There has been a toxic mix of problems plaguing Nigeria’s health service including inaccessibility of quality health care, corruption, poor health infrastructure, insufficient financial investment, and lack of sufficient health personnel. Over the years the government’s performance in the sector has been abysmal. Investment in infrastructure has been poor, and meagre remuneration for health workers has created a massive brain drain to the US and Europe.
A 2013 report by the World Health Organisation on the state of health financing in the African region showed that member states of the region, of which Nigeria is a member, are on average still far from meeting key health financing goals such as the 2001 Abuja Declaration target of allocating 15 per cent of the government budget to health.
Now in 2020, only about seven countries — Rwanda, Botswana, Niger, Zambia, Malawi and Burkina Faso, Togo — have met the Abuja target. In 60 per cent of the countries, the health sector share of total government expenditure is below 10 per cent, according to the World Health Organisation.
Only recently the country failed to meet that commitment when President Muhammadu Buhari proposed the 2021 budget, allocating less than 10 per cent to the sector. The budget proposes N547 billion for healthcare, about seven per cent of the total N13.08 trillion budget.
Nigeria’s highest-ever public budget share for its health was seven per cent. That figure fell to less than 4 per cent in 2019. This shows that the seven per cent proposed for 2021 is a very marginal improvement over the 2019 and 2020 figures.
When ARISE News spoke with the Senator representing Enugu North senatorial district, Chukwuka Utazi, who is the Chairman, Senate Committee on Primary Healthcare and Communicable Diseases, he said the major problem with the health sector has always been funding. According to him, President Buhari’s statement while presenting the 2021 budget that all aspects of the health sector will receive a 100 per cent funding is a welcome development.
“The whole problem has always been funding, we hope that this move by the president to allocate more funds to the health sector in this years’ budget will be sustained,” the senator said while addressing questions on the state of healthcare in the country.
He added that “the only way to have a sustainability plan for Nigeria’s health institutions and infrastructure is freeing the so many resources being put into capital projects. Those projects that can be concessioned to private investors to put their money there and recoup their money should not be taken by the government because once the government put so much money there it means that health institutions and the education sector will suffer.
“The rail line that the government is borrowing money to fund should not be so, those people lending money to us should come and bid for it. They should come, bid, build, operate and transfer the rail lines to us at the end of recouping their money so that we can use those monies and put in those areas that are less attractive for private investors to this country like health. If we do that, things will work well for this country,” Utazi said.
The senator accused state governments of paying lip service to the funding of health centres in their states but says plans are in place to ensure at least one ward in the 774 local government areas across the country has a basic medical health centre that can be accessible to the people in the community.
“Many states are not playing their part, but we are discussing these issues. We’ve always complained that we have not been fair to the health institutions in the country, governments at all levels, not just the federal government, the state government pays lip service to what they should be doing in terms of the health infrastructure in this country and when there’s a major outbreak like the coronavirus everything collapses.
“That’s why we had the integrated mobile medical outreach by the primary healthcare which was planned before the problem of restriction of movement came into force. Our plan was to touch the 774 local governments in the country to ensure things work, we have enough budgetary provisions to make sure they are all put to use. We are also working towards ensuring that at least one ward in the country should have a basic medical health centre that can be accessible to the people living in that community. So we are working on that to ensure things work for our people,” he said.
By Abel Ejikeme