Patients in Nigerian general hospitals are enduring lengthy waits, often extending for hours or even days, to receive medical attention. This situation is exacerbated by insufficient medical staff and the increasing demands placed on public healthcare facilities, according to recent findings.
Across major public hospitals in cities like Abuja, Kano, Rivers, and Lagos, investigations indicate that patients typically spend between five to seven hours waiting to see a doctor, effectively losing a full workday. In more remote or less developed areas, these delays can last for several days, with appointments frequently rescheduled due to a scarcity of physicians.
The consequences of these prolonged waiting periods extend beyond mere inconvenience. For many Nigerians, particularly those engaged in informal employment, spending half a day at a hospital signifies a complete loss of daily earnings. Individuals in formal employment may have to take time off work, risking pay deductions or disciplinary actions.
For patients in rural areas, where wait times can span days, the economic strain is amplified as patients and their companions must make multiple journeys to medical centers. Beyond financial losses, delayed access to crucial medical care can lead to the deterioration of health conditions, especially in cases requiring immediate intervention.
The root cause of this escalating crisis appears to be a combination of insufficient healthcare professionals, a weak primary healthcare infrastructure, and the continuous emigration of medical workers seeking opportunities abroad, all of which are straining Nigeria's healthcare system.
Data from the Nigerian Association of Resident Doctors and the Federal Ministry of Health reveals that approximately 18,627 doctors have left Nigeria between 2015 and 2024.
Currently, Nigeria's doctor-to-population ratio is around 3.9 per 10,000, significantly below the World Health Organization's recommended minimum of 10 doctors per 10,000 people.
The Nigerian Medical Association has also voiced concerns about the dwindling number of doctors, citing poor working conditions and inadequate compensation as primary drivers for doctors seeking employment overseas.
However, the Federal Ministry of Health has stated that it has developed a National Policy on Health Workforce Migration to manage the country's valuable healthcare workforce in a manner that benefits Nigerians.
At Kubwa General Hospital in Abuja, the pressure on the system is evident from the early morning. By 7:30 a.m., waiting areas are already crowded, with patients occupying corridors and any available seating, all vying for consultation cards. Some patients arrive even earlier in an attempt to avoid the extensive queues.
Grace Folusho, attending to her child, shared her experience: “I arrived before 6 a.m., but it's past noon and we are still waiting. If you don’t come very early, you might not see a doctor at all. It’s very tiring, especially with a sick child.”
Her situation is representative of a common pattern observed across the hospital, where patients regularly wait between four to eight hours before consulting a doctor. The process typically begins with obtaining a card, followed by a lengthy waiting period until their turn.
Onyekachi John recounted instances where severe overcrowding compels patients to abandon their attempts to receive care.
“One day, I waited from morning until about 2 p.m., and they informed us that the doctors had finished for the day. I had to return the next day. It’s very frustrating, but many of us have no other choice because private hospitals are too expensive,” he stated.
Despite the long waits, some patients express appreciation for the efforts of the medical staff who are working under immense pressure.
Sani Rofiat, who attends antenatal clinic at the hospital, commented that while the wait is long, the quality of care received is reassuring.
“Yes, the waiting time is long, but once you finally see the doctor, they are very thorough. The nurses are also supportive despite the large numbers. You can tell they are doing their best,” she remarked.
Hospital staff, speaking anonymously, attribute the situation to a high influx of patients and a limited number of personnel. One doctor mentioned that a physician typically sees between 25 and 30 patients daily, depending on their specific unit.
“We are extremely busy. We aim to give each patient sufficient attention, but the patient numbers continue to rise. Sometimes, we barely get a break between consultations,” the doctor explained.
According to the doctor, the workload frequently extends beyond official working hours. “There are days we finish very late. After work, most of us go straight home to rest. Some try to relax with family or engage in light exercise, but truthfully, exhaustion is a constant issue.”
Kano scenario
In Kano, similar scenes unfold daily at major government hospitals, where patients face extended waiting periods for medical attention.
Malam Jibrin Khalid at Murtala Muhammed Specialist Hospital recounted arriving early in the morning only to find a substantial number of patients already in the queue. After approximately five hours of waiting, he finally saw a doctor, but the process was not yet complete.
“I then spent an additional hour at the pharmacy, and not all the prescribed medications were available,” he noted.
He added that the high volume of patients means those who arrive late risk being turned away.
Malam Khalid also shared a distressing incident in February when his pregnant daughter was brought to the hospital at night, only to find no doctor on duty.
“She experienced prolonged labour because there was no doctor available to attend to her immediately,” he said.
At Aminu Kano Teaching Hospital (AKTH), the strain on the available medical staff is equally severe. Investigations revealed that in the General Outpatient Department (GOPD), staff often collect cards for about 50 patients who arrive as early as 6 a.m., with only three or four doctors working the morning shift.
Patients arriving after the daily quota is filled are typically asked to return later in the day or the following day. During weekends, the situation is even more critical, with sometimes only a single doctor available to serve all patients.
Ummi Kabir described being turned away after arriving around 7 a.m. because the day's quota had been reached. “I was told to come back the next day. My son had to contact a colleague at the hospital before I was eventually allowed to see the physiotherapist after a significant wait,” she recounted.
For many, these extended hours directly translate to lost income and reduced productivity.
Muhammad Murtala, a driver of heavy-duty vehicles, stated that he avoids public hospitals as he cannot afford to lose a full day of work.
“I once took my mother to AKTH and saw the long queue. I immediately decided to go to a private hospital,” he remarked.
Hours become days in Rivers
In rural communities, the situation is considerably worse, with waiting times stretching from hours into days. At Ahoada General Hospital in Rivers State, Chiman Kelechi reported spending almost a week trying to secure an appointment for his wife due to a lack of doctors.
He explained that after obtaining a card at the outpatient department, his wife was given an appointment for Wednesday, two days after their initial visit. However, upon their return, they still had to wait several additional days before a doctor was available.
“We kept returning before she was finally seen,” he said.
Malam Kelechi also pointed out the poor condition of the hospital's facilities, noting the absence of basic amenities such as water and consistent electricity.
“My wife was later admitted, but there is no running water. We have to fetch water from a distance. There is no power supply except in a few offices that use solar energy. The presence of mosquitoes can also expose patients to other illnesses,” he stated.
He raised concerns about emergency services, mentioning that many doctors reside outside the local community.
“What happens if there is an emergency at night? There might be one or two doctors on duty, but what if more are needed?” he questioned.
Another patient, Mrs Gladys Meta, said she visited the hospital for three consecutive days but could not see a doctor due to the large patient volume, forcing her to seek temporary relief from a local medicine vendor.
“I had to get medication elsewhere to manage my condition until I could see a doctor. If any hospital level needs more manpower, it is the general hospital. This is where most people access care. Many cannot afford private hospitals,” she commented.
Findings suggest that similar challenges exist in other general hospitals throughout Rivers State, including Elele and Abonnema, where patients face extended waiting periods due to a shortage of medical personnel.
A nurse at Ahoada General Hospital, speaking anonymously, confirmed that the limited number of doctors are overwhelmed by the patient load.
“It's not that the doctors are not working; it’s just that the number of patients is far too great for them,” she said.
Administrative bottlenecks in Lagos
In Lagos, the difficulties extend beyond just waiting times, encompassing complex administrative procedures that further impede access to healthcare.
At Gbagada General Hospital, patients and their families described the admission and discharge procedures as both stressful and time-consuming.
Tope Oluwo, who was attending to a relative admitted to the hospital, explained that navigating the system required visiting multiple departments.
“You have to go through a whole new level of stress. From accounts to the laboratory, kitchen, and theatre; you are constantly moving from one place to another,” she stated.
She added that the process becomes even more challenging during emergencies.
“Imagine someone who is critically ill, and you are asked to run around different departments. It’s overwhelming,” she said.
She also criticized what she perceived as a lack of empathy from some staff members.
“The government needs to improve. The system is not efficient. You often have to plead to get a bed,” she remarked.
At Igando General Hospital, patients reported similar issues, including a lack of available beds for emergency cases.
Anike Adeyemi stated that she witnessed situations where patients were not attended to due to the absence of available beds.
“There were no beds for emergencies. People were dying, and the response was slow,” she observed.
Doctors stretched thin due to brain drain
Healthcare professionals indicate that the challenges are largely attributed to manpower shortages, primarily caused by the 'brain drain' phenomenon and increasing patient demand.
Lagos, with an estimated population of 20 million, had 7,385 doctors as of 2023, translating to one physician per 2,708 people. Kano, with an estimated population of 17 million, had 1,477 doctors, a ratio of 1:11,509. Rivers State, with a population of approximately seven million, had 2,194 physicians, or one doctor per 3,190 people. The Federal Capital Territory (FCT), with an estimated population of 4 million, had 4,453 doctors, a ratio of 1:898.
At Kubwa General Hospital, one doctor mentioned that physicians often attend to between 25 and 30 patients daily, sometimes more, depending on the unit.
“We are overstretched. We want to provide adequate attention to each patient, but the numbers keep rising,” the doctor said.
In Kano, Professor Isa Sadeeq Abubakar, a consultant at Aminu Kano Teaching Hospital, described the workload as excessive and unsustainable.
Doctors, he noted, frequently work long hours in public hospitals before moving to private facilities to supplement their income.
“They work from morning until late afternoon and then continue elsewhere until night. They go to bed late and wake up early to repeat the cycle,” he explained.
In addition to clinical responsibilities, doctors must also engage in continuous professional development, attending seminars and workshops to stay abreast of medical advancements. The demanding schedule leaves minimal time for rest, increasing the risk of burnout.
Stakeholders suggest that the emigration of healthcare professionals, commonly referred to as the “Japa” phenomenon, has significantly worsened the manpower shortage.
Dr Ajibowo Ismail, principal medical officer at Alimosho General Hospital, stated that the departure of younger doctors has placed additional pressure on the remaining physicians.
“Many of our colleagues, particularly the younger ones, are leaving. This puts more strain on the few who remain,” he commented.
While he affirmed that doctors continue to perform their duties professionally, he acknowledged that the heavy workload can escalate tensions between patients and healthcare providers.
“Sometimes patients become impatient and frustrated, which can lead to conflicts,” he noted.
He further added that despite the difficulties, many doctors exceed their duties to assist patients, even contributing personal funds to support those unable to afford treatment.
FG, NMA’s stance on migration of doctors
The Coordinating Minister of Health and Social Welfare, Prof Muhammad Pate, acknowledged the medical brain drain during the seventh annual capacity building workshop of the Association of Medical Councils of Africa in Abuja last year, noting that 16,000 doctors had left Nigeria in the preceding five to seven years.
He, however, stated that this phenomenon presents an opportunity to reassess and reform policies to manage the nation's valuable health workforce in ways that benefit Nigeria.
He remarked, “Under the Renewed Hope Agenda, and within the framework of the Nigeria Health Sector Renewal Investment Initiative, we have adopted a new approach—combining practical realism with forward-looking ambition.
“The National Policy on Health Workforce Migration is central to this approach. It is designed to manage health workforce migration with dignity—dignity for health workers, for the nation, and for the profession. It is guided by data and evidence, and it clearly indicates a direction. This is neither a restrictive policy nor one born out of resignation. We recognize that the global health workforce shortage stands at 18 million, and countries in the Global North are facing their own human resource challenges due to demographic shifts and other factors. However, our response is rooted in stewardship—balancing the rights of health professionals to seek opportunities abroad with our responsibility to protect the integrity and sustainability of our national health system.”
The NMA, in its communiqué following its Annual Delegates Conference and General Meeting in 2025, held in Katsina State, urged for improved remuneration and welfare for doctors to address the brain drain.
The NMA President, Bala Audu, stated, “The recommended doctor-to-patient ratio is 1:600, but due to the continuous exodus of medical doctors, this ratio has increased significantly. If you divide Nigeria's estimated population of 240 million by the number of practicing doctors, which is 30,000, you get a doctor-patient ratio of 1:8000.
“There are significant challenges prompting doctors to leave the country, including poor working conditions and remuneration. The NMA is also advocating for the universal implementation of the Consolidated Medical Salary Structure (CONMESS) across all health sectors as a measure to mitigate the brain drain.”
Implications of long wait, excessive workloads
Medical experts warn that extended waiting times may also encourage self- medication, as patients resort to quicker solutions outside the formal healthcare system. They also caution that excessive workloads can compromise patient safety.
A consultant physician at a general hospital in Abuja, who requested anonymity, observed that attending to a large number of patients daily increases the likelihood of fatigue, which can impact clinical judgment.
“When doctors are overworked, fatigue sets in. While it doesn't automatically lead to errors, the risk increases if there isn't an adequate support system,” the expert commented.
He emphasized the necessity of improving patient-to-doctor ratios and implementing structured rest periods to ensure the delivery of quality care.
Despite these challenges, healthcare workers maintain their commitment to their duties.
Dr Ismail from Alimosho General Hospital stated that doctors are guided by professional ethics and strive to provide the best possible care under challenging circumstances.
“We are trained to care for patients, and that is our mission. We give our utmost best,” he affirmed.
He also noted that conflicts occasionally arise due to misunderstandings or what he termed an “entitlement mentality” among some patients, but stressed that such instances are infrequent.
Experts suggest that resolving the issue of long waiting times in Nigeria's general hospitals requires a comprehensive strategy that includes the recruitment of more healthcare professionals, enhancing working conditions to retain existing staff, and strengthening primary healthcare centers to alleviate pressure on secondary facilities.
Investments in infrastructure, such as digital systems for patient management, could also contribute to streamlining administrative processes and reducing delays, they recommend.
For patients like Grace Folusho and countless others nationwide, the urgent need for reform is clear. “No one should have to spend an entire day just to see a doctor,” she concluded.
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