Important issues are the least celebrated in Nigeria. The media constantly splash political scoops and stories on their front pages. They call some 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, health
budget is not prioritized. In the 2016 budget, the Federal Ministry of Health was allocated over N250bn and ranked 5th largest allocation. However, only N28.65bn of this amount, ranking 11.46% 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% annual budget to improve 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 paucity of funds – at the last quarter of the year, only 15 % has been implemented in this year’s budget -we are sadly on a slippery slope to disaster in the health sector. Now this may represent a general overview of the dire situation of the health sector. But the situation is worse for the vulnerable: women and children in particular.
Many women including elites, die in the course of childbirth due to absence of healthcare facilities and lack of access to them where available either due to poverty or lack of information. Women in the rural areas still rely on traditional birth method with attendant risks, because government has not taken healthcare to their doorsteps. In this respect, again, the statistics is alarming. Nigeria accounts for 10% global estimates of maternal deaths and one of six countries that account for 50% maternal deaths globally. For every 100,000 live births, there is an estimated 576 deaths.
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% 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 3 to 6%. Nigeria cannot be compared to African countries like Rwanda, Botswana, Malawi and Zambia whose health allocation ranges from 16-18% and have surpassed WHO 15% 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 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 subsectors that record minimum success in Nigeria are heavily reliant on grants by international organisations.
By the National Health Act 2014, the government has to make a non-discretionary annual grant of not less that 1% 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.
