Omoragbon x-rays plight, rights of Nigerian Nurses, proposes N500,000 monthly salary as starting point

The criticality and significance of the role of nurses in health care delivery service, not just in Nigeria but across the globe, cannot be over emphasized. That is the reason the Lagos Talks 91.3 FM on Monday, April 7 2025, organised a webinar which brought together health experts, juggernauts, eggheads to jaw-jaw on the part to follow to ensure credible, actionable and enduring healthcare delivery service in Nigeria.

The webinar was organised to mark the 2025 World Health Day.

One of the professionals who spoke at the Webinar was Pastor Peters Osawaru Omoragbon, the Executive President, Nurses Across the Borders, President of Diaspora Nurses Association of Nigeria and General Secretary Nigeria in Diaspora Organisation, United Kingdom (NIDO-UK), a man with many decades of health care experience garnered over the years both in Nigeria and in the diaspora.

Omoragbon delivered a paper on the Plight and Rights of Nigerian Nurses: A comparative analysis with global standards.

For Omoragbon, he believes that the global nursing workforce is the backbone of healthcare systems, yet nurses in low- and middle-income countries (LMICs), particularly Nigeria, face systemic inequities that undermine their professional rights, dignity, and capacity to deliver quality care. He said that as the World Health Organization (WHO) emphasized, achieving Universal Health Coverage (UHC) by 2030 hinges on addressing workforce disparities and ensuring nurses operate in environments aligned with international standards.

He said that Nigeria, Africa’s most populous nation, exemplifies the paradox of a country rich in human capital yet crippled by healthcare workforce exploitation, migration crises, and institutional neglect. His paper provided a comprehensive analysis of the plight of Nigerian nurses, contrasting their working conditions, migration challenges, and policy frameworks with global benchmarks. He examined the systemic failures and proposed actionable reforms, advocating equity-driven policies to uphold nurses’ rights and strengthen Nigeria’s healthcare system.

Speaking on the Plight of Nigerian Nurses which he said is a multifaceted crisis; Omoragbon began by looking at his paper under various subtitles and with statistical evidence. He analysed the Poor Working Conditions and Remuneration, Quackery, Systemic Barriers to Professional Development, Migration Exploitation and Ethical Concerns.

He said that Nigerian nurses labour in environments marked by chronic understaffing, inadequate resources, and salaries that fail to meet basic living standards. For instance, a nurse in a state University Teaching Hospital in Lagos often manages 30–40 patients per shift, far exceeding the WHO-recommended nurse-to-patient ratio of 1:6 in acute care settings, adding that Entry-level nurses earn between ₦75,000–₦100,000 monthly (~$32.65–$65), while senior nurses with over a decade of experience rarely earn above ₦200,000 (~$124). Contrasting that with what obtains in the UK, he said that nurses in the United Kingdom’s National Health Service (NHS) earn £28,407–£42,618 annually (~$35,660–$53,500), with guaranteed overtime pay and pension benefits.”

He pointed out that the economic disparity is also exacerbated by Nigeria’s inflation rate, which reached 33% in 2024, eroding purchasing power. “Nurses often work multiple jobs or rely on informal “under-the-table” payments from patients to survive. In rural areas like Borno State, nurses face additional hazards, including exposure to infectious diseases like Lassa fever and inadequate Personal Protective Equipment (PPE). A 2023 survey by the National Association of Nigerian Nurses and Midwives (NANNM) revealed that 78% of nurses lack access to functional oxygen tanks, and 62% reuse gloves due to shortages.”

Relying on reports, he said in 2022, a nurse at Abuja General Hospital died of Lassa fever after treating a patient without PPE. Her family received no compensation, reflecting systemic neglect of occupational safety.

Speaking on what he called Systemic Barriers to Professional Development, he said Nigeria’s nursing education system is outdated and underfunded. He said, “The Nursing and Midwifery Council of Nigeria (NMCN) mandates a seven-year training pathway: five years of academic study, one year of internship, and one year of compulsory national service (NYSC). However, nursing schools lack simulation labs, e-learning resources, and opportunities for specialization. For example, Nigeria has only 12 accredited institutions offering postgraduate nursing programs, compared to over 200 in South Africa.”

He said the NMCN’s recent policies further stifle growth. “In January 2024, it imposed a mandatory two-year domestic service requirement post-qualification and a six-month verification process for nurses seeking overseas employment.” For Nurses these rules are exploitative, forcing them into underpaid roles while high-income countries like the UK actively recruited them. Comparatively, Ghana’s Nursing and Midwifery Council requires lesser years of domestic service and collaborates with diaspora networks for skills exchange.

He disclosed that quackery has become an Achilles’s heels in the healthcare delivery in Nigeria, adding that there are more quacks in the Nursing profession in Nigeria than there are the qualified. He stated that these are not helped by Nigerian medical doctors who for want of cheap labour for their private hospitals would go ahead to train individuals with low educational backgrounds on the skills of administering injections and how to deliver babies without the rudiments of going through the vigour of anatomy and physiology, the pathophysiology of disease conditions etc., adding that Regulations of these private clinics and hospitals are not done because, you have doctors as commissioners of health and Ministers of health. He said that Nigeria has a long way to go in putting the health of her citizens first.

On Migration Exploitation and Ethical Concerns the health expert revealed that over 42,000 Nigerian nurses migrated abroad between 2021–2023, driven by economic hardship and lack of career progression. He stated however, that their journeys are fraught with exploitation by recruitment agencies who charge exorbitant fees (₦300,000/~£150 for document verification).

Infesting the process is also the issue of Credential Discrimination, saying that Nigerian nurses in the UK face prolonged registration processes and are often placed in lower pay bands than British-trained peers.

Not done, Omoragbon narrated what he called Exam Fraud Allegation, he revealed that “In 2023, the UK’s Nursing and Midwifery Council (NMC) barred 669 Nigerian applicants after allegedly discovering proxy test-takers at an Ibadan exam center. This scandal underscores Nigeria’s lack of investment in credible certification systems. He explained what his organisation, Nurses Across the Borders, is doing to get justice for the nurses who were wrongly accused with no evidence, by getting a law firm on their behalf. He further disclosed other unfair treatments done to Nigerian nurses, saying there was a case of a Nigerian nurse in Manchester who reported earning £22,000 annually which was £6,000 less than that of a British nurse with the same qualifications; she was also expected to pay £500 monthly to repay recruitment loans.

Speaking on Global Standards for Nursing he gave lessons from High-Income and Regional Peers to back his argument. He spoke on World Health Organisation (WHO) Guidelines and Best Practices. He stated that the WHO Global Strategic Directions for Nursing and Midwifery (2021–2025) outlined four pillars for workforce strengthening dealing with Education. This has to do with the need to Align curricula with global competencies (e.g., digital health, disaster response).  Highlights of  what NABHI is doing include advocating on  Employment, to be designed to ensure safe staffing ratios and competitive wages. On Leadership, authorities are expected to integrate nurses into policymaking roles (e.g., ministerial advisory boards) and Service Delivery: Prioritize ethical recruitment and retention.

On how a neighbour like Ghana manages her Nurses, he revealed that Government of Ghana Partners with the Ghanaian-Diaspora Nursing Alliance (G-DNA) to modernize training and advocate for policy reforms and also offers tuition reimbursement for nurses who commit to rural postings, the case of Ghana sharply contrasts with those of Nigeria where the Government is not engaging with Diaspora Nurses in a meaningful as it does with the medical profession rather than improving domestic conditions.  He added that less than 5% of Nigeria’s health budget is allocated to workforce development.

He said that in High-Income Countries like UK, it relies on Nigerian nurses to fill staffing gaps, with 10,639 Nigeria-trained nurses registered in the UK as of 2023, stating however that the UK’s Code of Practice for International Recruitment lacks enforcement, allowing private agencies to exploit Nigerian nurses.  In Canada, on the other hand, the Express Entry system, he said, fast-tracks skilled nurses while funding LMIC training programs. For example, Canada’s $10 million investment in Kenyan nursing schools (2022–2025) aligns with WHO’s mutual-benefit principles.  He said that Canada’s collaboration with Kenya increased Kenyan nurse retention by 20% while addressing Canadian shortages.

Coming home to make a regional comparison, he revealed that Ghana streamlined credential verification to three months and also established the Nurse Retention Allowance, offering 30% salary bonuses for rural service.  He said that Kenya signed bilateral agreements with Saudi Arabia and Germany to “export” nurses while expanding domestic training capacity, and Critics argue this prioritizes remittance income over equity, as 60% of Kenyan nurses in the Gulf report wage theft.

Speaking on DATAFLOW/ WCEA/ NABHI and NIDOE Collaboration, he disclosed that Nurses Across the Borders through its global network initiated the above collaboration with DATAFLOW and WCEA bringing in the NIDOE on an initiative that would enhance cross-border medical capacity, credential verification, and mobile healthcare support for underserved communities in Nigeria.

He said “It has a double edged approach because it will not only streamline easy verification for professionals wanting to migrate, but would also verify any employment agency and their payments. The nurses know what they will be going to face and not get there to be exploited. The other benefit is that, it will aid repatriation of any Nigerian professionals wanting to come back to Nigeria to give back, which is why NIDOE is involved because it coordinates all the Nigerian professionals in UK and Europe.”

Pastor Peters Omoragbon made it clear that Nigerian nurses have some basic rights which are both legal and ethical.  On Right to Fair Labor Practices, he stated that the International Labour Organization (ILO) Convention 149 guarantees nurses’ fair wages, safe workplaces, and collective bargaining rights, saying regrettably however, that in Nigerian nurses face Union Suppression and leaders are routinely harassed; he said a 2024 protest against NMCN’s policies was dispersed with tear gas. And union activities are not allowed in private hospitals where a large chunk of nurses are employed and underpaid. Speaking on unpaid Salaries he said State governments like Kogi owe nurses 18 months of wages, sometimes ago violating the Nigeria Labour Act (2004).

On Right to Freedom of Movement he said the Universal Declaration of Human Rights guarantees freedom of movement. He said the NMCN’s two-year service rule violates this right, trapping nurses in dysfunctional workplaces. But that rule has since been cancelled and nurses now free to migrate.

Legal challenges by the Nursing Group Admin (NGA) cite Section 41 of Nigeria’s 1999 Constitution, which prohibits restrictions on citizen movement.  He added that nurses have right to Professional Dignity, “Nigerian nurses endure systemic disrespect, including: -Gender Discrimination: 87% of Nigerian nurses are women, yet they are excluded from leadership roles. Only 2% of hospital CEOs are nurses, Subordination to Doctors: Nurses are not given their pride of place in health facilities in Nigeria, instead made second class professionals.

Pastor Omoragbon made great recommendations which if our government accepts them would go a long way in bringing reforms to the health sector in Nigeria.

One of the recommendations called for Aligning with World Health Organisation (WHO) Standards in Education: Partner with institutions like Diaspora Nurses Association of Nigeria-DNAN,  Nurses Across the Borders and Johns Hopkins to establish simulation labs and e-learning platforms; Wage Reforms: Benchmark salaries to WHO’s living wage guidelines (e.g., ₦500,000/month for entry-level nurses); Ethical Recruitment: Adopt the WHO’s Global Code of Practice by requiring destination countries to fund Nigerian training programs.

On strengthening Governance and Advocacy, he called for full autonomy of NMCN and the establishment of the Directorate of Nursing to be headed by a Nurse like every other Directorate headed by medical doctors, instead of the current situation where a division of nursing is created under a Directorate of Hospital Services headed by a medical doctor. The 1980 IAP Industrial Arbitration Panel pronounced Nursing as a Profession sui generi subject to no control by other professionals. The Federal Government is yet to respect this ruling and continue to relegate the Nursing profession as an appendage of the medical professions.

Diaspora Engagement: Create a Nigerian Nurses Diaspora Commission to facilitate knowledge exchange and investment. There is a Nurse Technical Committee made up of leaders of Diaspora Nurses Organisations set up in 2012 by the FMOH. This committee after two years has not been engaged by the FMOH. That needs to be resuscitated.

Global Solidarity and Accountability, High-Income Countries: Allocate 0.1% of health budgets to LMIC nurse training and Civil Society: Support campaigns like, Diaspora Nurses Association of Nigeria, NABHI, NIDOE and NIDO Chapters with Nursing to amplify nurses’ voices.

Concluding, he said that the plight of Nigerian nurses underscores a global health inequity crisis. While Nigeria grapples with brain drain and exploitation, high-income countries benefit from Nigerian expertise without reciprocal investment. He said “Addressing this requires dismantling exploitative policies, aligning Nigerian standards with WHO guidelines, and fostering international solidarity. As the WHO asserts, ‘No health without a workforce”—a truth demanding urgent, collaborative action to uphold nurses’ rights and rebuild Nigeria’s healthcare system.’