CSOs, lawmakers worried about budget provisions in health sector
The assessed poor provisions in 2017 budget and usual implementation challenges in the health sector have drawn the ire of civil society group and the House of Representatives Committee on Health.
The development, when left uncorrected, may lead to worsened socio-economic outcomes during the 2017 fiscal year, raised more concerns for the organisers and participants at the just concluded Health Budget Legislative Retreat, in Owerri, Imo State.
The Manager, Technical Projects, Direct Consulting and Logistics, Dr. Laz Ude Eze, expressed concern that out of N304.2 billion budget for the sector, less than N53 billion was only provided for capital projects.
More worrisome too was that the ministry’s headquarters alone got 50.5 per cent of the capital projects, leaving 49.5 per cent for 115 sub-sectors, including its tertiary institutions, medical centres, health research institutes, primary health centers, among others.
Analyzing the trend of capital budget implementation in the sector, the expert said government has not gotten it right since over the years, as there are fears that the little provision would be faithfully committed to the good of all.
For example, government provided 23 per cent capital votes in 2015, released and cash-backed 16 per cent, but ended the year with actual implementation of 12 per cent.
He flayed the inclusion of refunds to donor agencies for funds that were not accounted for under the capital votes projections, meaning that there is less provision for health infrastructure than acclaimed.
The Lead Director, Centre for Social Justice, Eze Onyekpere, at the retreat, bared fangs that while Nigeria is signatory to several treaties and conventions, as well as Acts that support right to life, it has been bedeviled with sheer ill-will to implement them appropriately.
The adequacy of the health provisions in the budget would mean that if government cannot meet its 15 per cent ratification for the sector, under the Abuja Declaration, it should go halfway.
According to him, while resources available may be so little, “we must make the best use of it to achieve greater efficiency and results through a coordinated value for money approach. Budgetary realignment is needed and the time to do it is now.
He said that the state must recognize its duties and take no step to deny, obstruct or violate already accrued rights and ensure non-discrimination of access to facilities.
“We must adopt appropriate legislative, budgetary, judicial, promotional and other measure towards the full realisation of the right to health. The 2017 budget as it is, does not guarantee these,” he said.
The Chairman, House of Representatives Committee on Health, Chike Okafor, recalled that the committee has severally discussed issues of funding and implementation of health provision, which persist till date.
He said that the sector’s budget should be targeted at the masses through the Primary Health Care (PHC) where 75-80 per cent sicknesses are recorded and treatable as well.
“The challenge is non-functionality of the PHCs and it ought not to be so. We are committed to pursuing the implementation of the provision in the National Health Act, which set aside one per cent of Consolidated Revenue for health.
A lawmaker and member of the Health Committee, Johnbull Shekarau, said it is quite important that these anomalies are pointed out now, although the budget process is nearing completion.
“Funding is important, but it is more important to know how much of the funds really add up value for the country. If a product is N50 in the market, but because it is government, that same product now turns to N5000, what is the value for the country?”, he said.
Another lawmaker, Austine Chukwukere, maintained that indepth corruption is at the root of the sector’s challenge, not just funding, citing a provision for refund of donor funds of N6.5 billion in the health budget, he said this was the result of breach of agreement.
For him, the “template system” of budgeting has only aided corruption, as all the agencies of government are only interested in allocating anything money to budget heads, even what does relate to their core activity.
In a communique at the end of the retreat, the participants urged the National Assembly committees to work to meet a six per cent minimum target for the health sector before passing the budget, while the refund to GAVI and Global Fund, should be sourced from service-wide votes.
They also mandated government to sustain ongoing efforts to recover the mismanaged money and punish offenders, while the concentration of funds at the ministry’s headquarters would be reappraised and moved to different agencies with the statutory mandate to implement the tasks for which funds are attached to.
Government reform should be widened to include automation and the deployment of appropriate technology to “sweep” in all revenues into the relevant government accounts.
NASS should pass resolution calling for a transparent and comprehensive presentation of budget requests through health sector specific budget preparation template.
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