Nigeria
Nurses and Midwives, NANNM, Abuja and Lagos chapters, recently took to the
street to express their disapproval of the new circular on certificate verification
NMCN.
The nurses converged on the
NMCN’s offices in Abuja and Lagos to express their dissatisfaction. They
threatened a nationwide strike, describing the new guidelines as an effort to
hamper their freedom.
The nurses and midwives were at
the NMCN office protesting, singing, and carrying placards peacefully around
the premises.
Some of the placards read,
‘Address unemployment among nurses, address quackery, address nurses’ welfare’.
Others are: ‘#No to
verification rules,’ ‘Stop frustrating the Nigerian nurses,’ ‘We are going
through a lot already, protect nurses, protect healthcare,’ ‘NMCN, we say
no to the verification rules,’ NMCN don’t reduce nurses.’
Meanwhile, some others took to
social networks to protest against the policy.
For instance, a public health
nurse, identified as @DTechNurse on X, said, “It is absolutely wrong to attach
Nigerian nurses’ verification conditions to Chief Executive Officers who are
always Medical Doctors.
“Nurses now await the approval
of a medical doctor before they can make progress in their career. This
decision has to be reversed.”
Also, @AlongeElijah wrote,
“Nonsense!!! This is a denial of human rights, and it shall be informed to
@ICNurses @WHO @UNHumanRights. Haven been verified by different nursing bodies
around the world. There has never been an occasion where regulating bodies
asked for work experience or mandated years of service”.
While reacting, the body of
Heads of the Nursing Services Department and Principals of Schools in Federal
Health Institutions (BOHNAPFHI) urged the Council to review the guidelines and
delete any item likely to frustrate early verification of the licence issued to
professional nurses by NMCN.
In a letter signed by its
Chairman, Dr. (Mrs) Awoseemo Aderonke, addressed to the Registrar/Secretary
General of NMCN, the association urged the council to review some contents of
the circular to avoid a situation where the progress and development of nurses
were subjected to the determination of medical doctors or other professionals.
According to the group,
“verification of license issued by NMCN is to ascertain whether the one
presented by the applicant is issued by it and not fake, stressing that it
should have nothing to do with either character or working experience of the
applicant.
“I am directed by the body of
the Head of Nursing Department and Principals of Schools in Federal Health
Institutions (Basic and Post) in Nigeria to request and urge you to review some
contents of the circular to avoid a situation where the progress and development
of Nurses are subjected to the determination of medical doctors or other
professionals.
“Thus, affirmation of the
character of graduands has to be attended by the head of the training
institution, who is a professional nurse. While the license to practice should
be verified by the issuer, that is, the Nursing and Midwifery Council of Nigeria.
(NMCN).
“We would appreciate it if you
could further review the guidelines and delete any item likely to frustrate
early verification of the licence issued to professional nurses by NMCN. It is
our opinion that verification of the license issued by NMCN is to ascertain
whether the one presented by the applicant is issued by the NMCN and not fake.
It should have nothing to do with either the character or working experience of
the applicant.
“In addition, we humbly suggest
that the NMCN should endeavour to carry nurse leaders along when taking such
salient decisions in order to prevent regression.”
Over 42,00 nurses left Nigeria
in three years – FG
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Meanwhile, the Nursing and
Midwifery Council of Nigeria has said that over 15,000 nurses and midwives left
in 2023 to seek greener pastures in foreign countries.
The registrar of NMCN, Faruk
Abubakar, made this known on Tuesday on Channels Television’s Morning Brief
while fielding questions about the controversial new guidelines.
Justifying the revised
guideline for nurse’s verification, Abubakar said the number of nurses leaving
the country increases yearly.
“42,000 nurses left the country
in the last three years. Last year alone, it was over 15,000; the number is
increasing yearly”, he said.
When asked what the Council was
doing to protect and improve the welfare of the nurses, he said the Federal
Ministry of Health was working towards improving the nurses’ working
conditions, allowances, and salaries.
“The FMOH and the honourable
Minister of State (for health) are working hard to ensure a conducive working
environment, providing state-of-art equipment and instruments to help them
provide quality care for Nigerians.
“And I want to assure (you)
that within a couple of months, a lot has been integrated and provided in 2024
that will improve the welfare of the nurses we are talking about. When talking
about the salary they are talking about, I think it’s a general phenomenon, and
I believe it’s a general thing.
“There is a lot of progress
going on to review the salary, and nurses are also included in that policy. I
think it’s a general phenomenon; all other sectors are also complaining, and
the government is doing a lot,” he stated.
In an interview
concerning the matter, Dr. (Mrs) Awoseemo Aderonke, the Chairman of Nursing
Services Department and Principals of Schools in Federal Health Institutions,
BOHNAPFHI, said her association was more worried by about the issue of
professional autonomy.
Aderonke said the issue of
asking for the certificate of character from the medical doctors hasn’t gone
down well with BOHNAPFHI, adding that the development could take the nursing
profession back to the stone age.
She suggested that even if
there’s a need for such a recommendation it should be from a training
institution.
According to her, there were
steps that could be taken to ensure that the nation retained its young ones in
the profession in order to serve their nation.
She said: “You know the group
is the group of leaders in nursing, both in practice and education, for those
of us that work in federal institutions in Nigeria. So it’s a group of my
people, it’s a group of leaders that are ready to ensure that we uphold the
standard of nursing profession and plan for better life for the younger ones
and the future generations.
“Actually, I will say we are a
body and we have an association, we have the umbrella association which is
supposed to be the National Association of Nigerian Nurses and Midwives.
“And we have a branch of it
that covers the federal health institutions. So, the president and the chairman
of those groups have been informed. They were copied concerning our own view as
nurse leaders in federal institutions both in nursing practice and education.
“We don’t want to exceed
anything outside our paper because very soon we are going to hold our meeting,
our conference.
“And when we hold our
conference, we will come up as a body to look at issues, because the interest
of everybody and interest of the Registrar of Nursing and Midwifery Council of
Nigeria, NMCN, and the entire nurse leaders is to ensure that the people – the
citizens, they get the best at every point in time.
“With that at the back of our
mind, I believe there are steps that could be taken to ensure that we are able
to retain our young ones in the profession in order to serve their nation.
“The only issue that is being
stressed by my own association is the professional autonomy because when they
talked about Chief Executive Officer, CEO, and looking at Nigeria, the CEO in
federal institutions for now are medical doctors.
“We are convinced and we know
that the operation of our amiable Registrar is to ensure reforms and
professionalism of nursing to get better on a daily basis because he has come
up with many reforms, which we believe, every member of my forum will always drop
caps for this action of the man.
“So, the issue of asking for
the nurse’s character or certificate of character from the medical doctors
doesn’t go down well with us because we cannot take our profession back to the
stone age.
“Moreover, the nurses prepare
these people. It’s expected that the head of the training institution, either
the head of nursing department or nursing science department in our
universities or the head of program in each of our various colleges of nursing
sciences and principals of schools – are the one that are expected to comment
on their character.
“What we are actually talking
about is the verification of certificates. For you to have that certificate,
you are expected to have gone to a certified training school, well accredited.
“When we talk about
accreditation, we talk about all the resources in terms of personnel and
infrastructure and all things that are there. And since they are adequate and
the person is presented for the professional exam, and the person passed – the
professional exam we are talking about is being organized by the Nursing and
Midwifery Council of Nigeria with the help of leaders in nursing education and
practice, that means everything about it is about nursing.
“It’s expected that even if
there’s a need for such a recommendation, it should be from a training
institution. That’s what we are really emphasizing.”
Suggesting further on how the
profession could retain its best, Aderonke said, “Another aspect of it I want
us to talk about that we mentioned in our letter is that the Council has the
responsibility to verify certificates; it’s the Council that issues the license
and certificate. That means it is the issuer that has those responsibilities.
“The emphasis of our leaders,
yes, we have the concern of our community.
“It is a personal decision,
either for you to stay or want to go. I don’t believe you can coerce people but
people can be encouraged in many ways. People can be motivated in many ways to
stay. And part of the motivation is this professional autonomy that we are
talking about.
“We can’t sell professional
autonomy out. We can’t trade with it because that is what we have been doing
and building in order to ensure that nursing as a profession also stands out as
one of the best professional groups in the nation.
“I believe there will always be
a way out. Yes, the interest of our people is very important, it’s dear to us.
I know some people that are just encouraged that they want to stay. There are
people that even travelled and they came back again, and they were able to
bring the skills they acquired there for the benefit of the community.
“I think as we talk about the
freedom of movement, if we put in some things to motivate them, to encourage
some people, they could even say, ‘I want to go in the next two years’. When
you’re being motivated, you can say ‘Okay, let me spend five years serving the
land for me to go and explore’.
“This is what we are saying. Actually,
we are not attacking the Registrar. The Registrar is very amiable. He’s a man
that listens to advice. But you know as leaders, sometimes you make decisions,
you may look at things from different dimensions.
“That’s what we are battling
with, even in education; people don’t want to come into academics again because
there’s nothing really much motivating them. It’s not easy. If you go to many
of our institutions now, many of our educators, for us to get lecturers, it’s
not an easy matter.
“I believe if we have this motivation,
when they go for workshops, you sponsor them. When they have to go for training
– things that will develop them, you give them necessary support. Nobody will
look out for other things.
“If you look at our country
Nigeria, we are so much blessed. Look at our weather, climate and many other
things. Look at our social setting – you rarely see people getting crazy,
except some people that go into addiction or whatever. Because if I have something
bothering me, I have somewhere to ventilate, you know, my colleagues will
advise me.
“The federal government, state
governments, private sector, and all the groups should motivate their
personnel, not only the nurses but even the medical persons.
“When they are working with
them, they need motivation. Everything is not about money; people need
fulfillment. Yes, money is also very important to take care of your basic
needs.
“Look at the situation of
things in the country today but salaries still remain the same. The government
should keep them motivated and accord them the honour.
“With this, one may not even
feel the need to go out. The only thing that can take them outside the country
is to acquire more skills to serve their community.”
Meanwhile, some members of the
National Association of Nigerian Nurses are accusing the president of the
association, Mr Michael Nnachi of compromise.
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