What Is Your Health Worth In Nigeria?
All over the world, governments are pouring a lot of money into strengthening apparent gaps in their health systems. Indeed, nations are having debates about their healthcare and citizens are demanding more. What is happening in Nigeria?
Recently, the Federal Government slashed the allocation to the Basic Health Provision Fund from N44.4bn to N25.5bn[i]. There was a lot of outrage, once again, the Nigerian government demonstrated to the citizenry that it did not care about their health. Never mind that we are in the middle of a global pandemic, and our weak health system is already groaning under the weight of pandemic.
The Basic Healthcare Provision Fund is one of the key ways the Federal Government funds healthcare in Nigeria. It is funded mostly by an annual grant of 1% from the Consolidated Revenue Fund (an account that harbors the government’s revenue), grants from international donors and funds from any other source. This fund is very vital to rejuvenating the ailing primary care system which is the bedrock of healthcare delivery in Nigeria.
50% of it goes to the NHIS to fund the Basic Minimum Package of Health Services. The components of the basic package include:
· Maternal & Child Health: 4 antenatal visits, delivery (including cesarean sections), 2 Post-natal visits, and free maternal care for all mothers in rural Nigeria.
· Screening and referrals for Cardiovascular & Diabetic Disease which involves: Blood Pressure Check and Urinalysis Test.
Every Nigerian is entitled to access to these services without any charge at the point of care, however, the introduction of this basic package is meant to be phased, and will be available to those who live in rural areas in the first 5 years of the package. This package was introduced in 2018, and it is worthy to note that in just the second year of operation, the government has slashed the funding. While this move may be justified by the marked drop in revenue due to the drop in oil prices, it is bewildering to note that the huge running cost of our bicameral legislature remains largely untouched, while the lifeblood of our existence has to suffer.
45% of the Basic Healthcare Provision Fund is allocated to the National Primary Health Care Development Agency. This allocation is also very important as it is known that the supposed foundation of our health system, primary care is in shambles. As at 2016, only 20% of the 30,000 PHCs nationwide were functional[ii]. In 2017, the Federal Government launched a campaign to revitalize 10,000 PHCs nationwide, yet the success of this project has been minimal[iii]. With lack of sustainability and insufficient funding, it is clear that we have a long way to go, and even though this money is a drop in the ocean, it is a much-needed drop.
The last component of the BHCPF is the 5% allocated to Emergency Medical Treatment. This money is meant to help reduce deaths from road traffic accidents. The FG hopes to achieve this by collaborating with the FRSC, Nigerian Police and ambulance service providers to transport accident victims to designated emergency service providers along 5 of the most dangerous routes in Nigeria. While this is a laudable plan, as at late 2019, the funds were yet to be released.[iv]
In 2017, 1% of the CRF was N35 bn. At that amount, each Nigerian was entitled to N194 per year from the BHCPF. The slashed budget reduces the allocation from the BHCPF from N264 to N141 per capita in 2020. The entire amount the FG planned to spend on the healthcare of Nigerians in 2020 was N2000[v], this figure has now dropped due to the budget review. Of course, this amount barely puts a dent in the health expenditure of Nigerians.
It was estimated that the total health expenditure was N22,570 (74$) per person in 2017[vi], and it is a well-known fact that out-of-pocket expenditure in Nigeria forms the bulk of health spending. This figure was approximately 77.2% of the total health spending[vii] in 2017, this translated to each Nigerian paying on average, N17,424 on healthcare needs.
It is evident from this that there is still a high level of gross underfunding of health care in Nigeria. With NHIS coverage still less than 5% of the population, the health budget not even up to half of the advised 15% of the total budget, we have a long way to go when it comes to rebuilding the health sector, and this slash definitely does us no good.
The big question is: What will Nigerians do about this?
To learn more about how and why you need to protect yourself financially when it comes to healthcare, please read this.
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References
[i] https://guardian.ng/news/outrage-over-cut-in-health-education-budgets/
[ii] https://www.informationng.com/2016/07/36-states-and-the-fct-to-share-1-5m-fg-fund-for-primary-healthcare.html
[iii] https://businessday.ng/features/article/failure-of-10000-phcs-to-take-off-leaves-nigerians-desperate-for-quality-healthcare/
[iv] https://nnn.com.ng/nma-calls-for-release-of-fund-earmarked-for-emergency-treatment/
[v] https://www.premiumtimesng.com/health/health-features/361373-nigeria-budgets-n2000-for-the-healthcare-of-each-citizen-in-2020.html
[vi] https://knoema.com/atlas/Nigeria/Health-expenditure-per-capita
[vii] https://knoema.com/atlas/Nigeria/topics/Health/Health-Expenditure/Out-of-pocket-expenditure-as-a-share-of-current-health-expenditure
