JOHESU Opposes Nigerias National Health Facility Regulatory Agency Amid Salary, Policy Disputes

Strains in Nigeria’s Health Sector: JOHESU’s Pushback Against Policies and Proposals

The Nigerian health sector is once again grappling with tensions as the Joint Health Sector Unions (JOHESU) and the Assembly of Healthcare Professionals (AHPA) voice their firm opposition to the proposed National Health Facility Regulatory Agency (NHFRA). Citing fears of industrial discord and legal missteps, the unions have demanded the immediate suspension of the agency’s establishment. Their grievances, however, extend far beyond this single issue, touching on salary inequities, policy implementation, and systemic neglect, all of which threaten to deepen the cracks in the country’s healthcare framework.

At the core of JOHESU’s discontent lies a perception of exclusion and marginalization in the decision-making processes that shape the health sector. The union has accused the Federal Ministry of Health of sidestepping due diligence by introducing the Drug Revolving Fund (DRF) Standard Operating Procedures (SOP) without subjecting it to a legal review. Specifically, they argue that the SOP must align with the Pharmacy Council of Nigeria (PCN) Act of 2022, a legislative framework designed to regulate pharmacy practice and ensure the safe distribution of medicines. By bypassing this legal prerequisite, JOHESU contends, the ministry risks undermining the very regulatory integrity it seeks to uphold.

The issue of salary disparities has also reignited long-standing frustrations. While the Consolidated Medical Salary Structure (CONMESS) has seen periodic adjustments, the Consolidated Health Salary Structure (CONHESS)—which covers non-physician health workers—has remained stagnant since 2014. This disparity, JOHESU argues, not only erodes morale but also exacerbates divisions within the healthcare workforce. The union has called for immediate adjustments to CONHESS, alongside the release of seven months’ worth of arrears stemming from a previous salary review. For many health workers, these demands are not just about financial equity but also about recognition of their contributions to the sector.

On a more positive note, JOHESU has expressed approval of the federal government’s decision to increase the retirement age for health workers. However, this approval comes with a caveat: the union has rejected any attempt to differentiate between clinical and non-clinical staff in the application of the new policy. According to JOHESU, the 70-year retirement age must apply uniformly to all consultants, irrespective of their specific roles. The union has also reiterated the need for better enforcement of consultant pharmacist appointments, a long-standing demand that has yet to be fully realized.

Beyond these immediate concerns, JOHESU has outlined a broader agenda for reform. This includes the reconstitution of boards for federal health institutions, the resolution of issues surrounding allowances, and the elimination of what the union describes as “unfair labor practices.” JOHESU has also called for continuous consultation between the government and stakeholders in the health sector, emphasizing the importance of dialogue in preventing industrial actions and fostering a more harmonious working environment.

The proposed NHFRA has become a lightning rod for many of these grievances. While the agency is ostensibly aimed at improving the regulation of health facilities across the country, JOHESU fears it could lead to further bureaucratic entanglements and conflicts of interest. The union has warned that the agency’s establishment, if pursued without proper consultation, could disrupt industrial harmony—a veiled reference to the possibility of strikes or other forms of protest.

This latest standoff highlights the chronic challenges facing Nigeria’s health sector. For decades, the sector has been plagued by underfunding, inadequate infrastructure, and a brain drain that has seen many of the country’s best and brightest medical professionals seek opportunities abroad. These systemic issues have been compounded by frequent clashes between the government and health workers, with strikes often leaving patients stranded and healthcare services paralyzed.

The grievances raised by JOHESU also underscore a deeper issue: the fragmentation of Nigeria’s healthcare workforce. Physicians, nurses, pharmacists, and other health professionals often operate in silos, with competing interests and priorities. This lack of cohesion has made it difficult to present a united front in negotiations with the government, thereby weakening the sector’s overall bargaining power.

As JOHESU pushes for the implementation of the October 2024 Memorandum of Understanding (MoU) with the federal government, the question remains whether these demands will be met or whether the health sector will once again be plunged into crisis. The union’s insistence on addressing salary disparities, reconstituting institutional boards, and aligning policies with existing laws reflects a broader desire for systemic change. However, achieving this change will require not just government action but also a willingness on all sides to engage in meaningful dialogue.

In the end, the stakes could not be higher. For health workers, these issues are about more than just salaries or retirement ages; they are about dignity, fairness, and the ability to deliver quality care. For patients, the outcome of this standoff will determine whether they can access the services they need without interruption. And for Nigeria as a whole, the resolution of these disputes will be a litmus test for the government’s ability to manage one of its most critical sectors.

As the nation watches and waits, one thing is clear: the path to a more equitable and efficient health system will require more than policy pronouncements and regulatory agencies. It will demand a fundamental rethinking of how the sector is structured, funded, and governed—an undertaking as urgent as it is overdue.