For the Nigerian health sector, the “2017 Budget of Recovery and Growth” did not meet expectations. From 2010 to 2016, the highest budget allocation to health has been 5.8%, which is not even up to half of the Abuja +12 declaration of allocation of 15% of the national budget to health.
The 2017 proposed allocation of 4% is further made ineffectual as inflation rate jumped to 18.84% due to economic recession.
It was against this backdrop, i.e. the effect of economic recession and high inflation rate, that the theme for the 2017 MamaYe Day commemoration was conceptualised - “Maternal and Newborn Health: Making Health budgets Work for Nigerians”.
In the analysis of the 2017 health budget as presented by Esther Agbon, the MamaYe Health Financing and Advocacy Advisor, the budget was made on certain assumptions in the nation’s Medium Term Expenditure Framework (MTEF) and Fiscal Strategy. In the MTEF, oil price benchmark was at $44.5 per barrel, whereas oil price was over $50 per barrel. Inflation rate was based on 12.92%, when in reality, the inflation rate was 18.84%. Also, while exchange rate was N305 to $1 in the assumption, $1 was N445 in the parallel market.
Looking at the total 2017 budget of N7.2 trillion, and the health budget of N304 billion (which is 4% of the total budget), Esther said that if Nigeria must meet the Abuja 15% declaration, it would need additional N790.585 billion. She explained that marginally, the purchasing value of N304bn (based on the MTEF’s assumptions) is N257bn in today’s reality.
An interactive panel that followed the health budget presentation sought to explore the effect of a low health budget on maternal and newborn health services. One of the areas looked at was funding the National Health Act to achieve accessible, basic healthcare. One of the discussants, Dr. Francis Ukwuije from the Federal Ministry of Health, after explaining the process of budgeting, said, "In economic terms, health is a failed market because of lack of economic equilibrium as outcomes aren’t visible with input".
L-R Dr. Francis Ukwuije, Dr Ene (Preston Health), Professor Ladipo (ARHF), Joy Solomon
Because health isn't visible like infrastructure, it is difficult for budget holders to invest in it. The solution that Dr. Francis proposed was the need to have an investment case on health to convince decision makers that we can do better in health than other sectors. His statement seemed to suggest that, in clearer terms, players in the health sector development endeavour must describe political gains in their advocacies for increased funds for healthcare.
Mrs. Joy Solomon, a new mother who was part of the interactive panel, was MamaYe’s eye into the effect of paltry health budget and lack of health insurance. She recounted her experience of how her family struggled to pay for certain services that were expected to be free, when she gave birth.
Professor Oladapo Ladipo, who chaired the interactive panel, said that a “Critically sick population can't be productive. If we do not invest in RMNCAH, we will not achieve the SDGs.” He said that the economists must be convinced that the high maternal mortality ratio in Nigeria due to poor investment is social injustice.
In an earlier presentation, Mrs. Toyin Saraki, the founder of Wellbeing Foundation Africa, who was the special guest at the event, said in her speech that “If at least 1% of consolidated revenue fund is devoted to restoring, revitalising and building resilience in our primary health sector, it is an investment we will continue to reap the dividends for years to come.”
Mrs. Toyin Saraki flanked by members of the Market Women Association Abuja
The MamaYe Country Director, Dr. Tunde Segun, said that more lives of mothers and babies could be saved if all the investments being clamoured for were put in place and judiciously used. Earlier in his opening presentation, Dr. Segun reminded the audience at the event that the MamaYe campaign is about encouraging everyone to take actions that can save the lives of pregnant women and newborns.
Mrs. Toyin Saraki and Dr. Tunde Segun
Other issues that have impact on the affordability and accessibility of maternal and newborn health care services that were discussed on the panel were “Funding the National Health Act to achieve accessible basic health care”, “Budgeting Adequately for health to improve service delivery”, “Health Insurance as a guarantee for financial protection for the poor” and “Timely Fund Release and its impact on quality service delivery”.
Many representatives of development organisations and women from the Association of Market Women of Nigeria, Abuja Chapter, graced the MamaYe Day 2017.