ABSTRACT:
Healthcare worker migration has emerged as a defining challenge for health systems in low- and middle-income countries, particularly in sub-Saharan Africa. In Nigeria, this phenomenon is often framed as an individual choice driven by economic incentives. However, less attention is paid to the structural conditions within domestic health systems that precipitate migration, especially excessive work hours. This study examines the prevalence and consequences of prolonged work hours among healthcare workers in Nigeria and explores how these conditions influence migration intentions and decisions. Using a case study design, the research draws on data from a purposive sample of 84 healthcare workers across multiple cadres. Quantitative and qualitative data were analysed to assess work patterns, perceived wellbeing, burnout, job satisfaction, and migration considerations. Findings indicate that excessive work hours are widespread and normalized, driven by chronic workforce shortages, inadequate financing, weak labour protections, and governance gaps within the health system. Participants reported physical exhaustion, psychological distress, reduced quality of care delivery, and diminished professional fulfilment. Importantly, prolonged work hours were not experienced as isolated stressors but as part of a broader system failure, reinforcing migration as a rational coping and survival strategy rather than a purely aspirational choice. The study situates healthcare worker migration within the context of overlapping polycrises, including economic instability, health system underinvestment, and global inequities in health workforce distribution. It highlights how governance and financing failures amplify workload pressures, erode retention, and undermine health system resilience. By reframing migration as a predictable outcome of structural neglect rather than individual disloyalty, this research underscores the need for policy responses that prioritise fair workload regulation, workforce planning, and health worker wellbeing. Addressing excessive work hours is presented as a critical governance and financing intervention for strengthening health systems, improving retention, and safeguarding population health in an increasingly crisis-prone global order.