By Kayode Adebiyi
For decades, Nigeria’s healthcare system has been held in a tight grip by recurring
industrial actions, with a cycle of ultimatums, warning strikes and indefinite
industrial action.
These disruptions have become a grim and agonisingly regular occurrence.
Even in the turn of the New Year, the sector continues to face turbulence over
salary adjustments and working conditions.
Recently, after 84 days of downing tools, the Joint Health Sector Unions
(JOHESU) suspended its nationwide strike following an agreement with the
Federal Government to implement unsettled salary adjustments and other
outstanding demands.
The suspension was announced in a communiqué jointly signed by JOHESU
National Chairman, Mr Kabiru Ado-Minjibir, and National Secretary, Mr Martin
Egbanubi.
“After exhaustive deliberations and review of the terms of settlement of the
conciliation meeting, the expanded NEC-in-Session voted unanimously to suspend
the ongoing indefinite nationwide strike action to allow for the implementation of
the FG-JOHESU Terms of Settlements,” the communiqué read.
According to the communiqué, key resolutions include the commencement of
Collective Bargaining Agreement (CBA) negotiations and immediate prioritisation
of outstanding issues on the adjustment of the Consolidated Health Salary
Structure (CONHESS).
While the suspension of the strike comes as a relief to many, some stakeholders are
questioning why non-implementation of agreements often triggers such strikes.
In the case of JOHESU, the strike was called on Nov. 15, 2025, as a result of the
non-implementation of a 2014 demand for CONHESS adjustment and other
outstanding welfare issues.
It is important to note that JOHESU only constitutes a fraction of workers’ unions
in the health sector, as its membership constitutes health workers such as
laboratory technicians, pharmacists, health registrars among others.
Recall that JOHESU’s counterparts in the Nigerian Association of Resident
Doctors (NARD) only recently suspended a planned nationwide strike scheduled
for Jan. 12.
The decision to suspend the strike followed negotiations with the government, but
the union issued a 4-week ultimatum to address demands.
NARD is demanding the payment of 2025/2026 Medical Residency Training Fund
(MRTF), 25-35 per cent CONMESS arrears, and improved and safe working
environments.
The suspended strike was supposed to be a follow up to NARD’s strike in late
2025 concerning unpaid salaries, poor working conditions, and inadequate
infrastructure.
Also, in August 2025, the National Association of Nigeria Nurses and Midwives
(NANNM) had to force the Nigerian government to the negotiating table after a
four-day strike.
The association was demanding, among other things, an end to unsafe staffing
ratios, poor wages, and failure to gazette the 2016 Nurses Scheme of Service.
In the Memorandum of Understanding (MoU) signed with NANNM, the
government agreed an accelerated implementation of some of the union’s demands
within four weeks of the formalisation of the MoU.
Experts such as Dr Obinna Oleribe, a Public Health Management Consultant, have
constantly emphasised that the first step towards ending incessant strikes by health
workers is to end institutional distrust fueled by years of unfulfilled promises.
They point out that the primary trigger for strikes is not just the demand for more
money, but the failure of the government to implement signed MoU.
“What is the essence of going into an agreement with a group, signing that you will
implement your side of the bargain at clearly defined timelines only for you to
renegade?
“How do you want the other party to perceive you when you can’t fulfill a promise
you made willingly?” a health practitioner, who prefers anonymity, asked.
He said it had become typical of the government to treat industrial disputes with a
“fire brigade” approach.
He said there had to be a fundamental shift in how the government and other
stakeholders approach labour relations.
“It is not peculiar to the health sector; a similar approach is deployed in responding
to labour disputes in other sectors such as education, petroleum, judiciary, and so
on,” he said.
To this end, some stakeholders suggest the establishment of a National Health
Labour Relations Commission to serve as a permanent mediator that tracks and
enforces the implementation of agreements.
However, beyond non-implementation of agreements, some stakeholders have also
identified inter-professional rivalry as a driver of incessant strikes in the health
sector.
They say the rivalry between doctors (NMA/NARD) and other health professionals
(JOHESU) often comes to the fore when one group receives a pay rise and the
other often goes on strike to seek fairness.
JOHESU leaders such as Felix Odusanya have been on record arguing for a
“presidential prerogative” to adjust the CONHESS to match the Consolidated
Medical Salary Structure (CONMESS) adjustments.
To address this rivalry challenge, experts recommend a unified salary structure or a
transparent, job-evaluation-based system.
It is therefore heartwarming that the Federal Government has unveiled a structured
framework aimed at resolving protracted industrial disputes in order to restore
harmony in the nation’s health sector.
Recently, the National Salaries, Incomes and Wages Commission (NSIWC) also
noted that a comprehensive job evaluation is currently underway that is essential to
determining fair placement for all cadres, thereby reducing the supremacy friction.
According to stakeholders, it is imperative for the government to pay better
attention to improving the welfare of health workers, as well as providing modern
infrastructure if it wishes to end the spate of strikes.
The Minister of State for Health, Dr Iziaq Salako, recently highlighted that
excessive work hours and poor environments pose risks to both staff and patients
in public hospitals.
Stakeholders, therefore, urge the government to continue the aggressive
recruitment seen in 2024 and 2025 (over 37,000 new clinical staff) to reduce the
workload that leads to burnout.
They also commend the Federal Government for recently approving an upward
review of the retirement age for skilled clinical health professionals in federal
tertiary hospitals and centres.
Under the new arrangement, skilled clinical health professionals` retirement age
has been increased from 60 to 65 years of age, or from 35 to 40 years of service,
whichever comes first.
Experts say the policy will ensure the retention of specialised skills, strengthen
manpower capacity, and ensure employment security.
“Evoking the policy of “no work, no pay”, often used as a deterrent, should also be
abolished because it only toughens the resolve of unions and deepens animosity,”
an expert said, but warned that ending the incessant health workers’ strikes
requires the government to treat them as partners in progress rather than
adversaries.
Ultimately, experts have warned that it will be difficult to have a healthy nation if
those who provide health are themselves in a state of professional despair.
NAN
