2016 Bud­get: Im­mu­niza­tion ver­sus cap­i­tal ex­pen­di­ture

Daily Trust - - HEALTH -

Icould feel the ten­sion in the de­par­ture lobby of the Aminu Kano In­ter­na­tional Air­port while await­ing our do­mes­tic flight to Abuja. I found my­self in the midst of many se­nior col­leagues work­ing in fed­eral ter­tiary in­sti­tu­tions in­clud­ing teach­ing hos­pi­tals and fed­eral med­i­cal cen­tres.

As we boarded our plane, I no­ticed two med­i­cal di­rec­tors of fed­eral ter­tiary in­sti­tu­tions, one fed­eral univer­sity vice chan­cel­lor, a pro­fes­sor and a for­mer teacher as well as a con­sul­tant work­ing in a fed­eral ter­tiary in­sti­tu­tion.

I ex­changed pleas­antries with all of them at the same time try­ing to re­spond to ques­tions asked by some of them regarding the 2016 fed­eral bud­get. I was im­pressed by the level of their un­der­stand­ing on mat­ters re­lated to im­mu­niza­tion fi­nances even though their work at ter­tiary in­sti­tu­tions has lit­tle to do with fi­nanc­ing im­mu­niza­tion.

“Aminu, we fol­low and read your health col­umn in Daily Trust News­pa­per ev­ery week and we are im­pressed that you have sus­tained this work for over a decade. We have learnt a lot regarding fi­nanc­ing im­mu­niza­tion in your write ups and have noted your sus­tained ad­vo­cacy to en­sure that the fed­eral govern­ment al­lo­cates ad­e­quate bud­get for it. How­ever, in do­ing that the other as­pects of health es­pe­cially fi­nanc­ing ter­tiary in­sti­tu­tions isn’t get­ting much ad­vo­cacy from you and your likes,” said one of them.

All through the 45 min­utes trip, I was en­gaged in dis­cus­sion and by the time we were dis­em­bark­ing, I was bet­ter in­formed about the chal­lenges also be­ing faced by fed­eral ter­tiary in­sti­tu­tions, and also grasped an­other chal­lenge be­ing faced by “in- pa­tients” when­ever hos­pi­tal work­ers em­bark in their nu­mer­ous strikes, aban­don­ing their duty posts in­clud­ing emer­gency ser­vices.

Our ad­vo­cacy for ad­e­quate fi­nanc­ing must be holis­tic and also all-en­com­pass­ing, and must take into con­sid­er­a­tion the many as­pects of health so that the suc­cess of one sub­sec­tor does not com­pro­mise an­other sub-sec­tor.

Let’s do a small analysis of the 2016 bud­get. The fed­eral bud­get to the Min­istry of Health is about 4.13% of the na­tional bud­get with a re­cur­rent ex­pen­di­ture of about 89% and cap­i­tal ex­pen­di­ture of about 11%.

The to­tal bud­get is ap­prox­i­mated at N250 bil­lion with the cap­i­tal bud­get ap­prox­i­mated at N28.6 bil­lion. What irked many pun­dits is that im­mu­niza­tion will be fi­nanced from the cap­i­tal bud­get and it got about N12.9 bil­lion which is about 45% of the over­all cap­i­tal bud­get. With this in mind, the 56 Fed­eral Ter­tiary Health In­sti­tu­tions plus other fed­eral health paras­tatals will be shar­ing the re­main­ing 55% cap­i­tal bud­get which is about N15.7 bil­lion to em­bark in new cap­i­tal projects. This is one of the nu­mer­ous anom­alies in the 2016 health sec­tor bud­get that must be ad­dressed ei­ther via sup­ple­men­tary bud­get or as we com­mence the prepa­ra­tion of the 2017 bud­get.

If we look at the im­mu­niza­tion bud­get in the Na­tional Pri­mary Health De­vel­op­ment Agency (NPHCDA), a bud­get that has a to­tal al­lo­ca­tion of about N17.4 bil­lion, im­mu­niza­tion alone will gulp N12.9 bil­lion which is about 88.4% of the NPHCDA cap­i­tal bud­get and about 72.6% of the over­all NPHCDA bud­get.

As I wrote in my ar­ti­cle of 24th May 2016, ‘In­side Pres­i­dent Buhari’s 2016 Signed Health Bud­get’, “we are de­lighted that in the signed bud­get N12.8 bil­lion for vac­cines, de­vices and op­er­a­tions pro­grammes for po­lio, measles, and yel­low fever among oth­ers is al­lo­cated. This is com­mend­able against the back­ground of dwin­dling fi­nan­cial re­sources in the coun­try.”

It is im­por­tant to note that as we are cel­e­brat­ing ad­e­quate bud­get for im­mu­niza­tion com­pared to other health sub-sec­tors, it wasn’t achieved with­out the te­nac­ity of the na­tional civil so­ci­ety or­ga­ni­za­tions and the me­dia. Dur­ing the bud­get re­view by the Na­tional As­sem­bly, N4­bil­lion was slashed from the 2016 bud­get as pre­sented by Pres­i­dent Buhari, that was about N8 bil­lion for Rou­tine Im­mu­niza­tion and Po­lio Erad­i­ca­tion re­spec­tively.

The bud­get was re­turned to the Na­tional As­sem­bly for con­sid­er­a­tion which led to the set­ting up of a 20-mem­ber com­mit­tee with the duty to con­duct a re­view and make rec­om­men­da­tions to the pres­i­dent. Fol­low­ing this de­vel­op­ment, the na­tional CSOs in col­lab­o­ra­tion with NPHCDA had car­ried out se­ries of rig­or­ous ad­vo­cacy via face to face press con­fer­ences and so­cial me­dia cam­paigns to in­flu­ence the suc­cess we are wit­ness­ing to­day. What lessons are there to learn? The pub­lic health ad­vo­cates, in­clud­ing news­pa­pers colum­nists and writ­ers and the health sec­tor lead­ers, in­clud­ing lead­ers of the Fed­eral Ter­tiary Health In­sti­tu­tions must find a com­mon ground and plat­forms for con­tin­u­ous en­gage­ment and di­a­logue in chart­ing a re­newed health sec­tor that caters for all con­stituen­cies.

All com­ments to Dr Aminu Ma­gashi, pub­lisher Health Re­porters (health­weekly@ya­hoo.com)

This is one of the nu­mer­ous anom­alies in the 2016 health sec­tor bud­get that must be ad­dressed ei­ther via sup­ple­men­tary bud­get or as we com­mence the prepa­ra­tion of the 2017 bud­get

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