President Muhammadu Buhari recently expressed shockat Nigeria’s swelling population. He said, “By average estimates, our population is close to 200 million today. By 2050, United Nations estimates put Nigeria third globally behind only India and China with our projected population at 411 million.This is a frightening prospect but only if we sit idly by and expect handouts from so-called development partners. The solution to our problems lies within us.”
Buhari’s position aligns with what experts in the health sector have advocated over the years. The irony, however, is that government has not matched the concerns with action as budgetary allocations, releases for capital expenditure and execution of health projects do not reflect the urgency required to tackle the country’s health challenges. For instance, data obtained from Partnership for Advocacy in Child and Family Health at Scale (PACFaH@Scale) show that in the 2019 budget, N1.2 billion was proposed for Family Planning, which is meant to encourage child spacing.But this amount was slashed to N300 million. This is too little to execute a national strategy. But it is not known, for now, what percentage of this amount has been released. It is not, therefore, surprising that Nigeria’s population is on the increase. The country’s contraceptive prevalence rate is at a dismal 17%, according to 2018 National Demographic Health Survey. In Rwanda it is 46%, Malawi 26% and Ethiopia 27.3%.
It is not only in the area of Family Planning that federal and state governments fail to make appropriate budgets or reluctantly release funds. In the area of Routine Immunization of children against tuberculosis, diphtheria, polio, measles, pneumonia and even HIV/AIDS, Nigeria has depended largely of foreign donations. For Maternal New-Born Child Health, and even Nutrition, national budgets are dismal. For instance, data from PACFaH@Scale says only N80 million is budgeted for Nutrition in the whole of Nigeria in 2019.
We call on the Ministers of Health, Dr Osagie Emmanuel Ehanire and Senator Adeleke Olurunnimbe Mamora, to liaise with the necessary government departments to ensure government prioritizes the release of budgetary allocations to health sector. Over the years, health budgets have performed very poorly, due to the country’s unrealistic budget cycle, but also due to inadequate release of votes for capital expenditure, and low utilization of released funds.
For instance, in 2018, N141 billion was allocated to capital projects in the health sector. Out of this only N21.62 billion was released, a mere 15.3%. But out of this amount only N13.35billion was utilized. At the end of the year, only 9.4% of the allocation to health was utilized. Therefore, those who celebrated the supposedly high capital allocation to health would have done so in vain. Over the last decade, that has been the experience in the health ministry.
The ministers should put in place measures to ensure that funds for capital projects are released and projects are promptly executed. This is necessary to stem the slide in thegood health indicators in Nigeria. At the moment reports say Maternal Mortality Rate in Nigeria is put at 814 out of 100,000 women who give birth. The mortality rate of newly-born children is 34.1 per 1,000 births. The reason for such high mortality rate is not far-fetched – the primary health care sector is not functioning. As a result, Nigerians have to spend money from their pocket to access healthcare. Those who lack money patronize quack doctors and engage in unsafe health practices.
For the ministers, there is a window of opportunity to improve health services. It is in the Basic Health Care Provision Fund, which aims to substantially improve funds available for primary healthcare. We encourage the ministers of health to work closely with relevant government departments to ensure that these funds are released in the early days of the budget’s lifecycle, and that these funds are applied in relevant thematic areas that can make positive impacts in the health of ordinary Nigerians.
