What are the return propensity of Nigerian medical doctors in the UK?

World Health Organization (WHO 2019) workforce projections suggest that by 2030, there will be a shortfall of about 18 million healthcare workers worldwide. Asia and Africa are the continents predicted to have the largest shortfalls, as many of their doctors are migrating to High Income Countries (HICs) (WHO 2019). Duvivier et al. (2017) have estimated that around one fifth of African-born doctors are working in HICs, and some African countries lose up to 70% of their health workforce to these countries.

The WHO suggests the desirable doctor-population ratio is 1:1,000 (Kumar and Pal 2018). Thus, with a population of over 200 million citizens in Nigeria (World Bank 2020), the country needs at least 200,000 doctors. However, only about 75,000 doctors were registered with the Medical Council of Nigeria in January 2020 (Ezigbo 2020) and in 2018, around 33,000 of Nigeria's registered doctors were practising abroad (Ihua 2018); with just under one in five of these (6,974 in 2019) working in the UK (African watch 2019).

This study aims to understand the migration of Nigerian doctors to the UK, their labour market experiences and the factors that might influence doctors' decisions to stay in the UK or return to Nigeria. Nigerian doctors are a free-moving group, whose skills are highly demanded in the world. The findings could aid the development of better policies to support Nigerian doctors working in the UK, or to make it easier for doctors to return to Nigeria. The findings could also inform policies for Nigeria to retain its doctors. Furthermore, it is envisaged that this study will contribute to the academic literature on the consequences of structural, financial and resource imbalances in a global system, by combining a focus on both the micro-and macro-level factors associated with migration decisions.

The research has the following objectives:
1. To identify the factors affecting Nigerian doctors' decisions to stay in the UK or return to Nigeria.
2. To appraise the labour market experiences of Nigerian doctors in the UK.
3. To understand how Nigerian doctors contribute to Nigeria from the UK, if at all.
4. To assess any measures currently adopted by the Nigerian government to attract its doctors back from the UK.
5. To investigate current migration policies in Nigeria, and their effectiveness.
6. To evaluate the benefits of return migration to Nigeria.
7. To access how the situation and decision-making of Nigerian doctors practising in the UK have been affected by the Covid-19 pandemic.

I will adopt a mixed methods approach of data collection, which is endorsed as appropriate for investigating complex social phenomena (Creswell 2011) such as migration (Crush 2019). The mixed methods approach will consist of an online survey, focus groups, and semi-structured interviews with Nigerian doctors in the UK. I will also review and analyse the Nigerian government policies and practices on return migration of medical doctors.

I will invite the respondents who complete the survey to participate in a further stage of the research: either an online focus group or an interview, or both, depending on their preference. There will be three discrete categories of participants for the online focus groups: those participants who have the definite intention of returning home; those who do not have the intention of returning home; and those who are undecided on their return intentions. These different groups with diverse return intentions will help in building a holistic picture of the return propensities of Nigerian doctors in the UK, which is a current gap in knowledge.

The study of return migration policies will involve fieldwork in Nigeria to identify relevant documentary material. In addition, interviews will be conducted with key individuals involved in formulating and implementing return migration policies.