Nigeria’s healthcare index is abysmal. With this grim picture, if the wealth of a nation is measured by the health of its citizens, Nigeria is at the bottom rung. This is not acceptable. The 2017 budget, which is already in the works, must, as a matter of urgency, increase the health budget to the agreed international benchmark.
Important issues are the least celebrated in Nigeria. The media constantly splashes political scoops and stories on their front pages. They call some people newsmakers. And newsmakers in our clime are mainly the big politicians who talk more, make bogus claims, accusations, and criticisms of policies, people and governments. To some extent, economic and negative stories follow. Economic stories, in order to corner a chunk of the advert revenue, and negative stories, because when it bleeds, it leads – a common refrain in journalism parlance. Even the age-long human-interest stories, which normally draw human empathy and conversely attract readership, have now been relegated. But you can’t blame the Nigerian media; they are a reflection of the country’s news consumption pattern.
In this warped neglect of issues that matter belongs the health budget process. Year in, year out, the health budget is not prioritised. In the 2016 budget, the Federal Ministry of Health was allocated over N250 billion and ranked the 5th largest allocation. However, only N28.65 billion of this amount, ranking 11.46 percent, was earmarked for capital expenditure, to be devoted to healthcare facilities and developmental projects. This is in contrast to the World Health Organisation (WHO) Abuja Declaration of 2001, which set a target of at least 15 percent of annual budgets to improving the health sector. This is also against the grains of the 2014 National Health Act which stipulates that one percent of the consolidated revenue fund be spent on the health sector.
If you factor in the poor implementation of the budget due to the paucity of funds – at the last quarter of the year, only 15 percent has been implemented in this year’s budget – we are sadly on a slippery slope to disaster in the health sector. This might represent a general overview of the dire situation of the sector, but the situation is worse for the vulnerable – women and children in particular. Many women, including the elites, die in the course of childbirth due to the absence of healthcare facilities and the lack of access to them, where available, either due to poverty or the lack of information. Women in the rural areas still rely on traditional birth methods with their attendant risks, because the government has not taken healthcare to their doorsteps. In this respect, again, the statistics is alarming. Nigeria accounts for 10 percent of global estimates of maternal deaths and one of six countries that account for 50 percent maternal deaths globally. For every 100,000 live births, there is an estimated 576 deaths.
As provided for in the National Health Act 2014, the government has to make a non-discretionary annual grant of not less that one percent of its Consolidated Revenue Fund for the funding of health related programmes. This provision was absent in the 2016 health budget.
Equally alarming is the mortality rate of children under five. Malaria, pneumonia and diarrhea have combined to decimate the population of children under this age bracket. In 2014 alone, 2.1 million under five deaths occurred as a result of malaria, while pneumonia and diarrhea accounted for 14 percent and nine percent, respectively. Challenges include malnutrition and stunting; these are indices that make human health security a zero sum game in Nigeria. Whereas optimal breastfeeding, adequate nutrition, child spacing and vaccination have the capacity to reduce child mortality, government has over the years paid lip service to all the local and international protocols it has signed up to, including the WHO’s recommendation of spending a minimum of $54 on the health of every person.
Nigeria is the most populous country in Africa and arguably the richest, if you take into consideration the country’s potentials. These resources have remained largely untapped; and not harnessed such that it can enhance the revenue profile of the country. It is disheartening to note that Nigeria has always had the problem of committing enough resources to the health sector. From 2006-2016, budget allocation for health ranged from three to six percent. Nigeria cannot be compared to African countries like Rwanda, Botswana, Malawi and Zambia whose health allocations range between 16 and 18 percent and have surpassed the WHO’s 15 percent benchmark.
Nigeria’s healthcare index is abysmal. With this grim picture, if the wealth of a nation is measured by the health of its citizens, Nigeria is at the bottom rung. This is not acceptable. The 2017 budget, which is already in the works, must, as a matter of urgency, increase the health budget to the agreed international benchmark.
The narrative that ran across all the presentations at a recent parley organised by Partnership for Advocacy in Child and Family Health in Nigeria (PACFaH), in collaboration with its seven partners, was the alarming underfunding of health. It is apparent that the sub-sectors that record minimum success in Nigeria are heavily reliant on grants by international organisations.
As provided for in the National Health Act 2014, the government has to make a non-discretionary annual grant of not less that one percent of its Consolidated Revenue Fund for the funding of health related programmes. This provision was absent in the 2016 health budget. Therefore, we all have a responsibility to ensure the government complies with the law by demanding that this salient provision of the NHA is imputed in the 2017 budget. This and other measures have become imperative, because, as they say, health, in itself, is a form of human security.
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