NIGERIA has spent 72 per cent of its health sector budgets to pay salaries and run offices in the past 11 years.
Data from the Budget Office of the Federation show that the Federal Government allocated N3.5 trillion (N3,545,594,778,327) to the sector within the period.
Of the fund, the Federal Ministry of Health got N2.9 trillion for recurrent (N2,905,050,442,117) and N640 billion (N640,544,336,209) for capital expenditures.
Recurrent expenditures refer to funds used to pay salaries, train employees and run offices.
Capital expenditures are spent on physical projects, namely building new offices, equipping them, and making other procurements.
The ministry’s capital budget for the period stood at nearly 19 per cent of its total budget (18.06).
Despite earmarking nearly 19 per cent of the budget to capital projects (N640,544,336,209), the government released less than 80 per cent (76.9) of the capital funds.
The government data show that only about N493 billion (N492,798,032,599) got to the ministry within the period.
In October 2021, The ICIR reported how salaries and costs of running offices gulped 73 per cent of the country’s 2022 proposed health budget.
This newspaper also published another report showing how the ministry proposed N91 million for its headquarters in the 2022 budget as money for anniversaries.
Sector’s budget below Abuja Declaration
The yearly budget for the ministry has been much less than what African leaders agreed to commit to the health sector in their respective states.
In what is famously known as Abuja Declaration, Heads of Government in Africa agreed to allocate 15 per cent of their national budgets to the health sector in 2001 at a meeting in Abuja.
The Nigerian government has since never dedicated up to eight per cent of its budget to the sector.
For instance, appraising the sector when President Muhammadu Buhari clocked six years in office in 2021, this newspaper reported that in 2016, the Federal Government had a budget of 6.06 trillion, out of which it earmarked 550 billion to the health sector. The amount represented 4.1 per cent of the budget.
In 2017, the total budget was 7.4 trillion. The health sector got 308 billion, representing four per cent.
There was a further decline in the percentage of the health budget to the national budget in 2018. The total federal budget was 9.1 trillion that year, from which the sector got 356.4 billion. Allocation to the ministry was 3.8 per cent of the national budget.
The country’s budget in 2021 was 13.6 trillion, and the ministry got 514 billion, being 3.7 per cent of the budget.
How poor budget affects sector
Because of poor funding, many of Nigeria’s public health facilities are in a decrepit state, and they lack the tools needed for services.
Many professionals in the sector have abandoned the country to work abroad because of poor pay and an inconducive working environment.
A recent series of investigations by The ICIR showed how consultants and other workers resigned from Federal Medical Centres Makurdi, Jalingo, Yola and Abakaliki in Benue, Taraba, Adamawa, and Ebonyi states, respectively, to pick jobs abroad.
Fifty-six years after the nation’s independence, the immediate past Minister of Health Isaac Adewole said in 2016 that no cancer machine worked in any of the nation’s hospitals.
The government estimates that cancer is responsible for 72,000 deaths in the country every year, with an estimated 102,000 new cancer cases annually.
Similarly, the Secretary to the Government of the Federation, Boss Mustapha also expressed shock over the deplorable state of the sector at the onset of COVID-19 in 2020.
The maternal and child health indices from the National Demography and Health Survey (NDHS 2018) further underscore the poor state of the sector.
The NDHS puts the Maternal Mortality Rate at 512 maternal deaths per 100,000 live births, the Infant Mortality Rate at 67 deaths per 1,000 live births, and the average Life Expectancy of people in the country at 54.7 years.
At different times, recurring strikes have crippled services in public hospitals because of workers-government face-offs over pay and other demands.
Almost half of country’s 75,000 registered doctors have travelled abroad – Minister
Speaking at the maiden Annual Lecture Series of the Nigerian Medical Association in Abuja on April 4, Minister of State for Health Olorunnimbe Mamora decried the high rate of brain drain in the sector.
Mamora, a doctor, spoke on the lecture’s theme: “Brain Drain and Medical Tourism: The Twin Evil in Nigeria’s Health System’’.
Mamora said almost half of the nation’s 75,000 registered doctors and other health professionals had left for greener pastures.
He attributed the exodus to poor remuneration, poor economic performance, poor security cover for lives and properties and immigration policy of developed countries that favour immigration of highly skilled individuals.
“The Federal Ministry of Health has noted with concern the rate at which Nigeria is losing her specialists and experienced health professionals trained at great cost to other countries that offer more robust welfare packages and other conditions of service.
“Emigration of health care professionals contributed immensely to the gap observed in the country’s human resources for health. Out of about 75,000 registered medical practitioners in the country, nearly half have migrated to other countries in search of the proverbial greener pastures. This observation is true for other cadres in the health sector.”
The minister said the government spent between $21,000 (N8,719,620, being CBN’s official rate of 415.22) and $51,000 (21,176,220) to train a doctor “under a relatively free educational system”.
Quoting a publication by the Asian Journal of Medicine, published in 2017, he said tourists from the country numbering 34,522 visited India in 2013, out of which 15,328 (42.4 per cent) went on medical tourism.
He explained that the CBN’s balance of payment report released in March 2022 stated that Nigerians spent $11.01 billion on foreign countries’ health-related services between 2010 and 2020.
Sector’s problems arise from poor funding, mismanagement – Okara
Meanwhile, the Registrar/Secretary-General, West African Postgraduate College of Medical Laboratory Science (WAPCMLS) and former National President of the National Association of Medical Laboratory Scientists (AMLSN) Godswill Okara blamed the sector’s crises on mismanagement and underfunding.
Okara said though the sector’s budgets had been poor, if the resources available are prudently managed, the sector would produce better outcomes than it had done.
He cited the reported failure of the State House Clinic, where the government spent billions but could not treat public officials who prefer going abroad for care as an example of reasons the nation’s health system was failing.