President Muhammadu Buhari on Tuesday proposed a capital expenditure of N46 billion for the Ministry of Health in the 2020 appropriation bill he submitted to the National Assembly.
Buhari also proposed N44.5bn for the Basic Health Provision Fund (BHCPF).
The proposed budget for the ministry is N4 billion short of the N51.1billion obtained in last year’s capital expenditure.
An aggregate expenditure of N10.33 trillion is proposed for the Federal Government in the 2020 budget proposal read by the president to the joint session of the National Assembly in Abuja.
The expenditure estimate includes statutory transfers of N556.7 billion, non-debt recurrent expenditure of N4.88 trillion, and N2.14 trillion of capital expenditure (excluding the capital component of statutory transfers).
Debt service is estimated at N2.45 trillion, and provision for a Sinking Fund to retire maturing bonds issued to local contractors is N296 billion.
While capital expenditures are monies spent on acquiring or maintaining fixed assets, such as land, buildings, and equipment, recurrent spending refers mainly to expenditure on operations, wages and salaries, purchases of goods and services, and current grants and subsidies.
Details of the budget proposal revealed that health came 11th as Works and Housing got the highest capital project proposal with N262 billion, almost six times that of health.
Even the Universal Basic Education Commission received N112 billion – more than double of what was allotted to health.
The spending plan did not, however, include a breakdown of what is to be spent on recurrent expenditure. In 2017 and 2018 the government proposed N71.1 bn and N51.1 bn respectively. The shortfall is an indication that Nigeria will again fail to meet the “Abuja Declaration” target of 15 per cent for the 19th year running.
The Abuja Declaration was adopted in April 2001 following the widespread shortfall in health budget by countries in Africa.
19 years later, only about seven countries — Rwanda, Botswana, Niger, Zambia, Malawi, and Burkina Faso, Togo — have met the Abuja target.
Nigeria that hosted the conference has never voted more than six per cent of its annual budget to the health sector.
The highest percentage since the declaration was in 2012 when 5.95 per cent of the budget was allocated to health.
Basic Health Care
For the first time since it started appearing in the budget, provision was made for the Basic Health Care Provision Fund (BHCPF) in the statutory transfers, which are the first-line charge in the proposal.
The N44.5bn proposed for it in 2020 is lower than the N51.22bn and N55bn provided in 2019 and 2018 which were not under the statutory transfer.
The BHCPF is the fundamental healthcare funding provided by the National Health Act. It was included in the national budget for the first time in 2018 since the Act was signed in 2014.
It provides for not less than one per cent of the Consolidated Revenue for healthcare funding.
The new funding was proposed even as Nigerians are still awaiting the release of N51.22bn BHCPF in the 2019 budget, today, only 25 per cent of the 2018 BHCPF has been released amounting to 13.77billion.
Stakeholders in the health sector have repeatedly decried the poor budgetary allocation, especially the late release or non-release of funding for most health interventions in the country. They said that it is a major cause of Nigeria’s grim health indices.
Various statistics show that Nigeria has one of the worst health care delivery records in the world.
According to the World Health Organization, Nigeria is rated 187th out of 191 countries in terms of health care delivery.
WHO said one-third of more than 700 health facilities have been destroyed in the country and about 3.7 million people are in need of health assistance.
The health body placed Nigeria at the third highest in infant mortality rate in the world.
Today, about 70 per cent of the country’s population still, spend out-of-pocket for health services, according to Budgit, a platform analyzing Nigerian budgets and public data.