On October 7, President Muhammadu Buhari presented before both sessions of the National Assembly, a proposed budget of N16.39 trillion (N16,391,023,917,692) for the 2022 fiscal year.
According to the President, the allocations to Ministries, Departments and Agencies (MDAs) were guided by the strategic objectives of the 2021-2025 National Development Plan, which amongst others include the strengthening of security, and enabling of a healthy populace.
Out of the total N16.39 trillion proposed budget, a sum of N711.28 billion (4.3% of the entire budget) is earmarked for the ministry of health, while N1.14 trillion (6.96% of the entire budget) is for the ministry of defence.
Based on the proposed federal government budget, and its allocation of N711.28 billion to the ministry of health in pursuit of the goal of a healthy populace, N3,453 is what the federal government has earmarked to cater for the health of all of its 206 million citizens.
The capital budget for the ministry of health stands at N194.60 billion, while recurrent expenditure is at N503.98 billion. The proposed budget for the ministry is the highest since President Buhari came into power in 2015.
The poor state of the health sector and government’s commitment to improving it might have been one of the reasons for the 29.37% increase in the proposed allocation to the ministry of health. President Buhari hinted at this by noting in his budget speech that critical health projects will be carried out in 2022.
Recall that because of poor health infrastructure and welfare, medical doctors went on strike twice between January and September this year. Beyond the strike, more than 500 doctors considered the option of leaving to another country as they indicated interest in a recruitment exercise by the Saudi Arabia Ministry of Health some two months ago.
A similar exercise was conducted in Abuja and Lagos in 2019.
If the N16.39 trillion budget proposed by the President is passed and the sum for the ministry of health approved, using the country’s estimated 206 million population, in the coming year, the cost of medical care budgeted for every Nigerian is N3,453. This is an improvement on last year’s figure pegged around N2,749 per citizen.
Nigeria is Still Far Below the Mark
Even though the proposed health budget and medical care amount per citizen is higher, in fact the highest in the last 5 years, the 2022 proposed health budget still falls below the 15% benchmark of health sector budget allocation which was reached by the leaders of the African Union (AU) in April 2001 at Abuja where the heads of state and government of the AU made a commitment to allocate 15% of their annual budget to improve the health sector.
While countries like Rwanda and South Africa have acted on their commitment by allocating at least 15% of their total budget to health, Nigeria still falls behind.
A review of the budgetary allocation to the health sector in the last twenty years by Dataphyte revealed that Nigeria has never met the 15% target agreed by the heads of state of the AU countries at the summit which is known as the Abuja Declaration.
The allocation to the health sector in the 2022 proposed budget is just 4.34% of the entire budget. This means that Nigeria has failed again by 10.66% to meet its 2001 health sector commitment.
Increase, but is it Sufficient? What health service can N3,453 buy?
Although this year’s budgetary allocation increased by 29.37% and the cost of healthcare per person is pegged at N3,453 higher than the 2021 figure, what healthcare costs can it cover?
Take an endemic illness like malaria, endemic because malaria accounts for 60% of all clinic attendance in Nigeria. The average cost of seeing a doctor in small clinics is N1,000 naira, the cost of a malaria test is also about N1,000. The cost of drug treatment for uncomplicated malaria is between N1,500 and N2,000. Not counting additional drugs like paracetamol, the average cost of treatment for uncomplicated malaria in a local clinic exceeds the budgetary allocation for each Nigerian. The cost goes way up for complicated malaria diagnoses that require hospitalisation, injections and intravenous medication.
The average cost for basic antenatal care, which includes periodic visits to see obstetric nurses during which routine tests are carried out, is between N25,000 to N35,000 in government institutions. This cost does not include ultrasounds which are as high as N5,000 and seeing consultants as may be required as pregnancy progresses. Private hospitals charge far more than this.
Reactions to N3,453 Figure Per Capita
Different reactions have trailed the proposed amount to the ministry of health and defence in the 2022 budget.
Reacting to the N3,453 figure per capita budgeted to cater for the medical care of every Nigerian in the proposed health budget, Jahdiel burst into uncontrollable laughter. “Between January and this month alone, I have spent about N250,000-N300,00 on my health, either treating malaria, typhoid or back pains”, he said.
To Jahdiel, the proposed amount looks and sounds surreal, considering how important health is and the medical needs of citizens in the country.
It was similar reactions from five other persons who spoke to Dataphyte. According to every one of them, they have spent between N7,000-N10,000 in 2021 on basic medical needs alone.
Haruna Mshellia, a federal lawmaker, also lamented the allocation to the ministry of health in the 2022 proposed budget. He noted that the money earmarked is not enough to address the challenges in the sector.
Way Forward
There is no doubt that the challenges in the health sector are many. However, they are solvable. According to the Nigerian Medical Association (NMA), if the government places importance on the health sector and improves the welfare of medical practitioners and other health workers, it will go a long way in solving the challenges in the health sector. Obansa and Orimisan also believe that one of the ways forward to the challenges is for the government to increase investment and public spending in the health sector.