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Published On: Tue, Jul 28th, 2020

Analyzing implications of Nigeria’s health budget cut

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By Tobias Lengnan Dapam

The fear that many Nigerians nursed about a potential cut in the country’s health budget has finally come to realization when President Muhammadu Buhari officially signed a budget that has no regard for the health sector struggling in the middle of a pandemic.

At first when the rumours of the cut were heard, many Nigerians were quick to dismiss it, saying that the government will prioritize the health sector at a time when ‘billions were flying in the air’ to address the coronavirus and cushion the effect it had on many Nigerians.

But recently when the revised budget was finally submitted, signed and delivered, Buhari shocked the world. His government damned every consequences and slashed the health budget by 40 percent in the midst of coronavirus outbreak.

Judging the events, it was hard to draw a line in the sand, considering the enormity of the pandemic and the number of daily confirmed cases and deaths recorded by the Nigeria Centre For Desease Control (NCDC).

Also, the cut came when Civil Society Organisations (CSOs), were worried about the increase in cases of malnutrition and maternal mortality worsened by Covid 19. They warned that the cut will have a dire consequences on an already weakened health facilities operating like morgues.

“Nutrition is among the causes of anemia, and anemia is a major concern among women, leading to increased maternal mortality and poor birth outcomes as well as reductions in work productivity. Over half (58%) of women age 15-49 have some degree of anaemia. Twenty- eight percent each are mildly anaemic and moderately anaemic, and 2% are severely anaemic (NPC and ICF, 2019)”

Also, the acting Chairman of the National Population Commission (NPC) Dr. Eyitayo Oyetunji while speaking to mark the World Population Day, said COVID-19 may have led to higher proportion of malnourished women, giris and children. “COVID 19 did not make it easy for women to access and utilize reproductive health facilities especially as the logistics of getting to health facilities were negatively impacted.

“This situation could have worsened the already high maternal mortality rate of 556
deaths per 100,000 live births. The likely effect of the COVID 19 pandemic on the delivery of contraceptives is better imagined.

“Already Nigeria is experiencing low contraceptive prevalence rate and unmet needs. The contraceptive prevalence rate (CPR) for modern method is 12% for married women, while for sexually active unmarried women, only 28% are using a
modern method. The unmet needs for family planning is as high as 20% in some parts of the country. The implication of limited access to commodities and services includes higher level of STIS due to unprotected sex, unwanted pregnancies, unsafe abortions, maternal mortality and unwanted pregnancies.”

It is unfortunate that despite these challenges, the revised budget recently signed by the President falls short of addressing the woes of many Nigerians, especially women and children.

In the proposed revised budget,  while the National Assembly complex renovation budget  was reduced to  N27.7bn (a reduction of 25.1 per cent), the Basic Health Care Provision Fund, which is meant to cater for all the primary healthcare centres across the 774 local government areas in the country, was significantly reduced by N44.4bn to N25.5bn, a decrease of more than 42.5 per cent.

The BHCPF is made up of one per cent of the Federal Government Consolidated Revenue from international partners such as the World Bank, Bill and Melinda Gates Foundation and the United States Agency for International Development.

It is the fundamental funding provision under the National Health Act and was appropriated for the first time in the 2018 budget since the Act was signed in 2014.

With the growing number of COVID-19 cases in the country, an increase in budget share to the health sector is expected to address the emergencies, but the same government that was begging Nigerians to contribute money to fight the pandemic is allocating billions for National Assembly renovation and fumigation of farms to kill grasshopper.

As the misplaced priority remains significant in the midst of pandemic, the Executive Chairman, Centre for Anti-Corruption and Open Leadership, Debo Adeniran, said it was unfortunate that Nigeria, which is the poverty capital of the world, would relegate the health and education sectors.
Adeniran said Nigeria had one of the highest maternal and mortality rates in the world as well as out of school children and the government ought to give priority to health and education.

He said, “Why should we waste N27bn on building that is not showing any sign of distress? It is a misplaced priority and a total waste. The National Assembly doesn’t need repainting let alone renovation.
“Nigeria is the poverty capital in the world despite being one of the most endowed countries. It is the misplacement of priorities that brought us to this sorry state we found ourselves.

“Nigerians are dying from treatable and preventable diseases and the government thinks it is right to slash the health budget while maintaining the N27bn for renovation? It is a shame.”

Also, the Executive Director of Human and Development Agenda, Lanre Suraj, said Buhari could not claim not to be aware of the injustice being done to Nigerians.
Suraj said reducing the health budget showed that the government had not learnt any lessons from the COVID-19 pandemic.

He said, “It will be very difficult to absolve the President of the blame. This is a disservice to young people and Nigerians in general. It is obvious the government doesn’t have the interest of the masses at heart.

The pandemic has exposed the poor state of the public health centres as they have failed to meet up to standard in the pandemic. To reduce the basic health care fund by almost 50 per cent and then maintain the budget for National Assembly complex renovation which has no bearing on the people is a betrayal of trust and all citizens must reject it.”

According to Prof Innocent Ujah, the head of the Nigerian medical association, the cuts have come just as more investment in health is needed.
“Our budget for health is unacceptably low, under 5%. With the Covid-19 pandemic, it becomes even more serious,” he said. “It will have an impact on our response to the virus.”
Ujah said he was shocked at the announcement of the cuts, as it had been assumed health budgets would be ringfenced during the pandemic.
Fuelling criticisms of the healthcare cuts has been the 37bn naira (£75m) set aside for renovations to Nigeria’s National Assembly buildings.

Speaking further on the implications of the budget cut, the Board Chairman of the Community Health and Research (CHR) Initiative, Aminu Magashi, said the health sector will not have enough money to finance the basic health care provision fund.

Magashi, who is also the Coordinator of the African Health Budget Network (AHBN), expressed worry that there won’t be enough money for distribution to Primary Health Care Development Agency, National Insurance Scheme and emergency services.

“Also, there wont be enough money to procure vaccine for immunization. The immunization money which is usually in partnership with global partners to procure drugs in the international market will be grossly affected by this cut.”

Magashi added that drug for family planing, tuberculosis, HIV, malaria, life saving drugs, cancer and many more will be affected by this budget cut.

As a way out, Magashi called on the government to prioritize health sector alongside defence.

“If defence has the highest budget, health should be number two or they should be side by side. This is because the security of every country must be policed by people who are healthy. If they are not healthy, they cannot deliver; so we need to provide more money for health to address that.”

He argued that in saner climes, health and defence are considered tops in the budget to promote both security and health of the people at the same time.

He called on the media to champion the advocacy and prevail on the government to to pay more attention to the health sector.

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