Out of N44tr budgets: FG, states spent N1.8tr on health in 3 years
The federal and state governments have a three-year combined budget of N44 trillion but only N1.8 trillion or 4.2 percent was voted for health, Daily Trust investigations have shown.
The figure covers the period between 2016 and 2018 and is well below the standards set by African Union and World Health Organisation (WHO)
The low vote is not the only setback for the health sector. An even bigger problem is that far less is allocated to the critical areas like recruitment of more doctors and nurses, upgrading of existing facilities and building of more hospitals and health centres.
The greater part of budgeted figures will be expended on salaries, allowances, general administration, and overheads.
Official data analysed by Daily Trust shows that the two tiers of government have budgeted a total of N733.8 billion for health, representing 4.1 percent of their N17.5 trillion cumulative spending this year.
In 2017, out of the N13.5 trillion total expenditure of the two tiers of government, only N591.8 billion (4.3 percent) was meant for health.
The federal and state governments voted N499 billion (4 percent) for health out of their combined votes of N12.5 trillion in 2016.
Although the figures represent a slight increase over the two years, it is well below the 15 percent benchmark set by the African Union (AU) during the Abuja Declaration in 2001.
These figures are too insignificant considering the mounting challenges of children malnutrition, routine immunization, maternal and infant mortality and family health, among others.
Nigeria, with a life expectancy of 53/54 years, according to the WHO report of 2015, had five disease outbreaks of yellow fever, monkey pox, meningitis, Lassa fever, and cholera in 2017 alone.
These figures are very unlikely to address the major public health challenges of malaria, diabetes, renal disease, typhoid, tuberculosis, hepatitis, hypertension, heart diseases/stroke, pneumonia in children, polio, chickenpox, and measles.
Many Nigerians are dying of preventable diseases due to the poor public health system. The National Health Insurance Scheme (NHIS), for instance, covers only five percent of the population in the country, made up of mostly federal civil servants.
“This means that Nigerians will not get the basic minimum standard of care at their primary healthcare centres,” ONE, an international campaign and advocacy group, said.
“The Nigerian health sector remains in crisis. In the last decade, we have not seen appreciable enhancements to the quality of healthcare for Nigerians,” according to ONE country director in Nigeria, Serah Makka-Ugbabe.
Lip service to Abuja declaration
In April 2011 AU leader pledged to set a target of at least 15 percent of their annual budget to improve the health sector.
By 2012, only Tanzania had reached this threshold, according to the WHO.
In 2014, four countries - Gambia, Malawi, Swaziland, and Ethiopia met the target at 15.7 percent, according to the report.
Since then six countries have been able to meet and surpass the 15 percent target. They are Rwanda (23.8 percent), Liberia (18.9 percent), Malawi (18.5 percent), Zambia (16 percent), Togo (15.4 percent) and Madagascar (15.3 percent). Four countries are clearly on their way to meeting the Abuja target: Swaziland (14.9 percent), Ethiopia (14.6 percent), Lesotho (14.6 percent) and Djibouti (14.2 percent).
Surprisingly, other countries outside Africa seem to allocate more funds to public health than many African countries. Data obtained from WHO indicate that Costa Rica allocates 27.7 percent, Marshal Island (24.4 percent), Andorra (23.1 percent), Argentina (22.5 percent), Switzerland (22.1 percent), New Zealand (20.1 percent), and United States (20.5 percent).
Booming medical tourism
In Nigeria, the National Health Act 2014 stipulates that one percent of the Consolidated Revenue of the Federation should be set aside for health funding.
A report by the Africa Health Budget Network said because the government spends so little, the burden of paying for healthcare falls disproportionately on households.
Due to poor healthcare infrastructure, Nigerians are spending about $1billion annually on outbound medical tourism to India, Egypt, Dubai, Germany, and United Kingdom, among others.
In April 2016, President Muhammadu Buhari said the federal government will not provide funds to any government official to travel abroad for medical treatment unless the case cannot be handled in Nigeria.
Despite this commitment, Nigerian public officials and their families always seek medical attention abroad, leaving behind poorly-funded public health sector characterised by incessant strikes by health workers, dilapidated infrastructure, and obsolete equipment.
“Corruption, delay in the release of funds, and lack of judicious utilization of the existing funds backpedal timely provision of healthcare services at all levels, said Auwal Musa Rafsanjani, executive director of the Civil Society Legislative Advocacy Centre (CISLAC).
Inadequate funding continues
In 2018, the federal government has budgeted N340.4bn (3.9%) for public health of its total budget of N8.6trn, an increase of about 10.4 percent over the N304bn (4.17 percent) of its total expenditure of N7.3trn spent on health in 2017.
In 2016, the central government voted N250.06 billion (4.13 percent) out of its N6.1trn budget for the year.
Twenty-four states will spend N393.4bn on public health this year. The 36 states of the federation have a combined budget of N8.95trn for 2018.
There are no health figures for Kebbi, Adamawa, Yobe, Niger, Benue, Kogi, Ebonyi, Enugu, Imo, Ekiti, Ondo, and Osun states.
Last year, 28 states in the country budgeted N287.6bn (4.63 percent) on health, a slight increase from the N249.27bn (4.1 percent) 30 of them spent in 2016.
In 2018, the north budgeted N176.8bn, a slight increase from the N155.2bn 15 of them spent in 2017. In 2016, the north spent N135.96bn on public health.
The south has voted N216.6 billion on health, almost double of the N132.4bn it spent in 2017. Seven southern states spent N113.3bn on health in 2016.
What every zone is spending on health
The northwest’s spending on health rose to N82.1bn this year, from last year’s N46.2bn. The zone spent N60.02bn in 2016.
The southwest has budgeted N116.6bn this year, from the N75.4bn it spent on health last year. This year’s figures are N26bn higher than the N80bn it expended on the sector in 2016.
The northeast health budget dropped from last year’s N57.8bn to N36.9bn this year. The insurgency-ravaged zone allocated only N51.46bn to health in 2016.
The north-central zone’s budget for health is N57.8bn, a slight increase to the N51.2bn it spent in 2017. This year’s figures are almost double of the N24.48bn it spent on the sector in 2016.
The south-south region total budget for health is N131.6bn, a huge rise from the N51.1bn spent last year. The 2018 figures are five times higher than the N25.41bn it spent in 2016.
The southeast’s states of Anambra and Abia budgeted N13.4bn for health this year. In 2017, Anambra, Enugu, and Abia budgeted N5.9bn for the sector. The three states of Anambra, Enugu, and Ebonyi spent only N7.9bn for health in 2016.
States with higher health budget
Lagos state, with a population of nine million according to 2006 Census, is spending N92.6bn on public health this year, having spent N51.4bn in the sector last year. Cross River is trailing Lagos with N75bn health budget this year. Rivers is spending N30bn this year, from the N27bn it spent last year.
Kwara health budget dropped from N26.1bn in 2017, to N24bn this year. Bauchi’s rose from N23.4bn last year to N25.5bn in 2018. Katsina’s budget on health rose from N6.5bn in 2017 to N23.8bn in 2018.
Ogun’s rose from N15.1bn last year to N21.2bn this year; while that of Borno dropped to N17.7bn from last year’s N19.5bn. Sokoto’ spending on health rose from N7.7bn in 2017 to N21bn this year. That of Kaduna also rose from N10.5bn in 2017 to N15.7bn this year.
States with lower health budget
States with least expenditure for health are Edo (N3.3bn), Plateau (N4.3bn), Taraba (5bn), Abia (N5.6bn), Zamfara (N5.9bn), Akwa Ibom (N6.6bn), Jigawa (N6.7bn), Anambra (N7.8bn), Bayelsa (N8.5bn), Nasarawa (N8.7bn), Kano (N9bn), and Gombe (N9.6bn).
Culled from https://www.dailytrust.com.ng
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