title: Industrial action by healthcare workers in Nigeria in 2013-2015: an inquiry into causes, consequences and control-a cross-sectional descriptive study.
abstract: Nigeria has suffered from several healthcare workers' strikes in the past 36 months, involving all categories of health workers. Frequent healthcare workers' strikes result in the closure of public healthcare institutions preventing Nigerians' access to quality health services. The purpose of this study was to identify the root cause(s) of strikes by healthcare workers, their effects on the health system and possible solutions to prevent, or at least reduce, industrial action.
  
  
  
  A cross-sectional descriptive survey was used to execute this study between February and March 2015. A self-administered questionnaire with both closed- and open-ended questions was used for this study. Data were analysed using EpiData™ and SPSS 21. Simple frequencies and chi-square analysis were carried out.
  
  
  
  A total of 150 healthcare workers participated in the study. Sixty-two (41.3 %) participants were males, 86 (57.3 %) married, 90 (60.0 %) Christians and 119 (79.3 %) graduates, and about half of the participants earn less than N129 000.00 (US$ 737.00) per month. Less than half of the participants (43.6 %) supported industrial actions. Poor healthcare leadership and management were cited as the most common (92 %), as well as the most important (43.3 %), cause of healthcare worker strikes in Nigeria. Other causes cited were a demand for higher salaries and wages (82 %), infrastructural issues (63.3 %) and inter-personal issues (61.3 %). Only 2.0 % rated current healthcare management as excellent, while 24.0 % rated it as very good. Several strategies were cited towards improving healthcare management.
  
  
  
  The findings of this study differ from previous studies that identified demand for increased salaries and wages as the most common cause of healthcare workers' strikes in Nigeria. Identified causes of these continued strikes, especially inadequate healthcare leadership/management, must be tackled in order to eliminate industrial action by healthcare workers. Training doctors in health management and leadership towards building skilled physician leaders is a strategy that is long overdue in Nigeria.
authors.affiliation: Excellence & Friends Management Care Centre (EFMC), Abuja, Nigeria. obinna.oleribe@expertmanagers.org.|, No 8, Excellence and Friends Street, Dutse, P. O. Box 200, PSIN, 901101, Abuja, Nigeria. obinna.oleribe@expertmanagers.org.
authors.forename: Obinna Ositadimma
authors.initials: OO
authors.lastname: Oleribe
authors.affiliation: Excellence & Friends Management Care Centre (EFMC), Abuja, Nigeria.
authors.forename: Iheaka Paul
authors.initials: IP
authors.lastname: Ezieme
authors.affiliation: Excellence & Friends Management Care Centre (EFMC), Abuja, Nigeria.
authors.forename: Olabisi
authors.initials: O
authors.lastname: Oladipo
authors.affiliation: Excellence & Friends Management Care Centre (EFMC), Abuja, Nigeria.
authors.forename: Ezinne Patience
authors.initials: EP
authors.lastname: Akinola
authors.affiliation: Excellence & Friends Management Care Centre (EFMC), Abuja, Nigeria.
authors.forename: Deborah
authors.initials: D
authors.lastname: Udofia
authors.affiliation: Hepatology Unit, Imperial College London, 10th Floor, QEQM Building, St Mary's Hospital Campus, South Wharf Road, W2 1NY, London, United Kingdom.
authors.forename: Simon D
authors.initials: SD
authors.lastname: Taylor-Robinson
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D003430:Cross-Sectional Studies; D005260:Female; D006282:Health Personnel; D006801:Humans; D007588:Job Satisfaction; D008297:Male; D008875:Middle Aged; D009042:Motivation; D009549:Nigeria; D010346:Patient Care Management; D010820:Physicians; D012456:Salaries and Fringe Benefits; D013317:Strikes, Employee; D011795:Surveys and Questionnaires
keywords: Health system; Healthcare worker; Industrial actions; Nigeria; Strikes