One of the of the most remarkable benefits that come with the dawn of every new year is the opportunity to ponder the past, review the present and where necessary re-strategise for the future.
This, no doubt, is the same cheering prospect that this year presents to the leaders and stakeholders of the Nigerian health sector.
Yet, even with this fresh hope of a new lease of life for the beleaguered sector, there are already indications that the biggest albatross to an improved healthcare delivery in the new year remains inadequate finance to tackle the myriad infrastructural, operational and administrative needs of the sector. The 427.03 billion naira 2020 health budget, which is just 4.14 per cent of the total budget of 10.33 trillion naira, is without doubt, a drop in the ocean when pitted against the needs of the health sector and the over 200 million citizens to care for.
It must therefore be emphasised that the health sector can only provide improved and affordable healthcare for Nigerians this year if the government and leaders of the health sector decisively tackle the perennial funding challenge and also ensure that funds for healthcare are judiciously used.
For the umpteenth time, we must restate that the Nigerian government has, over the years, not given the health sector the special attention it deserves and this continues to reflect in the haphazard way the sector is being funded and managed. Despite the fact that Nigeria was a key figure among the African countries which, under the auspices of the African Union at a conference in Abuja in 2001, pledged to increase health budget to at least 15 per cent of the annual budget, the government has not only failed to keep to this pledge but has consistently kept the health sector among the least of its funding priorities.
For instance, the 4.14 per cent of the 2020 budget allotted to health is a further reduction from the 2019 figure which was 4.75 per cent. That is basically in keeping to the government’s tradition of taking two steps forward and three steps backward when it comes to health. No significant progress or development can happen with such a lackadaisical approach.
Indeed, nothing illustrates this anomaly of policy summersaults in health financing more than the decision of the government to reduce by half the additional fund that is meant to help finance healthcare, which is one per cent of the Consolidated Revenue Fund (CRF). While the one per cent of the CRF, which is for the Basic Healthcare Fund (BHF) in the 2020 budget, was supposed to be 81.55 billion naira in accordance with the National Health Act, the government has cut this figure by half to 44.50 billion naira. This, it must be said, is a travesty for a nation that wants its citizens to enjoy adequate healthcare.
We aver that the first step to ensuring that the health sector fares better this year and beyond is for the Nigerian government to be compelled to reverse the CRF cut. This is because the reduction does not only contravene the law (National Health Act 2014), but also loudly indicates that the government does not consider health a priority. Health, we reiterate, must be a priority for the Nigerian nation because for the nation to be productive it must be healthy.
However, beyond the reversal of the CRF allocation to health, other tiers of government must also begin to commit significant resources to healthcare. The states and local governments must make provision of healthcare a cardinal programme by reviving the Primary Healthcare Centres (PHC) in their domains because majority of those who need care are actually at the grassroots.
Another area of healthcare financing that should be strengthened this year and beyond must be health insurance. State governments must begin to back this scheme because, if made functional, it will significantly help ensure more Nigerians, especially the poor, have access to healthcare. It will also fundamentally help the quest of the nation to achieve universal health coverage, not just in 2020, but beyond.