Medical doctors in Nigeria have raised fresh alarm over what they describe as a dangerous collapse of the country’s healthcare manpower, warning that only about 55,000 doctors are currently available to serve a population of over 220 million people.

The warning was issued at the Ordinary General Meeting and Scientific Conference of the Association of Resident Doctors (ARD), Federal Neuropsychiatric Hospital (FNPH), Yaba, Lagos, themed “Too Few Doctors, Too Many Patients: The Consequences of Manpower Shortage on the Mental Well-being of Nigerians.”

The doctors, including mental health experts, said the worsening shortage is already deepening Nigeria’s mental health crisis, leaving millions of patients without access to care.

They also disclosed that no fewer than 16,000 Nigerian doctors have left the country in the last five years under the “Japa” migration trend, further worsening an already fragile health system.

Confirming the figures, President of the Nigerian Medical Association (NMA), Prof. Omoti Ernest, said data from the Medical and Dental Council of Nigeria (MDCN) shows over 130,000 doctors are registered, but only about 55,000 are actively practising in the country.

He explained that with Nigeria’s population exceeding 220 million, this translates to roughly one doctor to between 3,600 and 4,000 patients.

“This ratio is far below the World Health Organisation’s recommended threshold of one doctor to about 600 people, highlighting the significant shortage of medical personnel and the strain on healthcare delivery,” he said.

“Many Nigerian-trained doctors have emigrated or are no longer engaged in active clinical practice, contributing to the country’s healthcare workforce shortage.”

Prof. Omoti said the mass migration of health workers has led to severe staff shortages, burnout among remaining personnel, longer waiting times for patients, and declining quality of care in public hospitals.

“Rural and under-served communities have been particularly affected, as they already struggle with limited access to healthcare services,” he added.

He identified poor remuneration, delayed salaries, insecurity, limited career advancement, and weak investment in health infrastructure as key drivers of the migration.

“Many professionals are attracted by better pay, improved facilities, and more stable environments in countries such as the United Kingdom, Canada, and the United States,” he said.

To address the crisis, he urged government to prioritise better welfare packages, modern medical infrastructure, expanded residency training, and structured career progression pathways.

“Strengthening security, ensuring timely payment of wages, and providing incentives for professionals to work in under-served areas will also help retain talent,” he said.

He also called for private sector partnerships and diaspora engagement programmes to support the health system.

Speaking at the conference, a Consultant Psychiatrist at the Federal Neuropsychiatric Hospital, Aro, Dr. Yesir Kareem, said the situation is even more alarming in mental healthcare delivery.

“Only about 55,000 doctors remain to serve a population of over 220 million Nigerians. More than 40 million Nigerians suffer from mental health disorders, yet about 85 per cent of them do not have access to mental healthcare services,” he said.

He added that Nigeria’s doctor-to-patient ratio has now fallen to about one doctor per 10,000 patients in some estimates, far below WHO standards.

According to him, the shortage is worsening untreated mental illness, leading to family breakdowns, substance abuse, unemployment, delayed diagnosis, and premature deaths.

“The economic consequences are equally devastating, with billions of dollars lost annually due to untreated mental health conditions,” he added.

He further revealed that about 94,000 doctors and nurses have left Nigeria since the beginning of the Japa wave.

President of the Association of Psychiatrists in Nigeria (APN), Dr. Veronica Nyamali, said the shortage has forced consultants to abandon higher-level duties to cover staffing gaps.

“There are gaps everywhere. Work that should be done by four psychiatrists is now being handled by one or two people. Consultants are increasingly forced to work at lower levels because the doctors they are supposed to supervise are no longer there,” she said.

She warned that Nigeria now has fewer than 150 psychiatrists nationwide, making mental healthcare increasingly inaccessible and expensive.

“When specialists become scarce, services become more expensive. Patients are forced to travel long distances. This is contrary to universal health coverage, where mental health services should be available, affordable and accessible,” she said.

Nyamali also said pharmaceutical companies are scaling down operations, reducing access to newer psychiatric drugs, while fake medicines are increasing in circulation.

“We now have fewer treatment options. Some newer drugs that offer better outcomes are no longer readily available,” she warned.

She noted that shortages are also pushing more patients toward traditional and faith-based healers, adding that psychiatrists are now engaging them to discourage harmful practices such as chaining and flogging of mentally ill persons.

“We recognise that people go to them first because they are available and affordable. Rather than confront them, we are engaging them and providing mental health education so patients can be referred appropriately,” she said.

She further linked rising mental illness cases to worsening economic hardship, insecurity, unemployment, substance abuse, kidnappings and trauma.

“People are being traumatised daily. Poverty, violence and insecurity are all social determinants of mental illness,” she said.

She also lamented that mental health care is largely financed out-of-pocket, with many essential drugs not covered by insurance schemes.

President of ARD FNPH Yaba, Dr. Okuwoga Temitope, said the manpower shortage is directly affecting access to quality mental healthcare.

“As mental health professionals, we witness first-hand the widening treatment gap, the burden on already stretched healthcare workers and the impact these shortages have on care delivery,” he said.

He added that resident doctors are increasingly suffering burnout, anxiety and depression due to overwhelming workloads.

The association called on government to improve remuneration, strengthen welfare, expand specialist training, and invest more in mental health infrastructure.

It also recommended integration of mental health into primary healthcare, expansion of telepsychiatry services, and increased public awareness to reduce stigma.

In its communiqué, the association reaffirmed its commitment to improving healthcare delivery and urged hospital management to fast-track the enrolment of newly recruited resident doctors on IPPIS to prevent salary delays.

The doctors also commended the Medical Director of FNPH Yaba, Dr. Olugbenga Owoeye, for restoring electricity supply to the Yaba and Oshodi units of the hospital, while calling for sustained power supply to support patient care and training.