Amidst high maternal and child mortality, high prevalence rates of communicable and non-communicable diseases, shortage of medical professionals/brain drain, and frequent strikes by the few available health workers, among others, the 2023 health budget falls short of the 15 per cent allocation, say stakeholders, as they called on government to prioritise the health of Nigerians.
Recall that about N1.17 trillion, representing 5.35 per cent, was allocated to the health sector out of the total of N21.8 trillion for the 2023 fiscal year. This is just about one-third of the 15 per cent Abuja Declaration.
The amount comprises N404.08 billion for capital expenditure and N580.82 for recurrent expenditure. It also includes N2.5 billion for Aid & Grants and a provision of N62 billion for retained independent revenue which could help the health agencies execute their other activities.
The health sector also gets N81.47 billion under the service-wide vote. This includes N69.57 billion for GAVI/immunization; N7.4 billion for counterpart funding including global fund, health refund to GAVI and N4.4 billion for military retirees under the National Health Insurance Scheme (NHIS).
Though, the 2023 budget shows a significant increase from the N826.9 billion allocated to the health sector in 2022 and the N547 billion allocated in 2021, advocacy accountability and partnerships manager with FP 2030, North West and Central Africa Hub, Yusuf Nuhu told LEADERSHIP that it is far from the 15 per cent that the federal government promised in 2001 in Abuja.
Nuhu stated that Nigeria’s inability to achieve 15 per cent allocation to the health sector may be due to the slim resources available in the country, while arguing that with strong political will and good leadership that prioritize the health of its people, it is possible to achieve that percentage. “We are not expecting Nigeria to achieve the 15 per cent over night, but we want to see real progress and it takes good leadership to achieve that,” he added.
He lamented that, over the years, the health budget has been roaming around almost in the same figure, adding that, “though, we saw a change in the 2023 budget, and we are happy about it, however, it is far from tackling the many challenges in the sector. We need strong political will and good leadership that will ensure that the health of Nigerians are prioritise, that will push the bar higher to ensuring that the budget reflect the 15 per cent that we are clamouring for over the years.”
Recall that the 2023 budget introduced a new line “scale-up of implementation of the national family planning programme, services and procurement of family planning commodities through counterpart -funding for 2023” with the sum of N20 million was created.
In response, Nuhu said, this is a huge progress made. However, he said government need to meet the unmet needs of family planning in Nigeria.
“There is a costed implementation plan for family planning in Nigeria, which outline the amount of resources needed to fully implement family planning programme in Nigeria. Nigeria has not been able to bridge the fund gap. With this budget line, it is in the right direction, but government and other critical stakeholders must do more,” he added.
Nuhu averred that government cannot do it alone, while calling on the government to build partnerships, work with other stakeholders and drive resource mobilization including from the private sector for implementation of family planning programme in Nigeria.
He revealed that the federal ministry of health has developed a private sector engagement strategy, but stated that the ministry needs to fully implement the recommendations from that strategy.
“The most sustainable way to implement any programme is through domestic resources. I call on the government to do more in ensuring that resources are available to enable the country to gradually move from where it is, which is below 12 per cent Contraceptive Prevalence Rate (CPR), towards achieving the 27 per cent CPR by 20230.
To tackle the many vices that have marred the health sector, Nuhu advised that Nigeria would need to develop credible data, to enable the country to plan, implement effectively and efficiently. “We are not doing very well, in terms of data in the health sector in the country. This has to be improved, for us to be able to drive progress.
“Also, the Nigerian government would need to deploy innovation and technology in the sector. This is very important. It saves a lot of cost and it is one sure way to reverse high mortality rate in the country. Finally, government need strategic partnerships to drive progress, in terms of implementation of health programmes to reach better outcome in the future,” he stated.
In the same vein, the chairman, Public Health Sustainable Advocacy Initiative, PHSAI, Barrister Ayo Adebusoye told LEADERSHIP that, the Nigerian government must start to prioritize the health sector.
Despite the many challenges that have marred the health sector over the years, Adebusoye said Nigerian government has not seen the reason to achieve 15 per cent budgetary allocation to the health sector.
According to Adebusoye, the 5.35 per cent is far from the Abuja declaration, of which Nigeria signed to commit at least 15 per cent of her annual budget to improve the health sector. With such under Investment in healthcare, Nigeria cannot achieve universal health coverage, says Adebusoye, while urging the government to prioritize the health sector in 2023 by coming up with complimentary budget for the health sector.
To tackle the frequent strikes by the Nigerian doctors, Adebusoye advocated for good working conditions of health workers. He said: “Quality healthcare services is not about big structures, it is about the personnel and equipment. So the condition of services is key.
“For the country to restore the health sector to its former glory, the healthcare practitioners’ salaries should not be tied to the civil services, they are specialists. That is why doctors in other climes are being paid higher than ours. So the working condition of doctors must not be hinged or tied to the civil service. The condition of services must be made more attractive.
“The management of the general, teaching and private hospitals must include local communities, the community groups, the traditional rulers etc. Of course the National Health Act has all those structures in place, like the local government authority and the hospital management board, but implementation is a big problem. Government must implement the Act, to improve the condition of services.”
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