Resident doctors have given the federal government a 14-day ultimatum to begin implementing outstanding agreements on their welfare and working conditions or face “further industrial action.”

The ultimatum takes effect from 1 October 2026, according to a communique issued at the end of the Nigerian Association of Resident Doctors’ (NARD) 46th Annual General Meeting (AGM) in Calabar, Cross River State.

According to the document signed by the association’s new President, Ogar Idoko, Secretary-General, Besongngem Akotanchi, and Publicity and Social Secretary, Ashimom Msughter, the meeting was held from 21 to 26 September.

The doctors said the ultimatum became necessary due to ongoing delays in resolving several welfare and professional issues, despite the government’s previous engagements and commitments.

Outstanding allowances, salaries

The resident doctors demanded the immediate payment of 19 months of outstanding Professional Allowance Table (PAT) arrears.

They also demanded payment of outstanding arrears arising from the 25/35 per cent upward review of the Consolidated Medical Salary Structure (CONMESS) for doctors and other affected health workers.

The association said several medical doctors were still owed salary and promotion arrears in various federal health institutions.

It also demanded the immediate correction of omissions and errors in the payment of the 2026 Medical Residency Training Fund (MRTF). It called for an upward review of the fund to reflect the current cost of residency training.

The doctors said the reviewed MRTF should also be captured in the 2027 Appropriation Act.

Other demands

The resident doctors called for the accelerated conclusion of the long-running Collective Bargaining Agreement between the Nigerian Medical Association and the federal government.

They said the unresolved review of the CONMESS salary structure had remained outstanding for about 17 years and was contributing to the brain drain affecting the health sector.

The association also called for a sustainable recruitment system to address “the critical manpower shortages occasioned by brain drain and guarantee safe and effective healthcare delivery.”

It demanded the implementation of the approved work-hour regulation policy, including functional biometric systems to document working hours and a standardised system for compensating doctors for excess workload.

The doctors also called for the implementation of “the Assault on Health Workers Prevention Policy across all health institutions with clear accountability mechanisms” and the payment of outstanding pension contributions.

The association further demanded urgent improvements in healthcare infrastructure, equipment and essential medical facilities across the country.

It said poor infrastructure and inadequate equipment were affecting patient safety, healthcare delivery and the training of resident doctors.

Threat of industrial action

Under the resolution, the AGM mandates that the NARD National Executive Council (NEC) “closely monitor” the government’s response over the next two weeks.

The association said it would take “all necessary lawful and constitutionally sanctioned actions”, including further industrial action, if the authorities failed to demonstrate meaningful compliance within the stipulated period.

The latest ultimatum follows several rounds of disputes between resident doctors and the federal government this year.

In January, the doctors suspended a planned nationwide strike scheduled to begin on 12 January after the National Industrial Court restrained the association from embarking on the action, and the government made fresh commitments.

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In April, resident doctors commenced a nationwide strike over the reversal of the Professional Allowance Table and other outstanding financial obligations. The action was suspended less than 24 hours later following government interventions.

In June, the association issued another 21-day ultimatum over unpaid allowances, salary arrears and delays in the residency training fund.

The resident doctors’ latest ultimatum, therefore, gives the federal government until 1 October to “commence demonstrable implementation of the resolutions contained in this communique.”

High blood pressure during pregnancy can put both the mother and baby at risk, if not detected and properly managed.

Pregnancy-induced hypertension (PIH) is high blood pressure that develops during pregnancy, usually after the first half of pregnancy. It can also progress to more severe hypertensive disorders, including pre-eclampsia.

A 2024 study, titled: “Prevalence and determinants of hypertensive disorders of pregnancy in Nigeria: a multi-centre study,” involving 71,758 women across 54 referral-level health facilities in Nigeria found that 6.4 per cent had hypertensive disorders of pregnancy.

Gestational hypertension accounted for 49.8 per cent of the cases, while pre-eclampsia and eclampsia accounted for 9.5 per cent and seven per cent respectively.

Speaking with PT Health Watch, Lewis Aituma, a Consultant Obstetrician and Gynaecologist, University of Benin Teaching Hospital, said pregnancy-induced hypertension is a major contributor to poor pregnancy outcomes for both mother and child.

Causes of PIH

Mr Aituma said there is no known single cause of the condition, but several factors can increase a woman’s risk.

He listed previous PIH, first pregnancy, advanced maternal age, diabetes, kidney disease, a long interval between pregnancies, family history of hypertension, multiple pregnancy and obesity among the risk factors.

The Nigerian study also found that women above 35 years, women who had never given birth, women with several previous births and those with a previous caesarean section or miscarriage had increased odds of developing hypertensive disorders of pregnancy.

Watch out for warning signs

Mr Aituma advised pregnant women to have their blood pressure checked routinely and watch for rising values.

He said women should also report persistent headaches, blurred vision, a feeling of abnormal heartbeat, chest pain and rapidly increasing swelling of the legs.

“Such symptoms should warrant an emergency presentation to the Obstetrician for expert evaluation and management,” he said.

However, some women with pregnancy-related hypertension may have no obvious symptoms, making regular antenatal checks important.

The World Health Organisation (WHO) recommends monitoring blood pressure during pregnancy because early detection and treatment of hypertensive disorders can help prevent serious complications.

How it affects mother, baby

When PIH is not identified and properly managed, Mr Aituma said it can progress to pre-eclampsia and cause serious complications for the mother, including eclampsia, seizures, stroke and kidney failure.

For the baby, he said it can increase the risk of premature birth, poor fetal growth, fetal death and premature separation of the placenta.

The Nigerian study found that 11.9 per cent of pregnancies affected by hypertensive disorders ended in stillbirth, while 3.7 per cent of women with the disorders died.

The researchers concluded that hypertensive disorders of pregnancy remain an important health concern in Nigeria.

WHO also identifies preterm birth, restricted fetal growth, placental abruption and maternal or fetal death among possible complications of severe hypertensive disorders in pregnancy.

Managing the condition

Mr Aituma said treatment depends on the severity of the condition and how far the pregnancy has progressed.

“For less severe forms, effort will be geared to blood pressure control and prevention of complications till the pregnancy is delivered,” he said.

He explained that where the pregnancy is still early, doctors may try to safely prolong it, while at later gestational ages, “the emphasis is to conduct a delivery.”

For severe cases, the priority is to control the woman’s blood pressure, prevent seizures and deliver the baby when necessary.

WHO also recommends close monitoring, blood pressure treatment and timely delivery where required, depending on the severity of the condition and gestational age.

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Reducing the risk

Mr Aituma said maintaining a healthy weight, exercising, making appropriate lifestyle changes and attending regular antenatal appointments can help reduce the risk of complications.

He also advised pregnant women to monitor their blood pressure regularly and report any concerning symptoms promptly.

“Overall, prognosis is good in early diseases. Women should watch out for common symptoms in pregnancy and report the same promptly to their Obstetrician for action, Mr Aituma noted.