Close up of doctor typing on laptop keyboard in medical cabinet at healthcare facility. Portrait of medic sitting at desk with documents using device with technology for consultations
The Nigerian Association of Resident Doctors (NARD) has recommended a maximum 48-hour work week and a 24-hour limit for continuous duty for healthcare personnel to address excessive working hours, burnout and fatigue.
The recommendations followed deliberations by the Federal Ministry of Health and Social Welfare’s Ministerial Committee on Work Hour Regulation and Casualization of Doctors.
In an update issued on Sunday and signed by Abdulmajid Yahya Ibrahim, NARD’s publicity and social secretary, the association said the committee conducted a nationwide assessment involving 6,350 healthcare personnel across Nigeria’s six geopolitical zones.
NARD said the assessment identified the need to address excessive working hours, burnout, fatigue and inadequate rest among healthcare workers, as well as potential risks to patient safety.
Under the proposed framework, healthcare personnel would work a maximum of 48 hours per week, including weekends.
The association said any authorised work beyond the limit must be properly documented and compensated.
The proposed guidelines also recommend a maximum eight-hour day shift and six-hour afternoon shift, while shifts exceeding 12 hours would only be allowed in emergency situations.
Healthcare personnel would be limited to two call duties per week, including weekend calls, with a maximum of one weekend call per month.
NARD further recommended an absolute maximum of 24 continuous hours of duty, including call duty.
The guidelines provide for at least 12 hours of rest between regular shifts and a mandatory 24-hour post-call rest period after weekday, Saturday, Sunday and public holiday calls.
Healthcare personnel would also be entitled to a minimum one-hour break after six hours of continuous work, including during shifts and call duties.
NARD said the breaks could be staggered where necessary to ensure uninterrupted patient care.
On excess working hours, the association said authorised additional hours should either be compensated above the normal hourly rate or offset through structured time off.
“Authorized 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 conduct research and undertake 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,” it said.
The association 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 centre leadership.
NARD, however, said the recommended limits would not prevent exceptional arrangements during genuine emergencies where patient safety and continuity of care require longer working hours.
The association said a second document addressing the “casualization and abusive locum appointments” of doctors would be released soon.
NARD credited Muhammad Ali Pate, Coordinating Minister of Health and Social Welfare, and Iziaq Salako, Minister of State for Health and Social Welfare, for supporting the work-hour policy.
It also commended its representatives on the ministerial committee, including Kwarshak Kevin Yakubu, Vice-President II, and Shuaibu Ibrahim, Secretary-General.
“NARD remains committed to protecting the dignity, welfare, rights and professional interests of every Nigerian doctor,” the association said.
The association added that it hoped the National Council on Health would approve the recommendations.
