WORKFORCE MOBILITY AND HEALTH INSTITUTIONAL PERFORMANCE IN NIGERIA: A STUDY OF AKWA IBOM STATE

This study examined health workforce migration and its implications for institutional performance within Nigeria’s public health sector, with particular reference to Akwa Ibom State. It was motivated by the continuous outflow of health professionals despite the introduction of various health sector reforms and residency training initiatives, which raised concerns about the effectiveness of governance structures and institutional performance in the health system. The study adopted a descriptive and documentary research design, drawing on both primary data obtained through interviews with health workers, hospital administrators, and policymakers, and secondary data sourced from relevant scholarly and policy literature. Thematic analysis was used to interpret the qualitative data. The findings indicated that health workforce migration had continued to exert a significant negative influence on the performance of public health institutions in Nigeria. Health sector reforms had produced limited outcomes due to persistent gaps between policy formulation and implementation, weak institutional coordination, and inadequate accountability mechanisms. These governance deficiencies contributed to poor working conditions, infrastructural decay, and persistent staffing shortages, all of which undermined service delivery and institutional efficiency. Similarly, residency training programmes were found to have been constrained by limited capacity, inadequate infrastructure, and systemic inefficiencies. Rather than functioning as an effective retention strategy, these programmes increasingly served as a pathway for international migration among medical professionals. The study therefore concluded that health workforce migration in Nigeria was largely driven by institutional weaknesses and governance failures rather than the absence of policy interventions, resulting in weakened performance of the public health sector. It recommended that government should strengthen policy implementation through improved accountability and monitoring mechanisms, invest more substantially in healthcare infrastructure and working conditions, and expand and reform residency training programmes to enhance capacity and reduce migration incentives among health professionals.