Understanding the exodus: a 15-year retrospective cohort study on the pattern and determinants of migration among Nigerian doctors and dentists

Abstract

Background: Nigeria faces a critical shortage of healthcare professionals yet experiences a significant annual exodus of doctors and dentists. This alarming trend threatens the country’s ability to provide equitable healthcare. Objective: This study investigated the patterns and determinants of migration among doctors and dentists who graduated from the University of Benin, Nigeria, 15 years ago. Methods: We conducted a retrospective cohort study that tracked 274 of the 379 (72.3%) eligible cohort. We computed the migration incidence rate per person-year from 2008 to 2023, covering 3,455 person-years of follow-up and analysed migration drivers as push and pull factors across macro-, meso-, and micro-levels. Results: Fifteen years post-graduation, 48.9% (134/274) of the cohort had migrated. While the annual incidence rate of migration remained stable for the first 8 years, it spiked after 2016, reaching 11.4 per 100 person-years in 2023. Among those who migrated, the majority (96.3%, 129/134) relocated outside the African continent. The top three destination countries were the UK (48.5%, 65/134), Canada (20.9%, 28/134), and the USA (19.4%, 26/134). The leading push factors were insecurity of lives and property (57.8%), concerns about children’s futures (50.3%), and limited career development opportunities (45.9%). The primary pull factors included security (56.3%), permanent residency (49.6%), and better pay in the destination country (46.7%). Significant predictors of migration included younger age, timing of marriage, and residency training status. Conclusions: To avert an impending crisis, the Nigerian government must address the root causes driving the increasing migration of doctors and dentists.