The Nigerian Association of Resident Doctors has recommended a maximum 48-hour work week for healthcare personnel as part of measures to reduce burnout, fatigue and excessive working hours in Nigeria’s health sector.
Under the proposed work-hour regulations, healthcare workers would also be limited to a maximum of 24 continuous hours of duty, while authorised working hours beyond the stipulated limit would be properly documented and compensated.
The recommendations were contained in a statement signed by NARD’s Publicity and Social Secretary, Dr Abdulmajid Yahya Ibrahim.
According to the association, the recommendations followed deliberations by the Federal Ministry of Health and Social Welfare’s Ministerial Committee on Work Hour Regulation and Casualization of Doctors.
The committee conducted a nationwide assessment involving 6,350 healthcare personnel across Nigeria’s six geopolitical zones.
NARD said the assessment revealed an urgent need to address excessive working hours, burnout, fatigue and inadequate rest among healthcare workers, as well as the potential impact of such conditions on patient safety.
Under the proposed framework, healthcare personnel would work a maximum of 48 hours per week, including weekends.
The guidelines also recommend an eight-hour maximum day shift and a six-hour afternoon shift, while shifts exceeding 12 hours would only be allowed in genuine emergency situations.
Two Calls Per Week
NARD recommended that healthcare workers should not undertake more than two call duties per week, including weekend calls, with a maximum of one weekend call per month.
It also proposed a maximum of 24 continuous hours of duty, inclusive of call duties.
The guidelines provide for at least 12 hours of rest between regular shifts and a mandatory 24-hour post-call rest period following weekday, Saturday, Sunday and public holiday calls.
Healthcare workers would also be entitled to a minimum one-hour break after six hours of continuous work, including during shifts and call duties.
NARD said such breaks should be staggered where necessary to ensure that patient care is not disrupted.
Excess Hours to Attract Compensation
On additional working hours, the association said any authorised excess work must be properly documented and adequately compensated above the normal hourly rate or offset through structured time off.
“Authorised excess work hours must be properly documented and adequately compensated above the normal hourly rate, or appropriately balanced through structured time-off,” NARD said.
The association also recommended protected time for healthcare personnel to engage in research and professional development, subject to approval by relevant health research and ethics committees.
NARD said the recommendations had been forwarded to medical directors and chief medical directors of health institutions for implementation.
“We are pleased to inform all members that these recommended guidelines have been forwarded to all MDs/CMDs for implementation across all health institutions,” the association said.
It urged hospital managements and heads of departments to ensure compliance, while encouraging its members to document cases of non-compliance and report them through their respective centre leadership.
Emergency Situations Exempted
NARD clarified that the recommended limits would not prevent exceptional arrangements in genuine emergencies where patient safety and continuity of care require healthcare personnel to work beyond the stipulated hours.
The association also disclosed that a second document addressing what it described as the “casualization and abusive locum appointments” of doctors would be released soon.
NARD commended the Minister of Health and Social Welfare, Professor Muhammad Ali Pate, and the Minister of State for Health and Social Welfare, Dr Iziaq Adekunle Salako, for supporting the work-hour policy.
It also acknowledged the contributions of its representatives on the ministerial committee, including its Vice-President II, Dr Kwarshak Kevin Yakubu, and Secretary-General, Dr Shuaibu Ibrahim.
The association said the recommendations were aimed at protecting the welfare of healthcare workers while improving the quality and safety of patient care.
“NARD remains committed to protecting the dignity, welfare, rights and professional interests of every Nigerian doctor,” the association said.
It expressed hope that the National Council on Health would approve the recommendations.
