Nigeria: The Latest 20 'Hidden' Destinations of Purported Health Spendings in the 2020 Proposed Budget

Photo: Dataphyte
Nigeria's 2020 Proposed Health Budget
16 November 2019

Abuja — About N5 billion will go to service major construction works in the nation's health sector in the 2020 proposed budget, but development experts, working around accountability process in public budgeting, worry that this may come to waste because the projects they are nominated to develop are not captured in the vision of the Ministry of Health, the regulatory institution for health development in the country.

In the proposed budget, a minimum of 20 health-related projects got generous appropriation but only for construction purposes and without regard for how much health facilities will be subsequently manned, staffed and remunerated, since the Ministry of Health which has these responsibilities has been bypassed by this budgetary arrangement.

"How do you allow a whopping N5 billion in public spending to create projects when you make no provisions or appropriation on how to staff them or give them functional meaning?" Nkem Ilo, chief executive at Public and Private Development Centre [PPDC], lamented in an interview with Dataphyte.

Over the years, construction is a notorious subhead through which corruption has been enabled in the Nigerian contracting and procurement process, and Ms. Ilo, whose organisation is a leading voice for transparency and accountability in the Nigerian civic sector, worries that the same fate that had fallen most abandoned projects "invariably awaits" these 20 nominated projects in the 2020 proposed budget.

Ms. Ilo's position is shared by Mr Segun Elemo, the executive director  at Paradigm Leadership Support Initiative [PLSI], who worries as well that unless the "integrity deficit driving budgeting process in the country" is courageously addressed, the "problem of budget padding" will always lead to wasteful investments" such as placement of projects in wrong or unrelated agencies.

This is what is responsible for the series of uncompleted or abandoned projects in the country, and it is all because of the absence of needs-assessment and political underhand in project allocation," Mr. Elemo said.

Influential project monitoring reports from bodies like UDEME (PTCIJ), TRACKA (BudgIT) and Value for Money (PLSI) corroborate the concern about government profligacy through multiple spending around single projects spread across or hidden in many agencies that were ultimately not completed or abandoned by MDAs.

20 Nominated Silent Destinations for Hiding Projects

SEE TABLE

The 2020 proposed budget offers the best illustration of this art of hiding projects in "silent" institutions.  In this particular case, whereas the key reference was for health spending, the nominated hidden outlets are 20 non-health institutions otherwise called Ministries, Departments and Agencies or MDAs.

In the proposed budget, agencies like the Border  Communities Development Agency is to construct and provision hospitals/health centres and provide solar-powered borehole facilities, totalling about N150 million. Yet nowhere in the appropriation is there a vision of the human resource component of the personnel that will run the projects if they ever get completed and meet the specific health standards that the Ministry of Health which has been sidelined solely has discretion for.

The Ministry of Niger Delta also proposes the same spending jamboree of constructing and providing hospitals/health centres in the oil-producing states cohorts totalling about half a billion Naira, again without a vision of the human resource component of the personnel that will run the projects, if it ever gets completed.

The National Intelligence Agency, NIA, the country's spy outfit leads the trail in grabbing the lion's share of this hidden spending with almost a billion Naira [N969.9million] in generous gifting for the "rehabilitation/repairs of hospital/health".

Overall, the 2020 proposed budget provides for health-related expenditures worth 171 billion naira (N171,146,082,086) which are not within the regulatory purview of the health ministry, according to DATAPHYTE analysis. Details of these additional health spendings in the 2020 proposed budget are listed in the table below.

Component    Proposed
Construction / Provision of Hospitals / Health Centre    7,774,719,768
Counterpart Funding Including Global Fund/Health/ Refund to GAVI    5,500,000,000
Drugs & Medical Supplies    2,535,885,383
GAVI / Immunization    22,734,412,586
Medical Consulting    194,060,190
Medical Expenses    4,304,210,164
National Agency for the Control of AIDS (NACA)    2,244,381,813
NHIS Contribution by FGN    82,705,001,987
NHIS (Military Retirees)    11,737,075,338
Purchase of Health / Medical Equipment    26,637,411,831
Rehabilitation / Repairs – Hospital / Health Centre    4,055,919,099
State House Medical Centre    723,003,927
TOTAL    171,146,082,086

Photo: Dataphyte
Breakdown of Nigeria's 2020 Health Budget

As the table above illustrates, some of the funds are genuinely targeted to address special health issues such as immunization and HIV/AIDs. Other important health allocations in the budget are the national health insurance scheme; the allocation of N2.24 billion to the National Agency for the Control of AIDS (NACA); the N82.7 billion Federal Government's contribution to the National Health Insurance Scheme (NHIS) and the special budget of N723 million to the State House Medical Centre.

In the same vein, some N11.74 billion NHIS fund is allocated to military retirees, as well as the GAVI Immunization project worth N22.73 billion, plus "the Global Fund Counterpart funding, including refund to GAVI" with the budget of N5.5 billion.

The 'Breakdown of Budget' chart shows the categorization of these health budgets to non-health agencies.

The chart shows that allocation for hospitals (or health centre) is N7.77 billion (N7,774,719,768); N2.53 billion for Drugs and medical supplies; N194.06 million for Medical Consulting; and N4.3 billion for Medical Expenses.

The purchase of health/medical equipment across ministries had  N26.64 billion. A total of N4.05 billion (N4,055,919,099) for rehabilitation/repairs of Hospitals and Health Centres.

Implications of the extra 171.15 billion

DATAPHYTE's first analysis of the allotted funds to the Health sector through the Ministry of Health showed the federal government proposed 427.3 billion naira. This is only 4.14% of the proposed budget for 2020 as budgetary allocation to the Federal Ministry of Health. The report decried the government's N44.50 billion allocation to the Basic Health Care Fund (BHCF) as against the right allocation which was estimated to be N103.3 billion. This estimate is a 1% measure of the 2020 Consolidated Revenue Fund (CRF) of N10.33 trillion.

You will recall that N44.50 billion allocation to BHCF violates the National Health Act (2014). The Act stipulates that at least one per cent of the Consolidated Revenue Fund (CRF) must be allocated to BHCF.

The sum of extra health budgets in related and unrelated MDAs, as shown above, is 171,146,082,086. This amount added to the Ministry of Health's budget of N424,022,751,254 would come to N594.17 billion (595,168,833,340).

Even if this is considered an increase in federal government's total commitment to health from 4.14 per cent to 5.75 per cent, yet the value is quite low for Nigeria considering the troubling health indicators.

A brief overview of these other MDAs shows that The Nigeria Building and Road Research Institute got over one billion naira. Also, the Nigeria Intelligence Agency received N969 million. The federal Ministry of Niger Delta got 480 million.

The Border Communities Development Agency (BCDA), 163 million. The new Ministry of Humanitarian Affairs also got N150 million to rehabilitate hospital. Other agencies were: the EFCC with N12 million. Nigeria Atomic Energy Commission got N100 million.

Overall, the budgeting process in the country still requires a more robust needs assessment. Despite the incessant budget scrutiny by civil society organizations, the Nigerian government continues to allocate projects funds to wrong ministries and agencies of government. This violates the basic principles of budgeting and public contracting and might explain the unending corruption in the implementation of government projects.

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