The Problem With Nigeria’s 2022 Health Budget

President, Major General Muhammadu Buhari (retd.), signed the N17.16 trillion health budget for 2022 On Thursday, December 30.

A sectoral breakdown of the budget indicated that N724 billion (4.2 per cent) was allocated for healthcare across the 36 states of the federation and the Federal Capital Territory.

With this allocation, Nigeria has once again failed to meet its Abuja Declaration commitment which requires the nation to ensure that 15 per cent of its annual budgetary allocation goes to health.

However, to allocate a paltry 4.2 per cent of the budget to the health sector at a time the country is facing numerous challenges such as the scourge of COVID-19 pandemic, cholera, malaria and other infections is a sad commentary not just on the state of the health sector, but also on how the Federal Government view the needs of the sector.

It must equally be stated that allocating such a meager amount to the sector also explains the premium placed on human lives by the government.

Going by the approved budget and the country’s population of over 206.1 million as estimated by the World Bank, an average Nigerian is only entitled to N3,510 worth of medical care in 2022. That’s an equivalent of 8.50 US dollars if converted using the official N413/dollar rate.

While there may be an increase in what is budgeted compared to recent years, the fact is that there isn’t much gain when the variables of inflation rate and increase in population are considered.

For instance, the approved 2022 budget was scaled up by 24 per cent when juxtaposed with the N549.8 billion budgeted for the sector in 2021.

However, in the actual sense of it, this increase is nearly rendered insignificant by the inflation rate.

Recall that the country’s inflation rate peaked at 18.12 per cent in April 2021 and the World Bank has predicted that Nigeria may have one of the highest inflation rates globally in 2022, with increasing prices diminishing the welfare of Nigerian households.

Most importantly, the plan to remove fuel subsidy mid-2022, as announced by the Minister of Finance, Zainab Ahmed, is also expected to cause a spike in fuel pump price and that will ultimately see inflation in prices of goods and services.

In all of these, Primary Healthcare Centres bear the brunt. They are the worst affected with most of them poorly staffed and without necessary basic facilities.

Yet, with their closeness to the grassroots, the PHC’s are supposed to cater to the basic health needs of most Nigerians.

The National Primary Health Care Development Agency, the agency in charge of the PHCs nationwide, got N24 billion in the approved budget.

If shared across the 30,000 PHCs in the country, each of the centres will run on N800,000 for the year. It is quite obvious that N800,000 is too small to run a PHC properly in a year.

Decrying the neglect of the PHCs, the Minister of State for Health, Senator Olorunnimbe Mamora, at a public hearing organised by the House of Representatives Committee on Health Institution, said less than one-third of the 30,000 primary healthcare centres in the countries are functioning optimally.

He then urged the two legislative Chambers to stop passing bills seeking to establish more hospitals and other health facilities across Nigeria.

“A number of the existing health facilities and institutions are groaning under the pains of inadequate funding. Whether federal medical centres, whether they are teaching hospitals, even at the primary health centre level in the communities.

“It would interest you to know that at the last audit that the ministry of health carried out, out of about 30,000 primary health centres in that audit report, we have less than one-third that is functional and even those ones are not fully functional because the functionality is not determined by the building, the physical structure,” he said.

The comprehensive and tertiary healthcare centres are overwhelmed because of the failure of these PHCs, said a former President of the National Association of Nigerian Nurses and Midwives, Abdulrafiu Alani Adeniji.

“The primary healthcare centre is expected to take care of 70 per cent healthcare needs of Nigerians. The state is supposed to take care of 20 per cent and the Federal takes care of the remaining 10 per cent. But the situation is upside down. People who have malaria are going to the teaching hospital when the primary healthcare centres should have taken care of them,” Adeniji had said in an interview.

It is imperative for the Nigerian government to as a matter of urgency take the bull by the horn and tackle the myriads of challenges confronting the health sector.

The FG must go beyond paying lip service by prioritizing the funding of the health sector and ensuring appropriate budgetary provision for the sector must be the starting point.

While the 2022 budget is already signed by the president, the Federal Government should consider a supplementary budget for the health sector.

The supplementary budget could be used specifically to address the infrastructure deficit in the sector and thereby ensure our public hospitals are able to provide the quality healthcare that Nigerians need.

The Nigerian nation must begin to make a quality investment in the health sector.

Quality investment in healthcare will not only help the country to reduce medical tourism and brain drain in the health sector, but it will also help fast-track our quest for national development across sectors.

PUNCH