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2023 BUDGET AND THE HEALTH SECTOR
The authorities should give significant attention to health issues
Aside having one of the worst infant mortality rates in the world, Nigeria is the second country with the highest number of people living with HIV/AIDS; the first with the highest number of malnourished children and the highest number of people lacking access to basic primary health care. With 840 maternal deaths in 100,000 and 143 deaths in 1,000 under-five-year-children, Nigeria loses 2,300 under-five children and 140 women every day. With such dire statistics one would imagine a level of seriousness when discussing health budget. But every year, in the process of appropriation, the National Assembly members treat health allocations without due regard for the critical nature of the sector.
In the 2023 Appropriation Bill before the National Assembly, the sum of N1.17 trillion is provided for the health sector by the executive. Despite that this allocation is far below the 13 per cent recommended by the World Health Organisation (WHO) and the 2001 African Union (AU) 15 per cent Abuja declaration, there is nothing to suggest that the lawmakers may not tamper with the allocation in a manner that makes nonsense of the plan for the critical sector. That has been the pattern every year. The consequence of this state of affair in the health sector is that several Nigerians now habitually fly to India and other countries to obtain what they consider quality health services at a very huge cost to our economy.
In the 2022 budget, the allocation to Basic Health Care Provision Fund (BHCPF) was reduced by almost N10 billion, from N54.05 billion to N44.56 billion. The essence of the BHCPF is the attainment of the Universal Health Coverage, by funding primary healthcare clinics across the country in order to give Nigerians in rural areas access to health. Ordinarily, the allocation to these healthcare centres should not be less than one per cent of the Consolidated Revenue Fund. Yet the lawmakers still tampered with the initial N54.05 billion that was grossly inadequate.
Another issue that concerns many stakeholders is the lip service being paid to maternal health, neonatal health, and birth control, in the face of an astronomical population growth. The lack of access to contraceptive commodities exposes women to unwanted pregnancies and other related health challenges. Government, at all levels, has failed to match finances with rhetoric about child spacing, by never making budgetary allocations for it, and refusing to release funds for the procurement of commodities when the line item features in their budgets. Many advocacy groups enlighten communities about the importance of child spacing to families’ health and wealth but lack the critical resources.
Meanwhile, due to both lack of job fulfilment and inadequate remunerations at home, Nigerian medical practitioners are leaving the country in droves for Canada, United Kingdom, Saudi Arabia, Kuwait and other Asian, European and American countries where their services are required, and the reward systems are better. This latest form of brain drain poses huge challenge to our beleaguered health sector and should worry the authorities in our country.
Without raising budgetary allocation for health, and ensuring such funds are released, the multiple challenges facing the sector could worsen. In many primary healthcare clinics in rural areas, there are no nurses and midwives, as health workers have migrated abroad or to urban centres due to the lack of medical equipment, unacceptable work environment, slow career progression and poor remuneration.
The only way to reverse the trend is to ensure increased health financing through deliberate collaboration between the executive and the legislature. President Muhammadu Buhari underscored the significance of health to human capital development while presenting the 2023 Appropriation Bill before the National Assembly. It is now left for the lawmakers to do the needful.