IF NIGERIANS’ poor health indices are to improve, government needs to devise innovations for optimal health budget performance.
Presently, it is estimated by the 2013 National Demography Health Survey (NDHS) that the country records 576 deaths from every 100,000 live births and Infant mortality ratio of 69 deaths out of every 1000 live births making Nigeria one of the worst places to give birth by World Health Organisation (WHO).
The continuing poor indices are hinged on the inability of yearly budgets to address vital aspects of health which include maternal and child health as well as infant Nutrition.
This was the view of stakeholders at a one-day Health Financing Dialogue organised by Lagos State Accountability Mechanism for Maternal and Newborn Health (LASAM) in collaboration with Save the Children International, NNNGO-PACFAH @SCALE, Lagos State Civil Society Partnership, DEVCOMS and MamaYe-Evidence for Action.
The concerns over health budget performance at all tiers of government especially as it concerns Primary Health Care (PHC) and Maternal, Newborn Child Health and Nutrition. (MNCHN) made the stakeholders to call for review of how funds for healthcare are sourced alongside optimising spending for its performance.
Director of Advocacy and Communication, Pharm Access Foundation, Dr. Olamide Okulaja in a keynote presentation at the Lagos State Health Financing Dialogue described present health budget activity of federal government and states as “imbalanced and poor” due to the skewed nature.
Okulaja observed that over the years over 85 percent of governments’ spending on health have gone into recurrent expenditure of salaries, wages and consumables leaving little to capital development.
According to Okulaja, “The bulk of Federal Government spending on the healthcare sector is allocated to recurrent expenditure (salaries and overheads including medical consumables) thus resulting in inadequate capital expenditure in the healthcare system”.
He noted, “Insufficient spending on healthcare has led to poorly equipped hospitals which are usually unable to treat complex ailments, resulting in dire consequences for patients hence, Nigeria’s Health Outcomes are appalling”.
Okulaja in comparing health budget allocations and spending among Federal, Lagos, Kwara and Adamawa States, observed that in 2017, a meagre 4% of total Federal budget was allocated to health; Lagos allocated 6%, Kwara achieved 15% while Adamawa State gave 8% of its total budget to health.
He expressed concern that of the 6% Lagos State allocated to health in 2017, only 33% of it went for capital projects while 67% went to recurrent. Even at that, only 21% of the actual health budget was released for spending, Okunlaja pointed out.
He therefore advised that in appropriating adequate domestic resources to the health sector, “dedicated analytic, policy, and advocacy efforts are required”.
Okulaja equally recommended tax innovation as potential revenue source through sin taxes (such as tobacco and beer), telecoms taxes, and additional corporate and social responsible tax among others.
He also suggested improving health expenditure efficiencies. He identified leading causes of inefficiencies to include higher-than-necessary prices for medicines; use of substandard and counterfeit medicines; overuse or oversupply of equipment and technologies; and inappropriate or costly mix of staff and inappropriate hospital size.
Okulaja called for prioritizing healthcare, social health insurance, involvement of private sector participation and donors while government strives to build on the tangibility of healthcare to derive optimal outcome.
Examining the various options for financing healthcare a panel of discussants at the event agreed that the model for innovation would have to be all inclusive, cooperative and a partnership of ideas that effectively work.
Lagos State Commissioner for Health Dr Jide Idris in his remark disabused minds of citizens that government do not feel their plight. He noted, “The limitations in the system only permits that we rely on income to government which are not often in control of Health Ministry and disbursement from the Finance ministry to actualise outcomes”.
Idris calls for inter-sectoral collaboration and a paradigm shift from how budgeting are done by carrying people along to know exactly what they want so they can follow and demand accountability.
Chair, House Committee on Health, Honourable Segun Olulade urged citizens to take town hall meetings seriously saying, “Citizens demand and requests are often collated at town hall meetings to plan budgets and so, Residents cannot ignore such gatherings”.
Director of Budgeting, Ibrahim Obajomo sees the need for officials of the ministry of health to be diligent in their modules for health budget to ensure optimal performance.
Chair of the Lagos State Civil Society Partnerships Barrister Ayo Adebusoye advocated for improved health budget allocation to 15%, prompt and timely release of the budget and a budget with human face.
Launching the #FundNaijaHealth campaign, Country Director, MamaYeE4A, Dr. Tunde Segun called for dedication of stakeholders to ensure higher survival rates of mothers and their children by committing increased funding to programmes that promote MNCH+N.