Nigeria’s health sector has been fraught with suboptimal public investment to sustain its development and achievement of key development objectives such as Universal Health Coverage (UHC) and other health components of the Sustainable Development Goals. Over the last years, appropriation to the health sector in the national budgets has consistently fallen shot of the Abuja Declaration of the African Union that recommended 15% allocation of national budgets to the health sector. Also, healthcare investment per person has been below the recommend N6,000 per capital.
This low level of public investment in the sector has contributed to the huge out-of-pocket payment for health by citizens in the country, which currently stands at about 77% total expenditure on health. Access to and delivery of health care services are as a result grossly inadequate, contributing to the low/negative health indices and outcomes as well as a huge disease burden in the country. Other outcomes are catastrophic spending contributing to increased poverty rate.
The 2023 National Budget was laid at the National Assembly by H.E, President Muhammadu Buhari on the 7th of October 2023. With a total budget estimate of N20.5 trillion, for the first time, over N1 trillion was allocated to the health sector with a budget share of 5.75% as against 4.7% in the 2022 Amended National Budget. Although the budget line for Family Planning has been re-introduced, the allocated N20 million is inadequate, viewed against the Country’s population and human development indices, and requirements for stability. This and other issues raised a cause of concern within the health partners’ space in the country driven by a commitment to ensure Nigeria achieves its global health goals.
To this end the coalition of CSOs working under the one voice coalition of the BMGF funded groups in Nigeria, and other partners request commitments and interventions to address the issues which are centered on the following:
1. a Fulfill Nigeria’s commitment to pay 4 million dollars for Family planning commodities, procurement, and consumables. There have been challenges with releases from the service-wide vote. Nigeria has not fulfilled its commitment level since 2018.
b Fulfill Nigeria’s commitment to allocate 1% of the nation’s health budget at all levels for family planning in line with efforts to reduce mother and child death rates in the country.
c Increase the Family planning budget line on programs “Improve family planning services through contraceptive use, interventions, and counterpart funding”. The proposed 2023 budget line item is insufficient to deliver on Nigeria’s health agenda.
2. Increase the current health budget, which is proposed at 5.75% of the total national budget (Nigeria’s global commitment (Abuja declaration 2001) is 15%). This is in line with Nigeria’s National Development plan.
3. Keep the 1% minimum BHCPF as a statutory transfer as provided in the National Health Act and other subsidiary legislations and guidelines. The BHCPF is critical for sustainability toward achieving Universal Health Coverage and RMNCH+N.
4. Increase the proposed budgetary allocation for polio eradication in the current health budget.
Honourable Usman Muhammad
Chairman, National Advocates on behalf of the group