The industrial action by health workers under the aegis of the Joint Health Sector Unions (JOHESU) since April 17, has crippled the health care system, with the Nigeria Medical Association (NMA) threatening to strike too, should the Federal Government yield to JOHESU demands.

The Federal Government’s “no work, no pay” issued against members of JOHESU, which makes up about 95% of the health sector, has not deterred members as State members join their counterparts in the strike, further crippling the health sector.

What the JOHESU strike is about

1. Failure to adjust CONHESS scale: In 2009, the late President, Umaru Musa Yar’Adua, approved two different salary structures in the health sector as negotiated by NMA and JOHESU (a recognized Trade Union of all Health Unions, excluding Medical Doctors). The Medical Doctors were under the Consolidated Medical Salary Scale (CONMESS) while all other Health Workers were placed on the Consolidated Health Sector Scale (CONHESS).


CONMESS 02; Registrar/Medical Officer ——————————————————Grade Level 12
CONMESS 03; Senior Registrar — Grade 11/Senior Medical Officer Grade 2 —Grade Level 13
CONMESS 04; Senior Registrar Grade 1/Senior Medical Officer Grade 1 —— Grade level 14
CONMESS 05; Consultant/Principal Medical officer Grade 2 ———Grade Level 15
CONMESS 06; Consultant Special Grade 2/Principal Medical Officer Grade 1— Grade Level 16
CONMESS 07; Consultant Special Grade 1/Chief Medical Officer ————————– Grade Level 17


CONHESS 7 INTERNS/NYSC ————————————– Grade Level 8
CONHESS 8 X -Officer 1 —————————————— Grade Level 9
CONHESS 9 Senior X-Officer ————————————- Grade Level 10
CONHESS 11 Principal X- Officer ——————————– Grade Level 12
CONHESS 12 Assistant Chief X-Officer ————————– Grade Level 13
CONHESS 13 Chief X-Officer ———————————— Grade Level 14
CONHESS 14 Assistant/ Deputy Director X-Officer ————- Grade Level 15
CONHESS 15 Director X-Officer ——————————— Grade Level 17
*X is the different professions that make up JOHESU*

2. Skipping CONHESS 10: NMA had accused JOHESU of skipping ‘CONHESS 10’ and requested that all members promoted to CONHESS 11 from CONHESS 9 be demoted to CONHESS 10 which was a misnomer according to the CONHESS scale as there was no CONHESS 10. The Ministry of Health issued a circular for the demoting of Officers from Grade 12 to 11, which began implementation in 2010.

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3. Non-implementation of Court judgment: following the disagreement of skipping CONHESS 10 and the failure of the then Minister of Labour to settle the dispute between the Ministry of Health and JOHESU, a legal battle began. In 2013, The National Industrial Court ruled in favour of JOHESU and ordered reinstatement of demoted members and compensated accordingly, which more than 5 years later is yet to be implemented.

4. Same scale promotion; As stipulated in the CONMESS scale, the entry point for a Medical Doctor is Grade Level 12, while other health workers started at Grade level 9. In perspective, a Medical Doctor who is undergoing Housemanship is entitled to #212,000 while a Senior Officer in the same level on the CONHESS scale takes home about #120,000 monthly.

Other demands include unpaid promotion arrears since 2012, the uneven appointment of Chief Medical Directors and Chairmen, Medical Advisory Committee, review of retirement age from 60-65years, autonomy of Teaching and Specialist Hospitals.

NMA reaction to the JOHESU strike

The NMA President, Francis Adedayo, in a statement, notified the Federal Government that any move to meet JOHESU demands would result in a strike action by the Medical Doctors.

“The NMA wishes to draw the attention of the Federal Government to our correspondence of April 21, 2014 on the above, in which we reminded Government of the collective bargaining agreement we had with the Federal Government of Nigeria in January 2014.

“It is also pertinent to once again remind Government about the concluding part of our letter no. NMA/PRE/SG/03/0751 of 21st March 2014, which states, “In view of the above, the NMA painfully wishes to inform the Federal Government of Nigeria that any award to the non-medically qualified health professionals that violates the January and July agreements of 2014 shall result in the resumption of the suspended withdrawal of service of 2014″. Please take this as a notice sir”.

JOHESU’s response

Responding to NMA, JOHESU National Vice Chairman, Ogbonna Chimela expressed disbelief saying, “It is baffling. One is surprised that a fellow worker in the system who had gone to government and made a demand which the government approved is now the one telling the government it will down tools if it accepts the demands of another worker.

“On what basis? We are all professionals in our own field and none of us is greater than the other. When you negotiated for yours, we never interfered but because of greed and ego, you just want to dominate and suppress everybody but we will not take that.

“They (NMA) are entitled to their own view but the government is there to instill what is right. Moreover it is not their personal money that will be used in paying us and it is not going to affect their salaries in anyway so I wonder why they are doing this to us.

“They claim to be the leaders of the health sector but are leaders supposed to be greedy, selfish, intimidating and not care about the welfare of others?”

NLC recommendations

Chairman, Nigeria Labor Congress Ayuba Wabba iterated the need to abide by the “Principle of Equal Pay for Equal Value” as contained in the International Labor Convention, which Nigeria is also a signatory.

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He warned against the ‘divide and rule’ tactics and obliged the Federal Government to look for “seasoned administrators, technocrats, to mediate” in the matter.

“When neutral people, seasoned stakeholders are allowed to come in they will give the government a better recommendation.

“Seasoned administrators abound in the civil service; they will be able to say what is right and wrong and we should be able to abide by it because going continuously in the wrong direction will take us nowhere.

“The issue is that the salary of people on the same grade level should be the same like is obtainable in the legal profession while the difference should be on professional allowances.

What is being done to call off the strike

Although JOHESU has confirmed that the Federal Government has made an offer to the Union, the National Chairman of JOHESU, Josiah Biobelemoye has accused the Ministers of Health of colluding with Medical Doctors to sabotage the efforts of the Federal Government.

“This very agreement was entered into and then a memo was made to Mr President as they claimed, even though they gave us a copy later.

“When they made this memo it was in December and the Ministry of Health defended her budget in February, but did not deem it to include that the amount it worked for the payment or settlement of this very issue.

“This goes a long way to show that there was dishonesty, insincerity from the beginning on the part of the Ministry (Federal Ministry of Health) because most probably the Minister is a Doctor; Minister of State (Health) is a Doctor and Minister of Labour who is supposed to be the chief negotiator, is also a Medical Doctor’’.

Chimela stated the need for the President’s intervention to prevent a total collapse in the Health Sector, as the meeting between JOHESU and officials of the Federal Ministry of Health ended in a deadlock, with no common grounds reached to resolve the crisis.

“From our investigation and from what we know now, we have discovered that our President, President Muhammadu Buhari, has not been well informed of the happenings in the health sector, is like some information are being blanketed; not getting to him because we know whom he is.

“He is a sincere man who has the love of an average Nigerian at heart. We know that he is humane and he cannot toy with the lives of Nigerians if he is well aware of this present situation in the Health Sector we know he would go direct in arresting the issue and resolve it, he added.

A Muslim, Nurse, Writer, Poet, who loves to sleep

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