Nigeria’s healthcare system is in crisis—not merely because of disease outbreaks, underfunding, or the flight of skilled professionals, but due to internal strife that is eating away at its very core. The sector now suffers from a persistent and destructive power struggle among healthcare professionals. Doctors, pharmacists, nurses, medical laboratory scientists, and other allied workers are embroiled in a battle for dominance, sidelining the one stakeholder who truly matters: the patient.

To restore the system, we must begin by healing those entrusted to heal others. The warning signs are already evident. Nigeria’s health indicators remain abysmal. Maternal mortality is among the highest in the world—993 deaths per 100,000 live births. Infant mortality exceeds 70 per 1,000 live births. Life expectancy sits shockingly low at 55 years. The country spends less than 5% of its national budget on healthcare—far below the 15% commitment set in the 2001 Abuja Declaration.

While Nigerian health professionals consistently demonstrate excellence and commitment, their efforts are undermined by a fractured system plagued by poor service delivery, fragmented care, and widespread dissatisfaction. Instead of focusing on innovation or improved outcomes, the system grapples with frequent strikes, leadership clashes, and professional turf wars.

Understanding the Root Causes

How did the Nigerian healthcare system become this dysfunctional? Several interwoven factors contribute to the escalating discord:

• Colonial Legacy and Hierarchy: The British colonial health system institutionalised a structure that placed doctors at the top, relegating others to subordinate roles. That structure has never been fundamentally reformed.

• Policy Ambiguities: The National Health Act and schemes of service lack precise role definitions, allowing room for overlapping responsibilities and frequent disputes. For example, vague provisions permit doctors to store and dispense drugs, effectively sidelining pharmacists.

• Siloed Education: Medical and allied health students are trained in isolation. As a result, they enter the workforce with limited understanding of teamwork or mutual respect.

• Ineffective Leadership: Appointments often rely on seniority within a professional cadre, rather than leadership skills, emotional intelligence, or visionary planning.

• Fragmented Unions: Multiple unions—like the NMA and JOHESU—pursue separate, often conflicting agendas. As a result, unity remains elusive.

• Unequal Compensation: Persistent disparities in salaries and benefits create resentment, making reconciliation seem like a far-fetched dream.

Counting the Cost of Disunity

The consequences of this internal war are devastating. Patients endure fragmented care, repeated errors, and frustrating delays. Healthcare teams operate in silos, wasting resources and missing opportunities for innovation. Constant strikes disrupt hospital services and erode public trust. Meanwhile, brain drain continues unchecked, as professionals seek better opportunities in environments where they are respected and valued.

While healthcare professionals in Nigeria argue over titles and territories, their counterparts elsewhere are showing what genuine collaboration can achieve.

Learning from Global Examples

• Canada integrates inter-professional education from the start, fostering team-based care among doctors, nurses, and pharmacists.

• Rwanda, despite limited resources, has built a resilient healthcare system based on mutual respect and effective task-shifting.

• The UK, where many Nigerian doctors trained, appoints hospital leaders based on competence, not professional background. Nurses, pharmacists, and administrators regularly lead major health institutions.

• The United States encourages cooperation through Accountable Care Organizations, where performance incentives are tied to teamwork and patient outcomes.

These models prove that patient-centered systems thrive on collaboration, not competition.

Reimagining Healthcare in Nigeria

We must envision a healthcare system where doctors and pharmacists jointly develop patient treatment plans, nurses and lab scientists coordinate patient monitoring, and leadership roles are awarded to the most competent—regardless of professional background.

This vision is not utopian. It is both achievable and necessary.

The Way Forward: Healing Through Unity

To move beyond the current dysfunction, Nigeria must take bold, coordinated steps:

1. Reform Policy Frameworks: Update the National Health Act to clearly define roles and foster collaborative practices across the sector.

2. Introduce Inter-professional Education: Revamp curricula to include joint training, simulated teamwork, and interdisciplinary projects that build mutual respect from day one.

3. Adopt Merit-Based Leadership: Appoint hospital and institutional leaders based on defined competencies, not hierarchy.

4. Establish a National Health Harmony Forum: Create a permanent platform for dialogue among all health unions and professional bodies to resolve conflicts and co-create solutions.

5. Incentivise Collaboration: Offer grants, awards, and bonuses to institutions that demonstrate effective interdisciplinary teamwork and improved patient outcomes.

6. Promote Attitudinal Shifts: Encourage all healthcare professionals to view one another as allies rather than adversaries. Empathy must replace ego.

Healing Begins Within

Inspirational poet Mattie Stepanek once said, “Unity is strength… when there is teamwork and collaboration, wonderful things can be achieved.” These words ring truer now than ever before. Healing Nigeria’s broken health system requires more than money or infrastructure—it demands a cultural shift rooted in trust, collaboration, and mutual respect.

Healthcare professionals must practice what they preach. They must heal the rifts that divide them, build bridges across professions, and unite under one common mission: to care for the Nigerian patient.

We must lay down our weapons of rivalry and pick up the tools of empathy.

We must remember that behind every unresolved conflict lies a patient in pain, waiting for healing.

Let us rise above ego, embrace unity, and build the kind of health system Nigerians truly deserve.

The patient is waiting—and time is running out.