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No WHO-recommended ratio of doctors to patients, as former Nigerian senator claimed

While discussing healthcare innovations, Lanre Tejuoso, the former chairperson of a Nigerian senate committee on health, sought to quantify the country’s shortage of doctors.

According to a July 2021 story in national daily Thisday, Tejuoso said the country’s population was about 200 million. 

This meant that the “density” of patients to doctors was high, when the World Health Organization (WHO) “has already prescribed the minimum expectation as one doctor to about 400 or 600 patients”, he reportedly said.

“However in Nigeria, we have a doctor to about 40,000 patients,” he said, as he criticised the loss of the country’s medics to countries such as the UK and US. 

But were Tejuoso’s claims about the doctor shortage accurate?

Claim

Nigeria has one doctor to 40,000 patients.

Verdict

Understated

This claim was also picked up by other media outlets. But Tejuoso told Africa Check he was misquoted. 

“It is approximately one to 4,000,” he said.

Experts have previously told Africa Check that because estimating the number of patients at any given time can be difficult, the doctor-to-population indicator is often used to represent coverage.

The number given for how many doctors are available to Nigeria's population has varied. 

In April 2019 the Nigeria Medical Association said there were 40,000 doctors taking care of 200 million people. Some media reported it as 42,000 doctors. This gives a ratio of one doctor to about 5,000 people.

Dr Oluwatosin Wuraola Akande, a public health physician, told Africa Check that to get the best estimate, we should find out the number of doctors currently registered with the Medical and Dental Council of Nigeria

In 2019, the council said 39,912 doctors were registered with it as of December 2017. This is the most recent data available from the council.

Based on this, the doctor-to-population ratio would be one doctor for up to 5,000 people.

Nigeria’s population is also higher, with the most recent official estimate being 211.5 million people. This would be a ratio of nearly one doctor for 5,300 people.

Claim

The WHO’s minimum recommended ratio is one doctor to between 400 and 600 patients.

Verdict

Incorrect

Africa Check has found several instances where an ideal ratio of doctor to patients or to the population is quoted, supposedly recommended by the WHO, including by Nigeria’s labour and employment minister Chris Ngige.

But the WHO says it does not prescribe any ideal ratio.

Dr Mathieu Boniol, a statistician at the international health agency, has previously told Africa Check that “a country’s number of healthcare workers should be adapted to its needs and the characteristics of its national health labour market”. 

A WHO spokesperson said they do not recommend a doctor-to-patient ratio because there isn’t a simple answer or one-size-fits-all solution.

"All health systems are different: different organisations, different financial systems, different organisations of the workforce. What could work in one country would not in another."

The agency further told Africa Check: “Any planning for a health workforce should therefore not rely on a single occupation perspective but should include the whole health workforce, across all sectors."

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