34 states fail on the 15% health funding benchmark since 2020 —Report

NIGERIA’S health budget as a percentage of the total budget is declining, with 34 states failing to meet the 15 per cent adequate health funding benchmark between 2020 and 2022.

The report by ONE Campaign, entitled Post-Pandemic Health Financing by State Governments in Nigeria 2020 to 2022, revealed that since the COVID-19 pandemic hit in 2020, public health allocations per person have also fallen from $10.8 per person in 2020 to $8.5 per person in 2022. This has an impact on the quality of healthcare delivery in the country.

According to the report, although the combined budgetary allocations of all 36 states increased by 12.8 percent between 2020 and 2022, in real terms, the health sector received less funding in 2022 than in 2020 when adjusted for inflation.

It also reveals that the proportion of total budgets allocated to health by most state governments is on a downward trend, reflecting the quality of healthcare delivery in the country.

While only three States have reduced their fiscal allocations to the health sector, it said that only two states (Kaduna and Sokoto) consistently met the 15% health allocation target between 2020 and 2022.

The report’s findings, however, show a deviation from this expectation, with more than 10 state governments in Nigeria reducing their fiscal allocations to healthcare since the pandemic hit in 2020, putting a strain on an already-stressed sector.

Nigeria Country Director at The ONE Campaign, Stanley Achonu, in a statement, said it was extremely worrisome that some state governments are slashing their annual allocations to health when they should be striving to meet the Abuja Declaration’s 15 per cent funding benchmark.

According to him, “Nigeria’s health indicators are reportedly some of the worst in Africa. COVID-19 has exposed additional gaps in the country’s healthcare system and has shown why the sector requires ambitious strategies and adequate funding to serve the masses, particularly the poor and most vulnerable in the society.”

He added, “as the 2023 budget season approaches, governments at all levels must prioritize health care and allocate a significant portion of their budget to improving healthcare delivery.”

Adequate disbursements should follow these allocations to finance health infrastructure and programmes.”

The report urges governments to demonstrate strong political will and commitment to the Abuja Declaration by allocating at least 15% of their total budget to health.

In addition, governments must commit to evidence-based programming, ensure effective stakeholder participation in budgeting processes, invest in primary health care centres, and complement adequate funding with sufficient health workers and effective health system governance.

This report is a follow-up on the “State of Primary Healthcare Service Delivery in Nigeria” report released in July to track state governments’ performance in implementing the Basic Health Care Provision Fund (BHCPF).