Budget padding is one thing, its performance is another!

In this age where the call for accountability of health budget is rising, we monitor health budgeting process to reveal the areas where policy makers must improve their performances to ensure justice to budgeting process, the budget, and its implementation.

The 2015 Federal Health budget scorecard was disseminated to stakeholders at a Media roundtable held on 28 June 2016. Professor Oladapo Ladipo, President of the Association for Reproductive and Family Health, chaired the event, which held at NAF Conference Centre and Suites in Abuja.

In his opening remarks, Prof Ladipo opined that there was no better time than now to discuss health financing, as the health sector was currently experiencing dire challenges ranging from poor infrastructure, inadequate human resources and poor funding.

He further disclosed that the allocation of about four percent (4%) of Total Government Expenditure to Federal Ministry of Health in 2016 was disappointing and stressed the need for the government to prioritise the health sector, adding that health is wealth and a healthy nation is a wealthy nation. He also said that it is every woman’s right to access adequately resourced maternal health care due to the all-important role of reproducing the next generation.

The scorecard assessed four distinct areas of Transparency, Participation, Adequate Resource Allocation and Budget Release for key agencies delivering Maternal and New Born Health (MNH) in Nigeria. The agencies include the Federal Ministry of Health main (FMOH), the National Primary Health Care Development Agency (NPHCDA) and the National Health Insurance Scheme (NHIS).

In reviewing the scorecard, the Health Finance and Advocacy Advisor of MamaYe, Esther Agbon, said the agencies’ performance on transparency which measured timeliness of publication of National Health Accounts (NHA), adherence to the budget timetable, publishing enacted budgets on websites and releases of capital budget were very poor.

The scorecard also showed that the Ministry of Health did not involve the Civil Society in pre-budget consultations. This reduced the opportunity to take up priorities of communities when preparing the budget.

The government also fell short on key commitments such as the fifteen percent (15%) allocation of National Budget to the Health sector as agreed by the Abuja Declaration of African Heads of Government in 2001, the one percent (1%) additional funding from the Consolidated Revenue Fund (CRF) of the Federal Government as stipulated by the National Health Act of 2014, as well as the Family Planning 2020 commitment, made at the London Summit in 2012.

Apart from the NPHCDA, which received over seventy percent (70%) of its capital budget in 2015, FMOH and NHIS received only fifty percent (50%).

The lead discussant, Barrister Eze Onyekpere, while concurring with the findings of the scorecard said the results of the scorecard were not surprising as in a related assessment conducted by Centre for Social Justice; the Federal Ministry of Health performed the least on the Fiscal Index in comparison to other agencies.

He advised that the Ministry of Health needs to align its budget to the overarching health sector policy and strategic development plans which seemed not to be in sync with the budgets developed.During the general discussions that ensued on the scorecard, participants were concerned about the timeliness and amount of capital budget released in relation to absorptive capacity of the agencies involved, as well as effectiveness of project implementation in 2015

They also advised that the National Assembly should not only assess CSOs on submission/analysis of memos but also on the use of such analysis.In formally presenting the scorecard to Journalists and the public, Prof Ladipo called on Government to:

  • Open up budget processes to CSOs and Communities
  • Release public information on budgets by publishing timely on websites
  • Budget adequate resources for health
  • Ensure timely release of capital budgets to ensure maximum budget performance

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