Migration refers to the movement of people from one place to another, often from one country to another, to settle either temporarily or permanently. It is a practice as old as humanity and is undertaken by people across all societies. Migration has contributed to the growth of nations, strengthened communities, and enhanced individual well-being by supplying human resources and raising living standards.
Although migration has many positive aspects, it becomes concerning when a country’s best brains and most talented individuals engage in desperate and continuous migration. This is the situation in Nigeria, where many young and able-bodied people migrate to other countries to pursue better opportunities. As a result, ‘Japa’ has emerged as a colloquial expression used by Nigerians to describe this phenomenon. The slang, rooted in the Yoruba language, combines two words — ‘Já’ (to break) and ‘Pa’ (away) — symbolizing a hurried escape. In this context, emigration from Nigeria is not merely a desire but often a necessity, driven by the need to flee an entrapping situation. Unfortunately, this mass migration frequently leads to a brain drain, with skilled individuals contributing to the economies of other nations rather than their own.
While all sectors in Nigeria experience workforce depletion, the health sector has been particularly affected. In 2022, approximately 75,000 nurses left the country; by 2024, over 16,000 doctors had emigrated. This exodus has severely impacted healthcare delivery, leaving the nurse-to-patient ratio at 1:1,160 and the doctor-to-patient ratio at 1:5,000, which fall far below the World Health Organization’s (WHO) recommended ratio.
The effects of ‘Japa’ on Nigeria’s health sector are profound. The mass departure of skilled healthcare workers has exacerbated the already critical shortage of staff in health facilities, and this not only compromises the quality of care but increases patient wait times and worsens health outcomes. Ultimately, the continuous exodus of healthcare workers threatens to collapse essential health services, particularly in rural and underserved areas.
Several push factors motivate Nigerian health workers to migrate. Beyond micro and meso-level causes such as family ties, limited career advancement, wage differential and the desire for better training and opportunities, macro-level factors like insecurity, underfunded health systems, poor infrastructure and weak policies on health worker retention need more emphasis.
Insecurity
Insecurity has become a pressing issue, with many parts of Nigeria plagued by banditry, insurgency, and kidnapping for ransom. According to the National Bureau of Statistics (NBS), between May 2023 and April 2024, 614,937 Nigerians were killed, and 2,235,954 were kidnapped. Healthcare providers are not spared from these threats. They often cannot access their workplaces safely or perform their duties without fear. There have also been reports of healthcare facilities being looted and medical supplies stolen by criminal groups. Consequently, insecurity is frequently cited as a major reason for the migration of healthcare workers.
Underfunded Health Systems and Poor Infrastructure
Another significant factor is Nigeria’s health system’s chronic underfunding and poor healthcare infrastructure. Many health facilities lack the necessary tools and equipment to deliver quality care. Beyond the absence of modern technology, some healthcare centres — from primary to tertiary levels — have no functional equipment at all. The lack of resources hampers service delivery and diminishes healthcare workers’ motivation, pushing them to seek better opportunities abroad.
Weak Policies on Health Worker Retention
The ‘Japa’ wave has created a critical shortage of healthcare workers in Nigeria, yet national policies remain inadequate in addressing staff retention or replacement. While Nigeria produces a sizable healthcare workforce annually — including doctors, nurses, midwives, and community health workers — retention remains a major challenge. Research shows that recruitment into the healthcare system is often influenced by nepotism, with powerful individuals securing jobs for their relatives. As a result, those without connections have little choice but to look for opportunities outside the country. Moreover, there is no clear policy on replacing those lost to migration.
The Way Forward
Given this backdrop, there is an urgent need to revamp Nigeria’s healthcare sector. The government must prioritize the security of healthcare workers by ensuring safe working environments. Furthermore, investment in healthcare infrastructure is crucial, focusing on equipping facilities with modern tools and technology. Policies should also be implemented to support transparent recruitment processes and offer competitive incentives to retain skilled workers. Addressing these issues holistically will curb the ‘Japa’ wave, strengthen Nigeria’s healthcare system, and benefit the nation’s health outcomes in the long run.