Daniel Otera
The growing departure of doctors from Kogi State is placing unprecedented strain on the state’s fragile healthcare system, as unresolved salary discrepancies and systemic neglect continue to push professionals out of public hospitals.
This comes despite visible investments in infrastructure and public health campaigns under the administration of Governor Usman Ododo.
In a statement issued after an emergency congress meeting held in June 2025, the Kogi State chapter of the Nigeria Medical Association (NMA) issued a stern warning to the state government, calling for the immediate implementation of the Consolidated Medical Salary Structure (CONMESS 2024) and the payment of all outstanding entitlements owed to doctors and healthcare personnel.
“The state must urgently address the widening disparity in salaries and entitlements between state and federal doctors. Failure to do so risks exacerbating the ongoing brain drain, as some local government areas already have no medical doctors,” the association stated.
The warning came amid rising concern over the escalating “Japa syndrome”, a term now widely used to describe the mass migration of Nigerian professionals particularly in the health and education sectors to countries offering better remuneration and working conditions. For Kogi’s healthcare sector, the consequences are proving especially dire.
Medical practitioners in the state have expressed growing frustration over the government’s failure to fully implement the revised CONMESS 2024 salary structure, already adopted by other states. According to the NMA, the state has also failed to pay promotion arrears, delayed approved wage awards, and ignored the Residency Training Fund obligations for doctors undergoing specialist training.
Also unresolved is the domestication of the Medical Residency Training Act (MRTA) a federal law enacted in 2017 to support postgraduate medical education and retain specialist doctors within the Nigerian health system.
In addition, the association expressed concern over the non-recognition of retired doctors who are re-engaged on contract terms. Despite their continued service in public health facilities, these senior professionals are reportedly not being placed on their appropriate retirement-grade salary levels.
“The approved circular mandates that such doctors be placed on their last grade level as a token of appreciation for their experience and service. Ignoring this directive is both demoralising and a disincentive to retention,” the statement noted.
The concerns raised by the Kogi NMA echo a broader national trend, as Nigeria continues to face a deepening exodus of healthcare professionals. According to the Federal Ministry of Health, more than 16,000 doctors have left the country between 2017 and early 2025. Similarly, over 75,000 nurses reportedly migrated abroad within the same period.
Health experts warn that Nigeria’s doctor-to-patient ratio has fallen well below acceptable global standards. While the World Health Organisation (WHO) recommends one doctor to every 600 patients, Nigeria is estimated to operate at ratios between 1:3,500 and 1:5,000, depending on the region. A 2023 report published in The Lancet placed the national figure at one doctor per 9,083 patients, underscoring a worsening workforce crisis.
“We are operating at approximately 1,000 per cent below the WHO-recommended ratio,” said Dr Bala Audu, President of the Nigeria Medical Association. “The Japa syndrome has hit the health sector very hard.”
While the Kogi State Ministry of Health has not released detailed figures on local staffing gaps, the NMA’s concerns align with nationwide trends. The mass exit of doctors, unresolved salary issues, and lack of professional incentives continue to threaten the stability of public healthcare delivery, especially in underserved states.
Despite highlighting these critical gaps, the Kogi NMA acknowledged visible improvements in healthcare infrastructure and public health interventions under Governor Ododo’s administration.
“We commend His Excellency, Governor Ododo, for his visionary leadership and significant investment in healthcare delivery across Kogi State. These efforts are already making notable impacts in improving public health outcomes,” the association stated.
The group cited recent gains in malaria prevention, drug procurement and distribution, and renovation of Primary Health Care Centres (PHCs) across local government areas. The NMA also praised the governor’s decision to appoint qualified medical professionals to strategic leadership roles in state health institutions.
“We appreciate the Governor for recognising the competence of our members. We assure him that they will represent the profession honourably and contribute immensely to advancing healthcare in Kogi State,” the NMA noted.
However, health policy analysts warn that infrastructure-focused reforms will not yield sustainable results without a proportional investment in human capital. According to the 2024 State of States report by BudgIT, most Nigerian states including Kogi continue to underinvest in personnel and operations despite significant budgetary allocations to health.
The report revealed that while states collectively budgeted over ₦2.3 trillion for health in 2024, only 58.16 per cent of those funds were released and utilised nationwide. In Kogi’s case, publicly available estimates show a health allocation of approximately ₦14.3 billion, representing 9.8 per cent of the state’s total budget. Yet less than ₦4.2 billion of this was earmarked for personnel costs, with the majority directed towards capital infrastructure.
“Without proportional investment in medical workforce welfare and retention, capital projects will not translate into meaningful or sustainable public health outcomes,” BudgIT analysts stated in the report.
The analysis further emphasised that the underfunding of salaries, training, and incentives continues to drive experienced doctors out of public hospitals especially in states like Kogi, where promotion arrears and wage awards remain unresolved.
The NMA’s statement concluded with a renewed appeal to the state government to address these long-standing issues before the system deteriorates further.
“We remain loyal and committed to supporting the government’s health vision, but urge immediate action on these critical issues to avoid further deterioration of healthcare delivery in the state,” the association stated.
Unless urgent reforms are implemented, stakeholders warn that the disparity between infrastructure development and workforce sustainability may undermine the gains made in Kogi’s healthcare sector. With local government areas reportedly operating without resident doctors, the risk of systemic collapse is no longer hypothetical but imminent.
