Dr. Chijioke Kaduru
As the Federal Executive Council prepares to present the second budget of this Administration to the National Assembly, President Muhammadu Buhari can demonstrate unparalleled commitment to Nigerians through the 2017 Budget and the commitments to the Health Budget contained within.
Nigeria has a weak health system, easily seen through the numbers of certain events that occur around the Country. Our own National Demographic and Health Survey of 2013 (NDHS) records 576 maternal deaths out of every 100,000 live births. This translates to the deaths of approximately 40,000 women every year (111 deaths per day or 5 deaths per hour) due to pregnancy or issues related to or aggravated by Pregnancy. Within the same NDHS, 69 infants die in every 1,000 live births and 128 children under 5 years die per 1,000 live births. This implies that 1 in 15 Nigerian children die before their first birthday and that 1 in 8 die before their fifth birthday.
Programs designed to enable families to choose the number and spacing of their children, increase the proportion of births attended by skilled health personnel, increase immunizations against vaccine-preventable diseases, provide early recognition, care and treatment to sick children especially children with Malaria, Pneumonia and Diarrhea, and programs to upgrade the status of women through education and enhanced participation in the labor force can all help to improve the probability of survival of young children.
A number of these programs already exist and are running across Nigeria. However, poor budgetary allocations to such critical programs has continued to undermine these programs, limiting our ability as a Nation to save the lives of women attempting to bring life into the world, and the lives of the babies. The programs that can save these lives are funded by the Capital Expenditure portion of the Health Budget, which stands at a meager N28 billion for 2016.
Beyond the very critical issue of saving lives and advancing the health of Nigerian families, the need for an increase in the Capital Expenditure portion of the Health Budget is evident in the current funding arrangement across Health programs. Currently, donors predominantly fund some of the most important programs that can save the lives of women and children. Programs cutting across family planning, immunization, nutrition and major childhood killer diseases fall into this category.
With the rebasing of Nigeria’s economy a few years ago, Nigeria moved up a development category and was no longer seen as a low-income country. This has resulted in the need for some of these donor funds to be wound down, as donor funds typically target countries in the low-income category. This means that while there is a gap in funding to support these programs currently, the gap is going to widen as donor funds wind down and are pulled out. Nigeria needs to take a position and begin to allocate increasing amounts of money to the Health Budget to sustainably fund these programs.
Additionally, as Nigeria looks to work its way out of a recession, the Nation must look to the evidence of some best practices around the World. Evidence from the work of the Lancet Commission on Investing in Health found that between the year 2000 and 2011, Health investments were responsible for nearly a quarter of economic growth in developing countries.
With limited income attributable to a global oil price crash, Nigeria must spend scarce resources smartly, for better outcomes. Investing in the Health Budget towards ensuring that the lives of women and children are saved, and that Nigerian families are healthier, increases the readiness of individuals to join the work force, increases the productivity of people already a part of the work force, reduces the number of days that members of a family are absent from work, and reduces the amounts of money committed by families to restore health. All of these have the potential to contribute to sustainable economic growth.
A recent Nigeria Health Budget trend analysis by the Partnership for Advocacy in Child and Family Health shows that 2016 was the year with the second lowest commitment to Health by the Federal Government, across a 10-year period. Additionally, the National Health Law mandates that 1 per cent of the Consolidated Revenue Fund of the Federal Government be committed to funding the Basic Healthcare Provision Fund.
The President Buhari-led administration cannot afford to be remembered for a legacy of inadequate funding towards saving the lives of women and children. The administration will also not want to be remembered for refusing to obey the rule of law as mandated by the National Health Law, especially when this law simply seeks to improve the lives and wellbeing of Nigerian children and families.
The Honorable Minister of health has a commitment to Nigerians to ensure that Child and Family health programs are adequately budgeted for and are a priority in the 2017 Health Budget. The Minister of Budget and National Planning has commitment to Nigerians to redeem his promise that he would work to ensure an increased 2017 Health Budget. President Buhari will need to lead this process to showcase his unparalleled commitment to Nigerians.
An investment in Health is an investment in the wellbeing of all Nigerians and an investment in the Economic growth and development of this nation.
Dr. Kaduru is a Public Health Physician who specializes in Child and Family Health programming, and Health Systems strengthening