Assessment of the National Policy on Health Workforce Migration

Abstract

Nigeria continues to experience significant health workforce migration, popularly known as Japa, which contributes to persistent shortages of doctors and weakens health system performance. To address this challenge, the Federal Government introduced the National Policy on Health Workforce Migration (NPHWM) in 2024, focusing on retention strategies, ethical recruitment, international collaboration, and improved workforce planning. Evidence on the policy’s practical impact, however, remains limited. A convergent mixed-methods design was adopted, combining a crosssectional survey with qualitative analysis. The study involved doctors working in public hospitals in Edo State, including facilities under the Edo State Hospitals Management Agency and three tertiary hospitals. A multistage sampling approach was used, and 82 respondents completed a semi-structured questionnaire. Quantitative data were analysed using descriptive statistics, Spearman’s rank correlation, and binary logistic regression, while qualitative responses were analysed thematically. Most respondents were early- to mid-career doctors, predominantly resident physicians. Awareness of the NPHWM was low, with 65.9% of respondents reporting no prior knowledge of the policy. Several intervention domains showed positive correlations with doctors’ retention intentions. However, logistic regression analysis identified only international collaboration and ethical recruitment as a significant predictor of retention (p < 0.05). Workforce data indicated modest stabilisation in the tertiary facility after policy introduction, but continued fluctuations in state-managed hospitals. A large majority of respondents (84.1%) expressed willingness to migrate abroad. Although the NPHWM is conceptually comprehensive, its measurable impact on doctor retention remains limited. Strengthening implementation and improving working conditions are necessary for meaningful retention outcomes.