Nigeria: National Health Dialogue - Why Nigerians Should Demand Accountability in Health Budget

14 October 2019

Dale Ogunbayo, a medical consultant and public health advocate has advised Nigerians to see a connection between their ineffective primary healthcare centres (PHC) and budgetary allocations and actual releases for health.

He spoke ahead of the annual National Health Dialogue organised by PREMIUM TIMES and its partners where he is billed to speak as one of the panel discussants.

The two-day event is scheduled for Tuesday and Wednesday at the Nicon Luxury Hotel in Abuja.

The medical expert said it is time to go beyond the rhetoric of demanding for more budgetary allocation for health which has not resulted in any improvement.

"We should start probing what was done with the actual budgetary releases and this demand should be led by the citizens", Mr Ogunbayo the managing director of Cumbamed Associate Ltd noted.

He said health outcomes will not improve until ordinary Nigerians are armed with the right information and consciousness to lead the demand for accountability in the utilisation of funds for health interventions.

The poor budgetary allocation has partly been blamed for the precarious health situation in Nigeria and President Muhammadu on Tuesday set yet another poor standard fueling the complaints.

From an aggregate expenditure of N10.33 trillion he projected for the 2020 budget, the President proposed N46 billion for health - almost six times less than the N262 billion received by Works and Housing for capital expenditure.

Condemning the proposal, health experts said more worrisome is whether the funds will be released fully and timely. They had repeatedly decried the poor budgetary allocation and late or non-release of fund for most health projects, saying it is a major cause of Nigeria's grim health indices.

But as budgetary allocations nosedive, actual releases have continued to make little or no impact as they either end in the pockets of corrupt officials or are mismanaged.

Asides budgetary allocations, Nigeria is a huge beneficiary of billions in foreign aids for health. Yet about 70 per cent of the country's population still spend out-of-pocket for health services.

A PREMIUM TIMES investigation in March revealed that Nigeria is among seven countries in Africa indicted for squandering billions of foreign aid for health from the Global Fund for years.

'Wastages in the health sector'

"I am not comfortable that we keep ignoring that there is a lot of wastage in the health sector. There is a lot of financial indiscipline which should be addressed before pushing for more funds", Mr Ogunbato said.

"If you are not getting as much as you demand for health budget, you need to ask yourself, have you maximised the bit you are getting?

"We need to tie more releases along with better efficiency in spending in the health sector. We are talking of human lives and we can't afford to allow funds to filter away and wastages to carry on."

The health advocate said poor budgetary allocations and non-release of funds for health are also fueled by the fact that actual releases are not making a visible impact in the sector.

"The health sector needs to demonstrate efficiency in expenditure of released funds to justify the demand for more. We need to convince the government on the efficacy of our financial management of the health sector.

"It is important we do our own part because the story has remained the same for years."

Time for Citizens to Start Making Demands

Mr Ogunbayo said the push for accountability should shift from health activists and start with ordinary citizens because they are the ones directly impacted by the poor service delivery at the PHCs.

"We must find ways to always push the final discussions to the citizens so they can begin to demand accountability.

"For now, the demand has been from CSOs and health professionals. We need to push it further so it will be the citizens making these demands.

"The citizens should start connecting the health services they get to budget releases. A man should be able to probe the possibility of his wife dying during delivery at a poorly equipped PHC to government spendings for health.

"We cannot be advocating for more funds without attaching it to more prudent spending."

The health experts believe that citizens will begin to lead the demand for accountability when they are armed with the right information.

Mr Ogunbayo said the upcoming National Health Dialogue will serve as a platform to equip Nigerians with data, facts and knowledge that will broaden their consciousness to critical issues affecting the health sector.

With the theme "Universal Health Coverage (UHC) - The Role of State and Non-State Actors in Healthcare Funding and Support," there will be discussions on providing better, equitable and affordable health options for Africa's most populous nation.

The dialogue is organised by PREMIUM TIMES, Premium Times Centre for Investigative Journalism (PTCIJ), the Project for Advocacy in Child and Family Health, PACFaH@Scale, the Project Pink Blue and the Nigerian Governor's Forum (NGF).

It will bring together health practitioners and advocates as well as political, religious and traditional leaders; the public and private sector and the media.

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