EIGHTEEN years after member-state of the African Union agreed to allocate 15 per cent of their annual budget to the health sector, Nigeria has continued to be a serial defaulter of this agreement.

A healthy population is truly the best insurance to help the economy thrive. This was the main premise of the 2001 Africa Union ‘Abuja Declaration’.

The federal government proposed the sum of N365.7 billion as the 2019 budget for the health sector, representing just 4.1 per cent of the national budget as against 15 per cent recommended by the ‘Abuja Declaration’.

If approved, the ministry would get N315,617,344,056 for recurrent expenditure and N50,146,387,170 for capital expenditure.

A look into Nigeria’s health budget for the past ten years (2010-2019) shows that provisions for the health sector have remained far below 15 per cent.

Over the past ten years, the Federal Government’s health budget has fluctuated, with percentages ranging from 3.9 per cent — being the lowest allocation — in 2010, to 5.7 per cent in 2013. Compared to the national budget, the year 2012 and 2015 had the highest budgetary allocation of 5.8 per cent to the health sector.

In terms of the amount allocated to health in the past ten years, the 2017 budget had the highest amount budgeted at ₦377.4bn naira. However, that equates to only 5.17 per cent of the total budget.

Nigeria is among the worst places in the world to accommodate a child, infant or mother. This is because one in eleven of all children who die in the world under the age 5 are Nigerian.

Sadly, the country’s health system has been neglected for long and this has led to negative health indices. The 2015 data from the World Health Organisation (WHO) showed that the life expectancy at birth is 53 years, which is below the Sub- Saharan Africa’s average of 56. Another index is the maternal mortality ratio, which stands at 814 per 100,000 live births, infant mortality rate stands at 69.8 death in every 1,000 live births and under-five mortality rate at 89 in every 1,000 live births.

Nigeria’s heavy out-of-pocket spending

The World Health Organisation (WHO) defines out-of-pocket payments (OOPs) as direct payments made by individuals to healthcare providers at the time of service use. According to WHO, Nigeria’s out-of-pocket spending is 95.7 per cent as against the recommended benchmark of 20 per cent, which means Nigeria is 75.7 per cent away from the recommended benchmark. This depicts that the bulk of health spending is on the people.