Patients, stakeholders decry inadequate manpower in general hospitals
Patients and stakeholers in Oyo, Ogun and Kwara States have urged the governments to urgently improve remuneration of medical doctors in order to retain their services in general hospitals and other public health facilities.
In a survey conducted by the report in the three South-West states, respondents were unanimous that poor remuneration and inadequate equipment and infrastructure were responsible for inability to retain personnel.
The World Health Organization (WHO) recommends a doctor-to-patient ratio of 1:600, meaning one doctor to every 600 patients.
Unfortunately, Nigeria’s ratio is significantly lower, at approximately one doctor per 10,000 patients, which is 1,000 per cent below the WHO’s recommended figure.
The hospitals visited in Oyo State are Jericho Nursing Home, Ibadan South-East Local Government Area, Ring Road State Hospital, Oni Memorial Children Hospital, in Ibadan South-West Local Government Area.
Others are Adeoyo Maternity Teaching Hospital, Yemetu, and Central Medical Diagnostic Center, Total Garden in Ibadan North Local Government Area.
Dr Muhammed Odedeji, a former Publicity Secretary, Nigerian Medical Association (NMA), Oyo State, said that lack of manpower was a major challenge being faced by most general hospitals in the state.
“As the government recruits, people ‘japa’ (relocate abroad) within three months of being appointed. That has left secondary care in a shambles.
“The current government of Oyo State has done a lot to improve the state and general hospitals, but number one issue that face the hospitals is the issue of low manpower, especially of doctors and nurses.
“It’s very difficult to see any hospital within the state that has enough personnel in terms of doctors and nurses,” he said.
Odedeji stressed that most general hospitals in the state have just one medical doctor.
“A medical doctor cannot work for 24 hours alone. No matter how efficient and how interested you are as a doctor, once you are the only one you will be limited.
“Patients’ management will just be done with the knowledge of the one doctor that is available.
“Most times, once you get to those hospitals by 4.00 p.m., you don’t meet any doctor. So this is a very big problem,” he said.
Odedeji also identified the issue of lack of adequate infrastructure within the hospital as another problem.
According to him, a number of general hospitals don’t have functional boreholes, no good source of electricity supply, while many of them rely on generator – which is not easy with the current cost of petrol.
“Sometimes at night there is total blackout in such a hospital and they may not be able to do their work effectively.
“Also some basic medical equipment needed within the hospitals are lacking.
“Ordinary Nebuliser – many of our general hospitals cannot boast of it. Nebuliser is the machine used to rescucitate somebody with acute asthmatic attack.
“It’s supposed to be a life-saving machine immediately they bring in the person. Unfortunately, that is not the case.
“It’s a pity that many of our hospitals don’t have the machine as simple as it is, as it does not cost more than N50,000.
“So many other life saving machines are also not available in most of the hospitals,” he said.
Odedeji, however, said that primary healthcare centers in the state were in far better state than the general hospitals.
“I don’t know what will happen tomorrow, but as I talk to you, primary healthcare centers are far better. It is just that we are not allowed to treat so many diseases in primary health centers,” he said.
Also, Dr Uthman Adedeji, President, Association of Resident Doctors (ARD), UCH, Ibadan, noted that general hospitals were the backbone of secondary healthcare.
Adedeji said that If properly equipped and staffed, general hospitals would reduce pressure on tertiary centers like UCH and improve health outcomes for the majority of citizens.
According to him, the political will to fund and monitor the hospitals consistently is what is required.
“Many general hospitals have aging buildings and equipment, while some facilities have seen recent renovations.
“Equipment like radiology units, operating theatre sets, and basic lab machines are often outdated or non-functional.
“Power and water supply remain inconsistent in several centers; there is a shortage of doctors, nurses, and other skilled health workers.
“Brain drain and internal migration to tertiary centers/urban areas have worsened the situation.
“Despite the constraints, health workers are doing their best, but long waiting times, drug stock-outs, and limited specialist services affect quality of care and patient satisfaction,” he said.
Adedeji urged the government to conduct a facility-by-facility audit of equipment, power, water, and structures, and develop a costed upgrade plan with timelines.
On health workforce retention, he urged improved remuneration, providing rural posting allowances, and ensuring prompt payment of salaries and hazard allowances.
“Also, the government should provide decent accommodation for doctors in general hospitals and scale up recruitment of doctors, nurses, and lab scientists.
“Partner with teaching hospitals like UCH for regular Continuing Medical Education (CME) and specialist outreach to general hospitals.
“There is need to strengthen drug supply chains to prevent stock-outs and Ring-fence funds for routine equipment maintenance.
“Besides, Public-Private Partnership should be explored for diagnostics, lab, and radiology to reduce downtime of essential services.
“Strengthen two-way referral between PHCs, general hospitals, and tertiary centers so general hospitals are not bypassed,” Adedeji said.
A patient at Ring Road State Hospital, Mr Bola Ayeni, expressed concern that only two doctors work at the hospital.
“Only two doctors working here is too small, they should employ more doctors so that it will be faster and easier for them to attend to patients.
Also corroborating Ayeni, another patient, Mrs Tinuke Adewale, stressed the need for more doctors to be employed.
“There is need to have more doctors and specialists to handle the number of patients coming here so that it will not be crowded,” she said.
In Ogun, the Director of Hospital Services, Dr Solomon Sokunbi, said that the Ministry of Health, through the Department of Hospital Services, had implemented several interventions aimed at safeguarding public health and maintaining professional standards across the state.
According to Sokunbi, governmrt had put in place measures to protect patients, uphold professional standards, and restore public confidence in the healthcare system across Ogun state.
Similarly, the Chief Medical Director (CMD) of General Hospital, Ota, Dr. Dayo Okeowo, said the state government had invested in infrastructure aimed at improving the quality of healthcare delivery in the hospital.
He said that the state government had upgraded the hospital’s emergency ward by providing oxygen cylinders, suction machines for clearing the airways of unconscious patients, blood pressure monitors, and other essential medical equipment.
The CMD also assured that the hospital now had reliable power supply, including solar and inverter backup systems, to run the theatre, laboratory, and Intensive Care Units (ICUs) without dependence on diesel-powered generators.
He added that the hospital has been provided modern equipment such as functional X-ray machines, ultrasound scanners, and anaesthesia machines to ensure safe and effective healthcare delivery.
“The hospital now has clean water, working toilets, and well-ventilated wards. These are the foundations that make all other treatments effective.
“No amount of drugs or doctors can prevent infections if the water supply is contaminated,” he said.
Okeowo further stated that the hospital’s digital system had been improved, enabling better management of patient records, faster treatment processes, and a reduction in mortality rates.
However, he appealed to the state government to employ more medical personnel, particularly doctors and nurses, to enable the hospital to attend to more patients.
A patient at the hospital, Mrs. Moji Ogunseye, commended the state government for investing in infrastructure in public hospitals across the state.
According to her, patients are now enjoying the availability of functional X-ray and ultrasound machines.
Ogunseye said that residents no longer have to go to private hospitals or other states for basic medical tests.
She urged the state government to further subsidise the cost of medical treatment, noting that healthcare services remain expensive for many residents.
A report correspondent, who visited the State Hospital, Ijaiye in Abeokuta, observed remarkable improvement from what obtained few years ago.
Some patients who spoke with the report commended the quality of healthcare services at the facility, citing prompt medical attention, affordable drugs, cleanliness of the environment and the dedication of health workers.
They expressed satisfaction with the care received, describing the facility as one of the best government-owned hospitals they had encountered.
Mr Johnson Okoh, whose wife is currently receiving treatment at the hospital, said he was impressed by the commitment of medical personnel to saving lives regardless of a patient’s financial status.
Okoh explained that before arriving at the Ijaiye hospital, his wife had received treatment at other state and federal hospitals but the experience at the State Hospital was different and remarkable.
“Since I brought my wife here, the doctors and nurses have been very attentive. They did not place us under pressure to make any deposit before treatment commenced.
“They are genuinely concerned about saving lives. The level of care and attention we have received here is commendable,” he said.
Okoh also praised the hospital’s neat environment, availability of bed spaces and quick response to patients’ needs.
“The environment is clean and conducive. We got a bed space without difficulty and the staff attend to patients promptly.
“The only thing we have been asked to pay for is medication purchased from the hospital pharmacy, and the drugs are quite affordable compared to what is obtainable outside,” he added.
Similarly, Mrs Olajumoke Sodeke, who recently delivered a baby at the hospital, described the services as excellent.
Sodeke said healthcare workers provided adequate care throughout her antenatal period, delivery and postnatal stages.
“The service here is top-notch. From my antenatal appointments to delivery and even after childbirth, the doctors, nurses and other health workers have been supportive and professional.
“They regularly check on both mother and baby and ensure patients are comfortable. Their concern for patients’ welfare is truly commendable.
“This was not so before now because when my sister had her first daughter here some years back, it was almost a nightmare,” she said.
Another patient, Mr Kehinde Ayinde, lauded the dedication of the hospital’s medical personnel but appealed to the government to recruit more doctors to ease the workload on existing staff.
He said that with additional manpower and continued investment in health infrastructure, the State Hospital, Ijaiye, would further strengthen its reputation for quality and accessible healthcare delivery.
In Kwara, the Commissioner for Health, Dr Amina El-Imam, said that the government executed the renovation and equipping of 193 Primary Health Centres (PHCs) across all 16 LGAs under the Basic Health Care Provision Fund (BHCPF).
El-Imam stated that several general hospitals have also undergone phased infrastructural upgrade, adding that this demonstrates the commitment of the state government to strengthen tertiary healthcare delivery and medical training.
“The State Government has converted the General Hospital Ilorin to Kwara State University Teaching Hospital (KWASUTH), a hospital which has recently been accredited by the Medical and Dental Council of Nigeria (MDCN),” she said.
El-Imam pointed out that the state has also entered into partnerships with two private universities (Thomas Adewumi University, Oko and Al-Hikmah University, Ilorin) for the conversion of two state-owned hospitals (General Hospital, Omu-Aran and Sobi Specialist Hospital) to their respective affiliated Teaching Hospitals.
“This unprecedented initiative is designed to bridge the gap in quality service delivery, expand training capacity for medical students, and improve the availability of skilled healthcare professionals within the state,” she said.
The commissioner further said that KWASUTH has a fully functional central generator capable of powering the entire facility during outages, which ensure that critical clinical services continue uninterrupted.
According to her, the hospital is also equipped with fully functional water facilities and storage tank system guaranteeing round-the-clock water supply for both clinical and non-clinical operations.
Similarly, the commissioner said over 1000 health workers across several professions were recruited into the primary healthcare system in 2025, while 150 nurses and midwives were recently recruited by the state.
El-Imam explained that while challenges exist, Kwara’s healthcare system had not been neglected but consitently undergoing considerable and sustained improvement.
Also speaking on the development in the General Hospital, the President of Association of Resident Doctors, Kwara State University Teaching Hospital (ARD-KWASUTH), Dr. Abdulfatai Abdulazeez commended Gov. AbdulRahman AbdulRazaq for the prompt payment of the 2024 Consolidated Medical Salary Structure (CONMESS), including two months’ arrears.
He added that the governor initiated the payment of the Medical Residency Training Fund (MRTF), saying that this is a crucial step in advancing the professional development of doctors.
Abdulazeez emphasized that this move was a clear demonstration of the administration’s commitment to strengthening the healthcare sector and investing in the future of healthcare professionals in Kwara.
He observed that the payment of CONMESS and MRTF would have a long-term positive impact on healthcare services in Kwara.
The president of the ARD-KWASUTH, however said that more was needed to be done in creating a conducive work environment.
He called for a more enticing system that will boost healthcare professionals’ morale, productivity, and job satisfaction, ultimately leading to better patient care and a thriving healthcare system.
“In Nigeria, addressing issues like brain drain, inadequate infrastructure, and poor remuneration can help create a more attractive healthcare sector.
“The World Health Organization (WHO) recommends a doctor-to-patient ratio of 1:600, meaning one doctor for every 600 patients.
“Unfortunately, Nigeria’s ratio is
significantly lower, at approximately one doctor per 10,000 patients, which is 1,000 percent below the WHO’s recommended figure,” he said.