Resident Doctors’ Strike: The Gains, the Pains, and the Road Ahead

By Elvis Eromosele

After one month of strained wards, overstretched consultants and anxious patients, the Nigerian Association of Resident Doctors (NARD) has suspended its nationwide strike. The industrial action, which began on November 1, exposed once again the deep cracks in Nigeria’s healthcare system, from inadequate staffing to unpaid arrears and weak infrastructure.

With NARD announcing the suspension on November 30 after signing a memorandum of understanding (MoU) with the federal government, attention now shifts to what the strike achieved, the disruption it caused, and what must change to avoid the next crisis.

Resident doctors form the backbone of Nigeria’s tertiary healthcare system. They manage most emergencies, handle everyday cases and keep teaching hospitals running 24/7. Their withdrawal of service meant inevitable nationwide disruption.

Their demands were long-standing:

• Better pay and settlement of salary and promotion arrears
• Improved working conditions
• Clear implementation of specialist and other allowances
• Adequate staffing to reduce overwhelming workloads
• Upgraded hospital infrastructure

For years, these issues had lingered without decisive action. By November, frustration peaked, prompting NARD to declare a “total, comprehensive and indefinite” strike.

What broke the impasse was a series of high-level conciliatory meetings between NARD and federal government officials. These talks produced a structured MoU addressing the union’s 19-point demand.

Key points include:

1. Timelines for Clearing Arrears: The federal government committed to settling salary and promotion arrears within four weeks. Hospital chief medical directors were instructed to compile and submit all outstanding promotion cases immediately.
2. Implementation of Allowances: Fresh guidance has been issued on specialist allowances, to be implemented through the National Salaries, Incomes and Wages Commission. Processes for the payment of the 25 per cent and 35 per cent allowances, along with the long-awaited accoutrement allowance, are also underway.
3. Reinstatement of the “Lokoja 5”: A committee recommended the reinstatement of five resident doctors dismissed from the Federal Teaching Hospital, Lokoja, a major symbolic win for NARD, with full implementation expected within two weeks.

These commitments, though promising, rely heavily on timely execution, an area where past agreements have faltered.

While the strike disrupted services nationwide, it also delivered meaningful progress for doctors and, ultimately, the health system.

1. Stronger Recognition of Resident Doctors: Through structured negotiations and a signed MoU, the government reaffirmed the essential role resident doctors play in Nigeria’s healthcare delivery.
2. Clear Deadlines: Unlike previous discussions that ended in vague assurances, this MoU includes concrete timelines, four weeks for arrears and two weeks for reinstatements. This boosts accountability and provides a reference point for future engagement.
3. Welfare Improvements: If carried out as agreed, the new allowances and timely payment structures will improve the financial well-being of resident doctors, many of whom work long hours for modest compensation.
4. A Consolidated Voice: The strike strengthened NARD’s bargaining power and sent a clear message about the need to prioritise health-sector reforms.

Every strike in the health sector comes at a high cost, and this one was no different.

1. Patients Suffered Most: Public hospitals, already stretched thin, struggled. Elective surgeries were postponed, clinics were shut, and patients with chronic conditions faced delayed treatment. For many Nigerians, particularly the poor, this strike deepened mistrust in the public health system.
2. Consultants and Nurses Were Overburdened: Senior doctors and nurses carried the weight of the system, working extra shifts and taking on tasks usually handled by larger teams. The heightened workload increased risks of burnout and medical errors.
3. Economic and Social Costs Increased: Delayed treatments often result in worse medical outcomes, higher treatment costs and reduced productivity. All of these add to Nigeria’s already heavy economic burdens.
4. Brain Drain Pressures Intensified: The strike reinforced the reasons many young doctors leave Nigeria — poor conditions, low pay and endless industrial disputes. The longer such crises persist, the more difficult it becomes to retain talent.

Suspending the strike provides relief, but it does not solve the underlying problems. For Nigeria to break the cycle of recurring industrial action, several fundamental reforms are necessary.

1. Honour Agreements Consistently: Meeting the newly agreed deadlines is essential. Rebuilding trust between the government and health workers depends on reliable follow-through.
2. Increase Health Funding: Nigeria spends far below the 15 per cent Abuja Declaration benchmark. Without greater investment, hospitals will remain under-equipped and understaffed, regardless of how many MoUs are signed.
3. Solve the Staffing Crisis: With thousands of health workers emigrating annually, Nigeria needs a bold retention strategy. This includes competitive remuneration, appropriate staffing levels and better career progression.
4. Modernise Hospital Infrastructure: Many tertiary hospitals rely on ageing equipment and insufficient diagnostic capacity. Investing in modern tools, emergency care facilities and digital health platforms will improve results and reduce system pressures.
5. Stabilise Industrial Relations: The health sector needs more proactive engagement, not crisis-driven meetings. Regular dialogue between the Ministry of Health, hospital management and unions can prevent disputes from escalating.
6. Strengthen Medical Training: Resident doctors are specialists in training. Better funding for teaching hospitals, more structured supervision and clear training pathways will ensure a steady supply of competent specialists.

Nigeria’s resident doctors have resumed work, but their strike was more than an industrial action — it was a reminder that the nation’s healthcare system is stretched to its limits.

The gains from the strike offer hope, but only if the government follows through. The pains highlight the urgency of reform. The path forward demands political will, consistent funding, and a commitment to treating healthcare as a national priority rather than an afterthought.

If this moment becomes a turning point, Nigeria can build a more resilient and equitable health system. If not, another crisis, and another strike, may not be far away.