Recruiting new nurses without retaining experienced professionals is an unsustainable workforce strategy.

By Zarau Muhammad Kabir

Kano State risks deepening its healthcare workforce crisis unless urgent steps are taken to improve nurses’ welfare, implement outstanding salary reforms and create better conditions for professional growth.

Across emergency departments, maternity units, neonatal wards and primary healthcare centres, nurses remain central to healthcare delivery. They monitor patients, administer medications, coordinate treatment and provide essential support to patients and their families, often under demanding conditions.

However, increasing numbers of Nigerian nurses are seeking employment opportunities abroad, attracted by better remuneration, improved working environments and clearer career-progression opportunities.

The trend, widely described as brain drain, is raising concerns about the sustainability of healthcare services, particularly in states such as Kano, where population growth continues to increase demand for medical services.

For Kano, retaining experienced nurses is no longer simply an employment matter. It is a critical public-health priority.

Nigeria’s Nursing Brain Drain: A Growing Concern

The scale of Nigeria’s nursing migration is becoming increasingly difficult to ignore.

In May 2026, the President of the National Association of Nigeria Nurses and Midwives (NANNM), Haruna Mamman, reportedly disclosed that more than 57,000 Nigerian nurses had left the country within five years, with approximately 16,000 relocating to the United Kingdom by December 2025.

Although these figures are association estimates rather than independently verified national registration data, they highlight the growing challenge of retaining skilled nursing professionals.

Kano is also experiencing significant healthcare workforce shortages.

In January 2026, health authorities disclosed that the state needed approximately 4,000 additional healthcare professionals to address staffing gaps across its health sector.

Similarly, in October 2026, the Kano State Government announced the recruitment of 2,037 healthcare personnel, including 250 nurses and 250 midwives, while acknowledging that the migration of health professionals was contributing to workforce shortages.

These recruitment efforts are commendable. However, recruitment alone cannot resolve the problem if experienced professionals continue to leave.

A healthcare system that constantly recruits new personnel while losing its trained and experienced workforce risks remaining trapped in a cycle of staff shortages.

Why Nurses Are Leaving

Nurses migrate for several reasons, including inadequate remuneration, limited career opportunities, challenging working conditions and concerns about professional development.

However, salary remains one of the most significant factors influencing decisions to seek employment abroad.

Nursing is a demanding profession that requires technical competence, clinical judgement, emotional resilience and continuous professional commitment.

Nurses are responsible for monitoring patients, administering medications safely, identifying early signs of complications, coordinating treatment and providing critical support during emergencies.

Despite these responsibilities, rising living costs, transportation expenses, housing challenges, family obligations and the financial demands of professional development continue to place pressure on their earnings.

In comparison, many international healthcare employers offer more competitive salaries, better staffing arrangements, improved facilities and structured opportunities for professional advancement.

For nurses facing these realities, seeking opportunities abroad can become an understandable career decision.

The Cost of Losing Experienced Nurses

The departure of experienced nurses creates consequences that extend far beyond the loss of individual employees.

When skilled professionals leave, their responsibilities are transferred to those who remain, increasing workloads and exposing existing staff to greater fatigue, stress and burnout.

The health system also loses valuable institutional knowledge, clinical experience, mentorship capacity and professional leadership.

This is particularly concerning in emergency departments, intensive care units, maternity wards and neonatal services, where timely assessment, continuous monitoring and prompt intervention are essential.

In maternity and neonatal care, for instance, inadequate staffing can place additional pressure on professionals responsible for the health and safety of mothers and newborn babies.

Although staff shortages do not automatically translate into poor patient outcomes, they weaken the conditions required for safe, effective and timely healthcare delivery.

Ultimately, losing experienced nurses can undermine service quality, staff morale and the long-term capacity of healthcare institutions.

CONHESS Implementation: A Critical Retention Priority

Against this background, discussions surrounding the review and implementation of the Consolidated Health Salary Structure (CONHESS) in Kano State deserve urgent attention.

Fair and timely remuneration is not simply an additional employment benefit. It is an important recognition of the responsibilities, professional expertise and contributions of healthcare workers.

For nurses, improved remuneration can strengthen morale, reduce financial pressure and address one of the major concerns influencing workforce retention.

Uncertainty surrounding salary reform and its implementation has understandably generated concerns among nurses and their representatives.

The Kano State Government should therefore provide clear and timely information on the status of CONHESS-related discussions, outstanding administrative requirements and the expected implementation timeline.

Any announcement concerning formal approval or an agreed implementation date should be backed by an official government or relevant institutional communication.

More importantly, salary reform should move beyond discussions and become part of a broader commitment to improving healthcare workers’ welfare.

Investing in nurses’ remuneration is an investment in workforce stability. Without meaningful action, Kano risks spending resources on recruitment while continuously losing the experience and expertise needed to strengthen its health institutions.

Beyond Salary: Five Steps Kano Must Take

While improved remuneration is essential, addressing the nursing workforce crisis requires a comprehensive retention strategy.

The Kano State Government and relevant stakeholders should prioritise the following measures:

1. Prompt implementation of CONHESS

Government should conclude outstanding processes and ensure the timely implementation of applicable salary reforms and entitlements in line with established agreements and procedures.

2. Improved working conditions

Healthcare facilities need adequate staffing, functional medical equipment, safer working environments and appropriate staff-welfare arrangements. Nurses cannot deliver their best when they operate under persistent institutional constraints.

3. Professional development and career advancement

The government and healthcare institutions should expand access to postgraduate education, specialist training, leadership development and other professional opportunities.

Nurses should be able to advance their careers and acquire specialised skills without feeling compelled to leave Nigeria to achieve their professional ambitions.

4. Reliable nursing workforce data

Kano needs an effective nursing workforce database that tracks recruitment, retirement, resignation, migration and staff retention.

Reliable data would help policymakers identify workforce gaps, anticipate future needs and develop evidence-based recruitment and retention policies.

5. Sustained engagement with NANNM

The government should maintain regular and constructive engagement with the National Association of Nigeria Nurses and Midwives.

Nurses and their professional representatives must have meaningful opportunities to contribute to decisions affecting remuneration, working conditions, professional development and workforce planning.

Government Leadership Is Essential

Addressing the nursing workforce crisis requires collective responsibility from government, professional associations, healthcare institutions and other stakeholders.

However, the leading responsibility rests with government because it determines the policies, funding priorities and institutional arrangements necessary to create a sustainable healthcare workforce.

The objective should not be to prevent nurses from pursuing professional opportunities elsewhere. Rather, it should be to make working and building a career in Kano an economically sustainable, professionally rewarding and attractive choice.

Recruitment without retention is an incomplete workforce strategy. Similarly, delayed salary reform risks weakening nurses’ morale, motivation and willingness to remain in the public healthcare system.

A healthcare system that fails to adequately value its nurses ultimately undermines its own capacity to deliver quality services.

Nurses deserve fair remuneration, professional recognition and dignified working conditions. Patients deserve accessible and quality healthcare. Kano State deserves a healthcare workforce that is adequately supported, motivated and retained.

The future of healthcare in Kano cannot be secured through recruitment alone. It must begin with valuing, supporting and retaining the nurses who continue to serve.

Zarau Muhammad Kabir, RN, BNSc, is a registered nurse and Secretary-General of the National Association of Nigeria Nurses and Midwives (NANNM), Unit Branch, Sir Muhammadu Sanusi Specialist Hospital, Kano State.