Posted on: Fri 15-08-2025

For decades, Nigerian nurses and midwives have been the quiet heartbeat of the nation’s healthcare system — tending to patients, managing wards, and keeping hospitals running often under difficult conditions. Their work has been largely without protest. But the silence has broken.

Two weeks ago, the National Association of Nigerian Nurses and Midwives (NANNM) embarked on a nationwide warning strike — the first in over four decades. The last time nurses downed tools on a national scale was in 1984. This time, their demands stretch beyond wages, focusing instead on long-standing structural reforms to restore dignity to the profession and prevent the health sector from further decline.

At the heart of their demands are: the gazetting of the nurses’ scheme of service approved by the National Council on Establishment in 2016, implementation of a 2012 National Industrial Arbitration Court ruling in their favour, creation of a nursing department within the Federal Ministry of Health, upward review of shift and uniform allowances, a separate salary structure, mass recruitment of nurses, and recognition of consultancy roles for qualified practitioners.

NANNM leaders stress that these are not mere financial requests. “Allowances are not the major issues here,” said the association’s Secretary General, Thomas Shetima. “It is about recognition, proper structures, and the ability to deliver quality care.”

A Crisis Exposed

The strike underscored long-simmering grievances. Nurses — who make up 65 per cent of Nigeria’s healthcare workforce — say they are routinely excluded from hospital policy-making and lack a dedicated directorate to oversee discipline, promotion, and professional development. The absence of adequate staffing means that in some facilities, one nurse cares for more than 20 patients at a time, far from the WHO’s recommended ratio of one nurse to four patients.

As Nigeria battles the “Japa” wave of skilled health workers leaving for better opportunities abroad, the impact on hospitals is evident. NANNM estimates that over 75,000 nurses and midwives have left the country in just five years. UK data shows that over 15,000 Nigerian-trained nurses and midwives have been licensed there since 2017.

The Cost of Neglect

Fertility Nurses Association of Nigeria president, Ebelechukwu Onwuagbaizu, called the strike “historic,” noting it was the first time nurses had acted independently of other health professionals. She argued that excluding nurses from policy-making is “sad and counterproductive,” given their central role in patient care. “There is no healthcare without nurses,” she said. “When doctors go on strike, services often continue. But when nurses withdraw, hospitals stall.”

Civil Society Legislative Advocacy Centre director, Auwal Rafsanjani, described the nurses’ demands as “realistic and long overdue,” warning that even a two-hour nurses’ strike could cause a severe health crisis. He criticised the government’s formation of yet another committee to address the matter, calling it “a bureaucratic delay tactic” that risks deepening mistrust between workers and the state.

State-Level Struggles

In Oyo State, NANNM council secretary Dr Samuel Adeyemi lamented the non-payment of the new minimum wage to nurses at LAUTECH Teaching Hospital, despite agreements reached earlier in the year. He also criticised the failure to pay uniform allowances and to implement career progression for nurses who gain higher qualifications — a system already adopted in Osun State.

Adeyemi painted a stark picture of staffing shortages, with some units operating at one nurse for every 20 patients. “We derive joy from caring for the sick,” he said, “but when dialogue fails, industrial action becomes unavoidable.”

A Turning Point

The strike may have been brief, but it has revealed how close Nigeria’s nursing workforce is to breaking point. For many, the fight is not just for improved conditions, but for the recognition that their work is indispensable to the health and survival of millions. Without urgent reforms, the country risks losing not only more of its nurses to migration — but also the stability of its healthcare system itself.

---

---