The Dark Side of Private Medical Practice in Nigeria.

Private medical practice in Nigeria has come a long way. Data from the Federal Ministry of Health as at 2011, revealed that more than 31% of health facilities belong to the private sector, which provides at least 70% of healthcare services in the country. Majority mostly offering primary and secondary care services.
There is limited information on the current number of health workers in the private sector. However, a study sponsored by the National AIDS Committee, based on a survey of 290 public-sector facilities in 2006, estimated roughly about 11,473 doctors and 56,400 nurses and midwives working in the private sector.

The persistently poor quality health services provided in public hospitals has made the private sector an unavoidable choice for consumers of health care in Nigeria. However, despite the enormous contribution of the private sector, workers in the sector are faced with lots of challenges which rarely reflect in general healthcare discussions.

1. Poor Working Conditions
Health workers in the private sector daily endure extreme working conditions coupled with no formal employment terms. This often results in ill-defined scope and duration of work, and other forms of exploitation.
Some private hospitals lack facilities for basic care, alongside operating services in facilities lacking minimum requirements, therefore exposing their employees to various health hazards.
The usual work schedule for doctors in most private hospitals consists of 2 - 3 work shifts in a day, with each lasting a minimum of 6-12hrs alongside a 48hrs weekend call ranging from once to twice a month.
However, irrespective of the poor working conditions, employees are saddled with the responsibility of maintaining positive image of the organisation.

2. High Work Load
There is a significant shortage of personnel in the health sector. This means fewer staff members must divide a significant workload, pushing some employees to the brink of exhaustion and overall decreasing job satisfaction.
 
3. Poor Remuneration
A doctor in the private sector is paid an average of N100,000 – 150,000 per month whereas, nurses are paid an average of N30,000 - 100,000. Considering the work requirements, duration of work and associated work related hazards, the salaries are low compared with other health professionals in public sector and other professions outside the health sector.
Other employment benefits like health insurance coverage, pension plan, access to loan are often not available. Most facilities also have no provision for leave, and as such employees are paid less the number of days they are absent from work.

4. Lack of Career Progression
Most private hospitals offer no opportunity for career advancement. This is often responsible for the high worker’s turn-over seen in the private sectors

In view of the above challenges, there is a need by the different bodies regulating private medical practice in Nigeria to set out guidelines to regulate the operations of private medical facilities in the country. Likewise a need to ensure strict compliance and sanctions for defaulting facilities.


Pharm Access Foundation, ‘Nigerian Health Sector, Market Study Report’

USAID: Nigeria Private Sector Assessment