Nigeria’s budgetary allocation to the health sector overtime has been abysmally low when compared with peer countries in other African region.
However, experts in the health care space say the problem goes beyond just budget funding but on way in which these funds are channelled that will help spur investment in the sector.
Health expert made this at a 2018 healthcare Nigeria conference, on the need for sustainable healthcare- the road map held in Lagos on 4th July.
“The Nigeria healthcare market has failed economically in the area of universal health coverage, maternal mortality, life expectancy, infant mortality to mention but a few and unless we apply the Laws of economics to Healthcare, it will continue to fail,” Olamide Okulaja, Director for advocacy and communication at Lagos-based PharmAccess.
“The solution with the Nigerian health sector is not on the financing, but in building frameworks and ecosystem that can absorb such financing.”
Okulaja was of the view that a mandatory health insurance scheme is of a good initiative, as this will help increase the demand for health services which in turn will necessitate the supply of health care services.
The World Health Organization (WHO) during the BAMACO initiative instructed countries of the world that their health care expenditure to GDP should be up to 15 percent.
This is because an improvement in a country’s health care will result in an improvement in the health of its citizen which will thereby, improve productivity as there is a link between health and economic performance.
Statistical data polled across several African countries shows that in 2016, Rwanda allocated 18 per cent of its national budget to health, while Botswana and Malawi have allocated 17.8 per cent and 17.1 per cent respectively.
Zambia is 16.4 per cent, while Burkina Faso is 15per cent. Meanwhile, Nigeria which hosted the “2001 Abuja declaration”, where it pledged alongside other member states of the African union to commit at least 15per cent of their national budget to health, is still at 4.3 per cent, with no trajectory towards achieving the 15 per cent target.
A BusinessDay survey, that captured the 2018 health budgetary allocation of these two countries, shows that Africa most populous nation(Nigeria), given her rapid level of population growth, should play catch up in terms of health funding when compared with a country like south Africa.
South Africa proposed a health budget of R205.446 billion ($17.1 billion) in 2018, this represents $299 per head when compared to its population of 57million, Nigeria on the other hand, home to some 193 million inhabitants, the highest in the African continent have planned a health budget of N340 billion ($946 million), this amounts to $5 per person when shared to each citizen of the country.
A case study that was raised during the conference on budget financing and how it affects the health system was the Tanzanian economy that spent an average of 10 percent of their total budget on health from 1990 to 2010, according to data from Tanzania budget office.
During this period, the economy recorded it lowest maternal mortality rate at 454 in 2010. However, in 2011, after it increased its health budget allocation to 10.5 percent, maternal mortality rate rose by 22 percent to 556 in 2015.
Abimbola Adebakin, CEO, Advantage Health Africa said that although there is need for increasing funding but it goes beyond increasing funds to getting the foundation right in the issues of system, processes and people.
“On the issue of system, we must introduce system that works in other industries like the financial sector, telecommunication, and art to health sector space”. Adebakin furthered.
Health experts further concluded that mandatory health insurance is the viable solution to Nigerian health system and no nation can achieve universal coverage without subsidization and compulsion as both elements are essential.
Subsidies without compulsion will not work; indeed, they could make matters worse since the healthy flee from the subsidized common pool, only to return when they expect to use a great deal of care. Compulsion without subsidies would be a cruel hoax for the millions of poor and sick who cannot afford health insurance. The experts concluded.
