There is significant paucity of data on the subject of this study and our study revealed some variation in national service experience between corps members in Nigeria and other countries.
A 15-year review of the compulsory community service scheme for South African medical doctors showed that two-thirds of respondents in their study expressed satisfaction with their accommodation and general welfare [28], as opposed to 89.2% of respondents in our study reporting one or more welfare-related problems such as exploitation, poor remuneration and lack of accommodation at their PPAs. Also, A study conducted among corps members in medical services (Doctors, nurses and pharmacists) in Kogi state found that the lack of improved salaries and infrastructure, and insecurity were some of the factors that negatively influence healthcare service delivery among the corps members.[19] These perceptual differences may be rooted in the fact that better welfare packages are made available for young South African doctors involved in the Community service scheme, and imply that drastic improvement in welfare for Corps medical doctors in Nigeria may go a long way in positively influencing perception of the scheme by doctors.
Our study has also shown that a majority (61%) of corps medical doctors do not believe that the experience of serving during the compulsory NYSC programme provides them with any sort of professional development. In contrast, up to 91% of Community service medical officers in the study in South Africa believe that their country’s community service scheme provides them with tangible professional development. [28] This may be correlated to the fact that they feel well orientated to their jobs and receive quality clinical supervision, characteristics that most Nigerian corps doctors perceive to be lacking in their various places of primary assignment.
More than half of our respondents (53.9%) were not deployed to any of their preferred states and about 80% of them did not enjoy the National service. This is at variance with a similar study done in Ghana were more than 80% of the participants were posted to their preferred regions in Ghana and most of them enjoyed their service. [11] It can thus be reasonably inferred that being posted to a region of one’s preference may be an important determinant of perception of national service by medical doctors, and that the perception of NYSC by Nigerian corps medical doctors may be significantly improved by posting many of them to their preferred states or geopolitical zones
About 72% of the participants in our study were doing the national service because it was mandatory while 74% of participants in the same study in Ghana were of the opinion that they would still do national service even if it were voluntary. [11] The comparatively positive perception of national service in Ghana could be responsible for this difference, and perhaps many more Nigerian corps doctors will show improved willingness to participate in the scheme if measures are put in place to ensure a higher positive perception of the scheme.
NYSC has been seen by employers as a source of free or cheap labour whereby corps members are offered paltry stipends which is not commensurate with the rendered services. [16] Corps doctors are not left out of this unfair treatment. According to our study, most corps doctors (66.9%) receive less than 80,000 from their PPAs while 17% of corps doctors are not paid a dime at their places of primary assignment. This is against the directives of the National Salaries, Income and Wages Commission on the allowances corps doctors are supposed to receive from their PPAs. [29] This gross reduction in earning potential of medical doctors during the period of national service could be a major contributor to the negative perception of the scheme.
51.6% of the corps doctors from our study reported no provision of accommodation at their places of primary assignment as part of the challenges faced. This is close to the findings of a study among corps member in Ibadan where 79.7% of respondents reported lack accommodation as part of challenges faced. [21] The study was conducted among 177 corps members from different fields in Ibadan, so the differences in sample size, distribution and population could account for the observed differences.
From our study, 15.5% of respondents cited poor security as part of the perceived challenges of participating in the scheme. This is close to the findings of a study done among corps members in Nigeria where 10% of participants reported that insecurity was a problem facing the scheme. [17] The relatively higher percentage from our study could be due to difference in sample size and sample population as the above study was conducted among corps members in Abuja.
Our study also explored the experiences of corps doctors at their places of primary assignment. About 17.8% of respondents reported bad PPA treatment while 59.4% considered their PPA treatment to be fair. Other problems faced at PPAs include No payment (17.0%), No accommodation (51.6%) and exploitation (41.4%). A study among corps members in Nigeria reported the above problems as part of the reasons corps members were rejected at some places of primary assignment. [17] Also, the above problems could make corps doctors reject a PPA. Out of 112 corps doctors who attempted to get their PPA changed, only less than half of them were successful. These statistics call on the attention of the of NYSC to be more proactive in the monitoring of the welfare of corps members posted to various PPAs.
About half of the respondents in a study done among corps members in Abuja reported that they would love to marry from the host communities where they served. [17] This demonstrates a positive perception towards one of the purposes of NYSC which is integration. In contrast, only 4.5% of our respondents reported finding a lover or spouse through the scheme as a perceived benefit. This significantly lower percentage reported in our study may be a consequence of the poor perception of the scheme by doctors, or other factors relating to difference in study populations such as differences in average age, experience, longer time spent in training.
Our study revealed that only 20.6% of corps doctors were satisfied with their Job and this is similar to the finding of a study done among corps members in Bayelsa where only 17% of respondents reported high level of job satisfaction. [20] Although unlike our study, the study population comprised of corps members in various fields, the similarity in results could imply a similar level of dissatisfaction with NYSC jobs between corps medical doctors and corps members in other fields. More studies are needed to explore this.
Corps doctors serving in the South East region reported the highest level of challenges compared to other regions. This finding was significant statistically and could be related to the poor treatment of corps doctors in the region as most of the corps doctors who reported bad PPA treatment were from South East region and this association was also statistically significant.
There was a statistically significant association between region of deployment and job satisfaction as North East region had the highest proportion of corps doctors happy with their work while South East and South South regions had the highest number of corps doctors unhappy with their job. This finding could be due to the variations in the treatment received in the different regions as majority reported good treatment in North East region while majority reported bad treatment in South East region.
From our study, 23.6% of respondents were of the opinion that the programme, NYSC should be scrapped completely, while 18.3% suggested that the programme be revamped. Almost half (42.9%) of our respondents suggested that the national service be made optional. These opinions suggest that the programme needs attention. Exhaustive and holistic assessment of the national service programme, with the implementation of befitting changes could grossly improve the perception of participants, including medical doctors.