The Nursing and Midwifery Council of Nigeria, MCN, recently issued a new circular that has upset Nigerian nurses. It updated the procedures for asking foreign nursing boards or councils to verify the credentials of registered nurses and midwives.

They are requesting that the contents of the circular be reviewed in order to prevent a scenario in which the decisions made by other professionals would affect the advancement and development of nurses.

This development coincides with inadequate finance, welfare, working conditions, and infrastructure for healthcare in the industry.

According to ZINGTIE, a pressing issue in the nation is that the updated standards for demanding verification of credentials for nurses and midwives coincide with the mass departure of healthcare workers, particularly doctors, pharmacists, and nurses.

Nigeria’s health sector has recently faced significant challenges due to brain drain, as the country is losing a large number of its healthcare workers to other nations.

This impending crisis overburdens government officials, and they need a comprehensive plan to address it.

According to the ZINGTIE, the NMCN revealed on Tuesday that more than 42,000 nurses have departed the nation in the past three years in search of better opportunities abroad. The council claims that in 2023 alone, more than 15,000 nurses left Nigeria.

Remember how the MDCAN revealed earlier in the year that over 100 members had left the nation in less than a year?

Furthermore, within the past eight years, at least 5,600 Nigerian doctors have immigrated to the United Kingdom (UK), according to health officials.

Some issues have been identified as the underlying causes despite being complex and multifaceted. These factors include low incomes, bad working conditions, a lack of professional possibilities, inadequate resources and infrastructure, political instability, and insecurity.

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Many have also pointed the finger at inadequate funding for the health sector as one of the reasons why professionals are leaving Nigeria, pointing out that the government of Nigeria devotes less than 5% of its yearly budget to this area.

In an attempt to resolve the situation, the NMCN updated its rules for validating nursing certifications, indicating that they were concerned about the impending threat of brain drain in the country’s health sector.

According to ZINGTIE, the NMCN has changed its standards and conditions in a memo dated February 7, 2024, which must be fulfilled by all applicants requesting the verification of their certificate(s) with overseas nursing boards/councils.

It stated that candidates must have two years of qualifying experience and pay a non-refundable application fee in order to request the verification of credentials to overseas nursing boards and councils.

Signed by Dr. Faruk Umar Abubakar, the Registrar/Secretary General of NMCN, the memo was sent to the following recipients: All States Ministry of Health & Federal Capital Territory, Abuja; University Teaching Hospitals/Specialist & Federal Medical Centre; Chief Medical Directors/Medical Directors; National President; Directors of Nursing Services; Heads of Department; Provosts & Principals; Coordinators; Zonal Officers; and National Association of Nigerian Nurses and Midwives, National Headquarters, Abuja.

The circular was also distributed to all nursing and midwifery council of Nigeria zonal offices, colleges of nursing sciences, schools of nursing & midwifery, all post-basic nursing programmes, hospitals management boards, all states, and the federal capital territory.

It provided that, “Eligible applicants must have a minimum of two (2) years post qualification experience from the date of issuance of the permanent practising licence. Any application with a provisional licence shall be rejected outrightly.

“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, Nursing and Midwifery Council of Nigeria. Please note that the Council shall not accept such letter(s) through the applicant.

“Applicants must have an active practising licence with a minimum of six months to the expiration date. Applicants must upload Certificate(s) of Registration only. Notification of Registration is not acceptable.

“The applicant shall receive prompt notice via his/her email and dashboard on the status of the verification application.

“Please note: Processing of verification application takes a minimum of six (6) months. All applicants shall ensure that complete requirements are met before initiating verification application as incomplete documentation shall not be processed.”

According to ZINGTIE, the NMCN is the only corporate, legal, administrative, and statutory organization tasked with carrying out specific duties on behalf of the federal government in order to guarantee that the general public receives safe and effective nursing and midwifery care through top-notch instruction and industry best practices.

The law gave the council the authority to control the standards for nursing and midwifery practice and education in Nigeria and to periodically evaluate these standards in light of the evolving health needs of the populace.

There are signs, though, that nurses and other medical professionals are protesting the new development, claiming the rules and specifications amount to a violation of human rights.

The health workers emphasized that no regulatory body had ever required years of service or requested job experience as a requirement for verification.

The National Association of Nigeria Nurses and Midwives (NANNM), Abuja and Lagos chapters, organized a demonstration in which the nurses voiced their opposition to the new circular on certificate verification (NMCN) and against the policy.

To vent their resentment, the nurses gathered at the NMCN offices in Lagos and Abuja. They declared that the new limits were an attempt to limit their freedom and threatened a national walkout.

At the NMCN office, the midwives and nurses were peacefully protesting, singing, and carrying placards throughout the building.

Some of the placards read, ‘Address unemployment among nurses, address quackery, address nurses welfare’.

Others are: ‘#No to verification rules,’ ‘Stop frustrating the Nigerian nurses,’ ‘We are going through a lot already, Protect nurses, protect healthcare,’ ‘NMCN, we say no to the verification rules,’ NMCN don’t reduce nurses.’

Meanwhile, some others took to social networks to protest against the policy.

For instance, a public health nurse, identified as @DTechNurse on X, said, “It is absolutely wrong to attach Nigerian nurses’ verification conditions to Chief Executive Officers who are always Medical Doctors.

“Nurses now await the approval of a medical doctor before they can make progress in their career. This decision has to be reversed.”

Also, @AlongeElijah wrote, “Nonsense!!! This is a denial of human rights, and it shall be informed to @ICNurses @WHO @UNHumanRights. Haven been verified by different nursing bodies around the world. There has never been an occasion where regulating bodies asked for work experience or mandated years of service”.

The group of Federal Health Institutions Heads of Nursing Services Departments and Principals of Schools (BOHNAPFHI) reacted by pleading with the Council to examine the guidelines and remove any clause that would impede the NMCN’s early licensing verification process for professional nurses.

The association urged the Council to review some of the circular’s contents in a letter signed by its chairman, Dr. (Mrs.) Awoseemo Aderonke, and addressed to the Registrar/Secretary General of NMCN. This was done to prevent a situation in which physicians or other professionals determined nurses’ advancement and development.

According to the group, “verification of license issued by NMCN is to ascertain whether the one presented by the applicant is issued by it and not fake, stressing that it should have nothing to do with either character or working experience of the applicant.

“I am directed by the body of the Head of Nursing Department and Principals of Schools in Federal Health Institutions (Basic and Post) in Nigeria to request and urge you to review some contents of the circular to avoid a situation where the progress and development of Nurses are subjected to the determination of medical doctors or other professionals.

“Thus, affirmation of the character of graduands has to be attended by the head of the training institution, who is a professional nurse. While the license to practice should be verified by the issuer, that is, the Nursing and Midwifery Council of Nigeria. (NMCN).

“We would appreciate it if you could further review the guidelines and delete any item likely to frustrate early verification of the licence issued to professional nurses by NMCN. It is our opinion that verification of the license issued by NMCN is to ascertain whether the one presented by the applicant is issued by the NMCN and not fake. It should have nothing to do with either the character or working experience of the applicant.

“In addition, we humbly suggest that the NMCN should endeavour to carry nurse leaders along when taking such salient decisions in order to prevent regression.”

In three years, more than 42,000 nurses departed Nigeria – FG.

In the meantime, over 15,000 nurses and midwives departed Nigeria in 2023 in search of better opportunities abroad, according to the Nursing and Midwifery Council of Nigeria.

While answering questions over the contentious changes on Channels Television’s Morning Brief on Tuesday, NMCN registrar Faruk Abubakar said this.

Abubakar cited the annual increase in the number of nurses departing the nation as justification for the updated guidelines for nurse verification.

“42,000 nurses left the country in the last three years. Last year alone, it was over 15,000; the number is increasing yearly”, he said.

In response to a question about the Council’s efforts to safeguard and enhance the welfare of nurses, he stated that the Federal Ministry of Health was attempting to raise the pay, benefits, and working conditions for nurses.

“The FMoH and the honourable Minister of State (for health) are working hard to ensure a conducive working environment, providing state-of-art equipment and instruments to help them provide quality care for Nigerians.

“And I want to assure (you) that within a couple of months, a lot has been integrated and provided in 2024 that will improve the welfare of the nurses we are talking about. When talking about the salary they are talking about, I think it’s a general phenomenon, and I believe it’s a general thing.

“There is a lot of progress going on to review the salary, and nurses are also included in that policy. I think it’s a general phenomenon; all other sectors are also complaining, and the government is doing a lot,” he stated.

Dr. (Mrs.) Awoseemo Aderonke, the Chairman of the Nursing Services Department and Principals of Schools in Federal Health Institutions, BOHNAPFHI, spoke with ZINGTIE about the topic and stated that her association was more concerned about the issue of professional autonomy.

According to Aderonke, BOHNAPFHI needs to respond better to medical professionals’ requests for a character certificate. She also stated that this development may bring the nursing profession back to prehistoric times.

Even if such a proposal is necessary, she suggested, it should come from a training facility.

She asserted that actions might be taken to guarantee that the country kept its youth in the workforce so they could serve their country.

She said: “You know the group is the group of leaders in nursing, both in practice and education, for those of us that work in federal institutions in Nigeria. So it’s a group of my people, it’s a group of leaders that are ready to ensure that we uphold the standard of nursing profession and plan for better life for the younger ones and the future generations.

“Actually, I will say we are a body and we have an association, we have the umbrella association which is supposed to be the National Association of Nigerian Nurses and Midwives.

“And we have a branch of it that covers the federal health institutions. So the president and the chairman of those groups have been informed. They were copied concerning our own view as nurse leaders in federal institutions both in nursing practice and education.

“We don’t want to exceed anything outside our paper because very soon we are going to hold our meeting, our conference.

“And when we hold our conference, we will come up as a body to look at issues, because the interest of everybody and interest of the Registrar of Nursing and Midwifery Council of Nigeria, NMCN, and the entire nurse leaders is to ensure that the people – the citizens, they get the best at every point in time.

“With that at the back of our mind, I believe there are steps that could be taken to ensure that we are able to retain our young ones in the profession in order to serve their nation.

“The only issue that is being stressed by my own association is the professional autonomy because when they talked about Chief Executive Officer, CEO, and looking at Nigeria, the CEO in federal institutions for now are medical doctors.

“We are convinced and we know that the operation of our amiable Registrar is to ensure reforms and professionalism of nursing to get better on a daily basis because he has come up with many reforms, which we believe, every member of my forum will always drop caps for this action of the man.

“So, the issue of asking for the nurse’s character or certificate of character from the medical doctors doesn’t go down well with us because we cannot take our profession back to the stone age.

“Moreover, the nurses prepare these people. It’s expected that the head of the training institution, either the head of nursing department or nursing science department in our universities or the head of program in each of our various colleges of nursing sciences and principals of schools – are the one that are expected to comment on their character.

“What we are actually talking about is the verification of certificates. For you to have that certificate, you are expected to have gone to a certified training school, well accredited.

“When we talk about accreditation, we talk about all the resources in terms of personnel and infrastructure and all things that are there. And since they are adequate and the person is presented for the professional exam, and the person passed – the professional exam we are talking about is being organized by the Nursing and Midwifery Council of Nigeria with the help of leaders in nursing education and practice, that means everything about it is about nursing.

“It’s expected that even if there’s a need for such a recommendation, it should be from a training institution. That’s what we are really emphasizing.”

Suggesting further on how the profession could retain its best, Aderonke said, “Another aspect of it I want us to talk about that we mentioned in our letter is that the Council has the responsibility to verify certificates; it’s the Council that issues the license and certificate. That means it is the issuer that has those responsibilities.

“The emphasis of our leaders, yes, we have the concern of our community.

“It is a personal decision, either for you to stay or want to go. I don’t believe you can coerce people but people can be encouraged in many ways. People can be motivated in many ways to stay. And part of the motivation is this professional autonomy that we are talking about.

“We can’t sell professional autonomy out. We can’t trade with it because that is what we have been doing and building in order to ensure that nursing as a profession also stands out as one of the best professional groups in the nation.

“I believe there will always be a way out. Yes, the interest of our people is very important, it’s dear to us. I know some people that are just encouraged that they want to stay. There are people that even traveled and they came back again, and they were able to bring the skills they acquired there for the benefit of the community.

“I think as we talk about the freedom of movement, if we put in some things to motivate them, to encourage some people, they could even say, ‘I want to go in the next two years’. When you’re being motivated, you can say ‘Okay, let me spend five years serving the land for me to go and explore’.

“This is what we are saying. Actually we are not attacking the Registrar. The Registrar is very amiable. He’s a man that listens to advice. But you know as leaders, sometimes you make decisions, you may look at things from different dimensions.

“That’s what we are battling with, even in education; people don’t want to come into academics again because there’s nothing really much motivating them. It’s not easy. If you go to many of our institutions now, many of our educators, for us to get lecturers, it’s not an easy matter.

“I believe if we have this motivation, when they go for workshops, you sponsor them. When they have to go for training – things that will develop them, you give them necessary support. Nobody will look out for other things.

“If you look at our country Nigeria, we are so much blessed. Look at our weather, climate and many other things. Look at our social setting – you rarely see people getting crazy, except some people that go into addiction or whatever. Because if I have something bothering me, I have somewhere to ventilate, you know, my colleagues will advise me.

“The federal government, state governments, private sector, and all the groups should motivate their personnel, not only the nurses but even the medical persons.

“When they are working with them, they need motivation. Everything is not about money; people need fulfillment. Yes, money is also very important to take care of your basic needs.

“Look at the situation of things in the country today but salaries still remain the same. The government should keep them motivated and accord them the honour.

“With this, one may not even feel the need to go out. The only thing that can take them outside the country is to acquire more skills to serve their community.”

In the meantime, some National Association of Nigerian Nurses members are accusing Mr. Michael Nnachi, the association’s president, of compromising.

However, ZINGTIE’s attempts to contact Nnachi were unsuccessful since he should have attended the interview he had set up with our journalist.

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