Tension is rising among members of the National Association of Nigeria Nurses and Midwives, who are threatening a showdown with the Nursing and Midwifery Council of Nigeria over the new guidelines for verification of certificates.
Nurses and midwives in the country had earlier in the week lamented the deactivation of the NMCN verification portal since December 2023.
The nurses, who spoke with our correspondent in separate interviews, alleged that the deactivation of the portal by the council was an attempt to hinder their freedom to pursue career opportunities abroad.
They also said it was not unconnected to the plan of the Federal Government to reduce the number of health workers travelling out of the country to seek greener pastures.
The NMCN is the only legal, administrative, corporate, and statutory body charged with performing specific functions on behalf of the Federal Government to ensure the delivery of safe and effective nursing and midwifery care to the public through quality education and best practices.
The council is mandated by law to regulate the standards of nursing and midwifery education and practice in Nigeria and to review such standards from time to time to meet the changing health needs of society.
In 2023, the NANNM said over 75,000 nurses and midwives left the country in five years to seek greener pastures.
It decried the insecurity in the country, particularly the rising cases of kidnap of its members for ransom, and violence against its members at their workplace while discharging their duties.
The President of the association, Michael Nnachi, had said, “As a result of poor wages and lack of decent work environments, over 75,000 nurses and midwives have emigrated from Nigeria within five years.
“Shortage of nurses and midwives, especially in certain areas of specialisation and geographic regions, the increased rates of attrition and a chronic shortage of nursing personnel in the country increased workloads on nurses without an equivalent compensation, exposing them to more health hazards and compromising the quality of healthcare delivery.”
The mass exodus of nurses has worsened an ongoing shortage of health workers, and poses significant threats to the healthcare delivery system, leading to limited access to care for many people.
Nnachi stated that the ongoing brain drain was affecting the workforce in the health sector.
He said, “It is overstretching nurses who are not even well-paid or well-compensated. It is overstretching the workforce. Look at the way the country is, there is insecurity. Prices of commodities have gone up in the market, and you are earning a salary that has remained stagnant all this while. So, how can you cope economically?”
The NMCN issued a memo dated February 7, 2024, revising the guidelines for requesting verification of certificates for nurses and midwives.
The NMCN said eligible applicants must have a minimum of two years post-qualification experience from the date of issuance of the permanent practicing licence.
The memo was addressed to all state ministries of Health, university teaching hospitals, specialist and federal medical centres, NANNM headquarters, universities offering nursing programmes, colleges of nursing sciences, schools of nursing and midwifery, all post-basic nursing programmes, and all nursing and midwifery councils’ zonal offices.
The memo signed by the Registrar of the council, Dr Faruk Abubakar, read in part, “A refundable fee per application shall be paid for verification to foreign boards of nursing as specified on the portal. This shall cover the cost of courier services to the applicant’s institution(s) of training, place of work, and foreign board.
“Eligible applicants must have a minimum of two years post qualification experience from the date of issuance of the permanent practicing licence. Any application with a provisional licence shall be rejected outright.
“The council shall request a letter of good standing from the chief executive officer of the applicant’s place(s) of work and the last nursing training institution attended and responses on these shall be addressed directly to the Registrar/CEO, NMCN. Please note that the council shall not accept such letter(s) through the applicant.”
The council also stated that applicants must have active practicing licences with a minimum of six months to the expiration date, and processing of verification applications would take a minimum of six months.
It added that the implementation of the guidelines takes effect from March 1, 2024.
However, the revised guidelines have sparked reactions from nurses.
According to them, the directive is an infringement on their basic human rights and is embarrassing to the profession.
A flier sighted by one of our correspondents on social media indicated that nurses in Lagos would stage a protest against the directive on Monday at the NMCN office in Yaba.
A nurse identified as @Nrs_Danie on X (formerly Twitter) posted the flier of a planned protest in Abuja.
He wrote, “Dear Nurses/Nigerians, There is a peaceful walk to NMCN coming up on the 12th of February 2024 in Abuja. Kindly donate anything you can, financially or in items listed in the flyer…the account number is there. No gree for anybody! #NotoNMCNVerificationrule.
“Me I have sent my own financial support, I will keep using online platform to raise awareness and support because this is everyone’s business! Kindly retweet and let it go far, tag anyone or everyone you know!”
Another nurse using his X handle @KelvinOssai said, “When the government succeeds in using NMCN to tie Nigerian nurses down, they will come for other professions. They will not make plans to improve the hospitals or salary of nurses and other health workers, oh, but they are concerned about your licence!!! Licence that you have earned and paid for. #NotoNMCNVerification #NotoNMCNverificationrules #NotoNMCNVerificationrule.”
On his part, the Secretary of the Lagos State chapter of NANNM, Toba Odumosu, said, “We reject that directive outright, but we will be meeting soon on the way forward on the matter.”
The Secretary of the Oyo State chapter of NANNM, Aina Oluwasegun, said, “The state executive members will meet soon to decide on the directive.”
Speaking exclusively with one of our correspondents on Friday, Nnachi said the council’s directive was meant to frustrate nurses from seeking greener pastures.
He stated, “The directive is very embarrassing. It’s an attempt to frustrate the nurses from seeking greener pastures and self-development. It is really embarrassing but we will take measures to look at it.
“The directive has consequences on practicing nurses, student nurses, and even those who aspire to be nurses; this is discouraging, and it will discourage them. It is frustrating.”
When asked about addressing the issue, he said, “At the leadership level, we need to come together and discuss. It is not a personal decision; we need to look at issues holistically, and then we will make decisions on that. It is something that concerns every nurse; it is not something that an individual will decide on. We all need to look at the directive.”
Nnachi, however, urged the Federal Government to provide a comfortable working environment and better pay for nurses to reduce brain drain.
He noted, “If the government wants to curb brain drain, they should do what we need and make nurses comfortable in Nigeria and give them a special salary package, which will be called enhanced nurses’ salary structure, and review their salaries and professional allowances.
“The reason is that in today’s society and economic condition, everyone will testify that nobody is coping well.”
Meanwhile, nurses have set up different WhatsApp groups to mobilise their colleagues to challenge the action of the council. Some of the nurses met in Abuja on Friday and decided to go to a radio station to vent their anger over the council’s directive.
At the radio station, a representative of the nurses, whose name was not given for fear of a witch-hunt by the authorities, said, “We won’t agree to the directive. The aim is to keep us in perpetual slavery, which we won’t agree to.”
It was gathered the nurses were also planning rallies across the country.
In its reaction, the Federal Medical Centre, Yenagoa chapter of the NANNM, said in a document addressed to the national headquarters by its Secretary, Donkori Menizibeya, “Our members have received the content of this circular with great displeasure, describing the circular as not only a decision against the general wellbeing of nurses in Nigeria in the face of paltry remuneration and poor working conditions but also as a deliberate attempt by the government to infringe on the fundamental right of Nigerian nurses.
“The situation at the moment has put the association in a state of crisis, and we foresee greater danger and chaos if immediate action is not taken.
“The Nigerian government is aware that it lacks legal grounds to prohibit Nigerian nurses from migrating amid the country’s current hardship and poor health system. Thus, has strategically resorted to using our regulatory bodies to freeze the potential of Nigerian nurses.
“Our members demand that this anti-nursing circular be withdrawn immediately as strategic policies such as this must not be detrimental to the professionals it is supposed to benefit, and hereby call on the national headquarters of our association to rise to the task and must now swing into action to ensure that the welfare and rights of Nigerian nurses are protected.
“Nursing leaders need to go back to the drawing table and make necessary corrections as a matter of utmost importance and urgency, and the onus now falls on the NANNM to be the non-violent driving force in correcting this anomaly before us today.”
Similarly, the Ebonyi State Council of the association, in a letter to the national body, said login into the portal and paying a non-refundable fee for verification of certificates by applicants was acceptable and commendable, but rejected the two-year experience after the issuance of permanent practicing licence before applying for verification, adding that it was more like enslaving its members against their wish.
In the letter signed by the state Chairman, Obasi Bornbless, and Secretary, Nwoke Chimezie, the body said, “Such rule or guideline will be more achievable if the government had sponsored the person(s) education and also have an outstanding bond or Memorandum of Understanding to substantiate this kind of decision, and not to be enforced on someone that solely sponsored his/her education on hard labour or loan assistance.
“People get educated for so many reasons, one of which is for greener pastures in a favourable and conducive environment where their needs will be met.”
It also faulted the request for a letter of good standing from the CEOs of the applicants’ places of work, especially for those working in hospital settings, describing it as derogatory and demeaning to the nursing profession in Nigeria, adding that the letter should rather come from the heads of nursing of the respective institutions.
“The government should be more concerned about improving the working condition of nurses and other health workers other than stopping the japa syndrome without any plan to improve factors that greatly contributed to it,” the chapter noted.
The Ondo State chapter of the association in rejecting the directive said in a letter by its Chairman, Orobode Felix, that nurses across the country were facing the dual challenges of being underpaid and having inadequate welfare benefits, adding, “As independent professionals, nurses possess the right to practice in any part of the world. Imposing restrictive measures in an attempt to keep them within the country is both unacceptable and should be vehemently condemned.”
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