While the federal government of Nigeria and other African governments vowed to allocate at least 15 per cent of their national budgets to the health sector, only two states in Nigeria have been able to achieve that, LEADERSHIP has learnt.
Recent statistics from BudgIT revealed that, in 2017, the 36 state governments in Nigeria planned to spend N6.75 trillion, whereas total health related budgetary allocation by states were a little above N332.1 billion or about 4.9 per cent of the total budget size.
A look at the 2017 budget projections of states show that only Kwara and Bauchi have surpassed the 15 per cent target. With a total budget of N135.26 billion and N145.45 billion, Kwara and Bauchi states allocated 17.24 per cent and 16.09 per cent of their budgetary allocations to their health sectors respectively.
The other 34 states in Nigeria are yet to meet that 15 per cent target. For instance, in 2017, with a total budget of N69.90 billion, Nasarawa State budgeted N8.10 billion to the health sector, representing 11.59 per cent.
Adamawa allocated about 7.13 per cent of its total budget of N120.46 billion to the health sector. With a total budget of N812.99 billion, Lagos State allocated 6.33 per cent to the health sector and in Kano State, out of the N217.90 billion total budget in the year under review, 5.08 per cent was allocated to health.
In 2017, states like Kaduna, Gombe, Taraba, Abia, Zamfara, Enugu, Sokoto, Plateau, Katsina, Edo and Cross River health budgetary allocations were below five per cent of their total budget. Worse still, states like Oyo, Niger, Akwa-Ibom, Ebonyi and Osun budgetary allocation to the health sector were below three per cent of their total budget.
The poor health allocation, according to critical observers in the sector, has led to the country contributing about 10 per cent to global burden of maternal deaths and has been listed as one of six countries that account for 50 per cent of global estimates of maternal deaths.
With health sector funding in Nigeria hovering below 10 per cent over decades and some states’ health allocations still below the 15 per cent commitment made by the government in the Abuja Declaration, it is glaring that government cannot solve healthcare problems alone.
Stakeholders have, however, advocated for government and private sectors to work together in order to improve the poor health indices in Nigeria and Africa in general.
Minister of health, Professor Isaac Adewole, said for Nigerians to have access to quality and affordable healthcare in the country, there is need for the public and private sectors to join hands together to revamp the sector.
Prof. Adewole, however, urged the private sector to join hands with this present administration in its vision to provide quality and affordable healthcare services to cater for the health needs of Nigerians.
On his part, the chairman, Dangote Foundation, Aliko Dangote, pointed out the relationship between health and economic growth, saying that healthy populations live longer and are more productive.
Dangote said Africa’s healthcare systems demand significant investments to meet the needs of their growing populations, changing patterns of diseases and the internationally-agreed development goals.
He said governments from both developed and developing countries are increasingly looking at Public-Private Partnerships (PPPs) as a way to expand access to higher-quality health services by leveraging capital, managerial capacity and know-how from the private sector.
As a businessman, and through Aliko Dangote Foundation, Dangote said he was committed to working with governments and key stakeholders for the development of impactful health initiatives in Africa in the belief that private sector leaders have a strong role to play.
In keeping with his passion to see healthier African people and a better continent, Dangote proposed to commit at least one per cent of his profit after tax to support the health sector. He however, charged business leaders to follow suit.
The co-chair of the African Business Coalition for Health (ABC Health), Aigboje Aig-Imoukhuede, on his part, said while Africa had made significant progress in the funding of healthcare, the continent is still very far from where it needs to be to achieve the Sustainable Development Goal 3 (SDG 3).
Aig-Imoukhuede, however, lamented that healthcare in Africa was constrained by scarce public funding and limited donor support, adding that out-of-pocket expenditure accounts for 36 per cent of Africa’s total health expenditure.
“Given the income levels in Africa, it is no surprise that healthcare expenditure in Africa is grossly inadequate to meet Africa’s needs, leading to a financing gap of N66 billion per annum,” he added.
Imoukhuede said it was clear that African governments cannot solve the challenges in the health sector alone, which is further exacerbated by the continent’s growing population and Africa’s changing disease portfolio, adding that there is no alternative but to turn to the private sector to complement government funding.
“Our continent accounts for less than two per cent of global health funding even though our very fertile people account for 16 per cent of global population and carry 26 per cent of the global disease burden.
“By 2050, Africans will account for more than 50 per cent of global population growth, much of that coming from my country Nigeria, a great opportunity and at the same time a ticking time bomb should we fail our health systems quickly.
“The private sector and the public sector working together as partners have the potential to change Africa’s healthcare from doom and gloom to progress and results. Africa’s private sector has great capacity to be relevant partners.
“The private sector must be encouraged to optimise and step up its involvement and contribution to health funding in Africa. We have seen what global private sector players accomplished in the fight against the AIDS epidemic through powerful coalitions such as GBC Health. This is an indication of the power of consolidated effort which Africa’s growing private sector can bring to solving our health challenges.
“African leaders now have a stronger sense of urgency to combat the lack of quality health care that Africans endure. The inequality of healthcare available to Africans compared to people in other parts of the globe is vast and unacceptably pervasive. With the cooperation of both the public and private sectors, there is a huge potential to boost health outcomes with significant financial gains,” he said.
President, Healthcare Federation of Nigeria, Mrs Clare Omatseye, challenged Nigerians to start asking themselves some serious questions especially in the health sector.
Omatseye said, “How can we be sure that every dollar allocated to healthcare is spent in the healthcare system? Even if the federal government decides to allocate 15 percent of the annual budget to the health sector, how can we be sure that the money will be spent in the sector and will improve the healthcare system?
“The fact that most Nigerians are still spending out of pocket and going to India is not an indication that all Nigerians can afford that. The rest of Nigerians that make up the larger number of the population are dying.”
She said there is a vicious cycle of poverty every time somebody gets sick, adding that the people going abroad for medical tourism are not more than 50,000 people and they are spending billions of dollars in a year.
Speaking on what can be done to improve healthcare even if Nigeria cannot meet the Abuja Declaration of 15 percent, Omatseye said Nigerians need to advocate for policy like PPP that would enable and unlock the private sector.
“The second issue is financing healthcare. We are almost doomed if we continue to finance healthcare with short term funds. So we need interventional funds; we need funds that are long term in nature. By investing in healthcare, you cannot get return on investment in two to three years. Healthcare investment is a long term investment for social impact.
“We have businessmen who are coming into the country with billions of dollars but are not in the healthcare sector. We have people in the government that are building hospitals and are outsourcing it to the private sector to run. The ball is in our court; we need to begin to understand that collaborations, partnerships are important. We need to leverage on technology to unlock some of these potentialities,” she added.
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