© 2018 - International Centre for Investigative Reporting
QUESTION: Will Nigeria ever abide by AU’s ‘Abuja Declaration’ on health?
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’.
One important and well-acknowledged criterion for determining quality of livelihood is good health, which the people can have when access to quality healthcare is guaranteed. Adequate funding for health by government is very important to quality healthcare delivery, especially for women and children.
Knowing this, heads of state of African Union countries met in April 2001 in Abuja and pledged to set a target of dedicating at least 15% of their annual budget to improving the health sector. A look into the Nigeria’s health budget for the past seven years (2010-2017) shows that provisions for the health sector have remained below 15% as agreed in the Abuja Declaration.
Over the past seven years, the Federal Government’s health budget has fluctuated, with percentages ranging from 3.81% — being the lowest allocation — in 2010, to 5.58% in 2011. The year 2012 had the highest budgetary allocation of 5.95% to the health sector.
In terms of amount allocated to health in past seven years, 2017 budget has had the highest amount budgeted at ₦377.4bn naira. However, that equates to only 5.17% of the total budget. At the state level, only Bauchi State has allocated 16% of it total budget to the health sector, while only three of the 36 states of the federation (including the FCT), have their health budgets very close to the 15% mark set in the declaration. The three states — Kaduna, Niger and Nasarawa — allocated 12.4%, 11.6% and 10.4% respectively to health in their 2017 budgets.
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 DTA 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 71.2 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% as against the recommended benchmark of 20%, which means Nigeria is 75.7% away from the recommended benchmark. This depicts that the bulk of health spending is on the people.
Were the Abuja Declaration to be fulfilled, the implication is the achievement of a healthy Nigerian population, a development that would lift the country economically and socially.