Recent strikes in Nigeria, the DRC, and Ghana highlight the chronic underfunding and workforce shortages undermining Africa’s healthcare sector, where reforms have yet to match the scale of the crisis.

In late July 2025, Nigeria’s National Association of Nurses and Midwives (NANNM) launched a weeklong nationwide warning strike after a 15-day ultimatum demanding better working conditions expired without government action. The union was calling for higher pay, the creation of a nursing department within the Health Ministry, and large-scale recruitment to offset the exodus of thousands of healthcare workers in recent years.

Doctors in the Democratic Republic of Congo went on strike in the middle of a cholera outbreak, citing a lack of medicine, equipment, and personnel. Weeks earlier, in June, Ghanaian nurses walked off the job to protest low wages, deteriorating working conditions, and the rehiring of retired staff to fill persistent shortages.

Around the same time, doctors in the Democratic Republic of Congo went on strike in the middle of a cholera outbreak, citing a lack of medicine, equipment, and personnel. Weeks earlier, in June, Ghanaian nurses walked off the job to protest low wages, deteriorating working conditions, and the rehiring of retired staff to fill persistent shortages.

Deep-seated causes keeping the sector under strain

These strikes reflect a deeper crisis. In many African countries, healthcare workers earn below the median income, often without risk allowances and with frequent payment delays. A December 2023 study published in Human Resources for Health, covering 33 African countries, found that medical salaries account for only 29 percent of national health budgets, less than $50 per capita, underscoring chronic underinvestment in a sector deemed critical.

The World Health Organization notes that Africa bears more than 24 percent of the global disease burden but has just 3 percent of the world’s health workforce. In several countries, the ratio of health workers to patients is ten times lower than the global average, driving burnout and discontent.

Working conditions continue to deteriorate. Aging equipment, medicine shortages, crumbling facilities, and insecurity in hospitals complicate daily operations. A 2023 joint report by the WHO and UNICEF found that nearly 40 percent of healthcare facilities in sub-Saharan Africa lack access to clean water, electricity, or basic medical supplies.

Working conditions continue to deteriorate. Aging equipment, medicine shortages, crumbling facilities, and insecurity in hospitals complicate daily operations. A 2023 joint report by the WHO and UNICEF found that nearly 40 percent of healthcare facilities in sub-Saharan Africa lack access to clean water, electricity, or basic medical supplies.

Efforts at social dialogue have produced limited results. Negotiation mechanisms between unions and government authorities remain weak and poorly institutionalized. According to the International Labour Organization, this lack of structure hampers progress on working conditions. Meanwhile, migration to wealthier regions is accelerating. Between 2022 and 2023, an estimated 4,000 to 20,000 African health professionals left for Europe or North America, according to the Migration Policy Institute and Doctors Without Borders, further straining national systems.

Limited progress despite reform efforts

Several governments have attempted to address the crisis. In Nigeria, authorities signed a memorandum of understanding with NANNM to suspend the strike. Reuters reported on August 2 that the government pledged to begin implementing some of the union’s demands within four weeks of the agreement.

Kenya launched the Partnership for Education of Health Professionals (PEP) in 2024 to strengthen medical training in collaboration with the Kenya Medical Training College and the Novo Nordisk Foundation. Rwanda has tripled its training capacity under the “4x4 Government Health Reform,” according to the Health Ministry.

Other countries are experimenting with retention measures. Namibia and South Africa have introduced bonuses and subsidized housing for healthcare workers in remote areas. Regional projects supported by the WHO and public-private partnerships are helping upgrade equipment and expand professional training.

Other countries are experimenting with retention measures. Namibia and South Africa have introduced bonuses and subsidized housing for healthcare workers in remote areas. Regional projects supported by the WHO and public-private partnerships are helping upgrade equipment and expand professional training.

In Benin, pay and status reforms have been underway since 2022. Salaries have increased by up to 56 percent across professional categories, while a decree now governs on-call allowances, backed by a dedicated 2-billion-CFA franc (about $3.5 million) budget. Additional hardship allowances are available for remote postings. The government says more than 1,600 new staff have been hired, ensuring the presence of at least one qualified health worker in major municipal clinics.

These initiatives signal governments’ intent to improve conditions for healthcare personnel, but their impact remains limited given the scale of the challenge. International reports stress that lasting progress will require stable funding, stronger governance, and regular social dialogue between unions and authorities.

Building sustainable capacity will also depend on integrating digital tools into training, workforce management, and healthcare delivery. For many African countries, the priority now is to maintain reform momentum and long-term support systems to stabilize a profession that is vital to the continent’s development.

Félicien Houindo Lokossou