En­gag­ing NPHCDA boss on 2016 ap­pro­pri­a­tion act

Sir, with all hu­mil­ity, you owe it to or­di­nary Nige­ri­ans to ex­plain what the N1, 061,256,144bn ear­marked for Mid­wives Service Scheme (MSS) this year will be used for? Is this money to clear pre­vi­ous year salary debt for the mid­wives or it is meant to pay

Daily Trust - - HEALTH - Dr Ado J Muham­mad, The Ex­ec­u­tive Di­rec­tor, Na­tional Pri­mary Health Care De­vel­op­ment Agency (NPHCDA)

Dear Sir, Greet­ings and con­sider this in­ter­ven­tion as a friendly ad­vo­cacy in the spirit of col­lab­o­ra­tion and na­tional de­vel­op­ment. Let me first be­gin by con­grat­u­lat­ing you and the tire­less NPHCDA team, Nige­ri­ans and de­vel­op­ment part­ners for en­sur­ing Nige­ria is free of Po­lio.

Sun­day 24th July 2016 marked two years with­out record­ing any po­lio case all over the fed­er­a­tion. Let me also has­ten to add that I have ac­cess to you as I could send you a text mes­sage or call your line or march to your of­fice and I am con­fi­dent you will at­tend to me and pro­vide re­sponse to my ques­tions.

Hav­ing said that, once in a while we will need to broaden our dis­course so that the com­mon man who is not in the tech­ni­cal en­vi­ron­ment will also know what is hap­pen­ing and of course the women and chil­dren that we are all work­ing de­serve to also par­tic­i­pate in a pub­lic dis­course.

My in­ter­ven­tion to­day is about the 2016 ap­pro­pri­a­tion act fo­cus­ing on the fi­nances ear­marked for NPHCDA. We are glad that Pres­i­dent Muham­madu Buhari has pro­vided about N12.9 bil­lion this year for Im­mu­niza­tion which is about 45% of the over­all cap­i­tal bud­get. The Im­mu­niza­tion bud­get in the NPHCDA bud­get that has a to­tal al­lo­ca­tion of about N17.4 bil­lion gulps about 88.4% of its cap­i­tal bud­get, and about 72.6% of its over­all bud­get. Below pro­vides fur­ther break­down of the funds:

• N9,821,331,311bn - Po­lio Erad­i­ca­tion Ini­tia­tive (PEI - in­clud­ing OPV + de­vices pro­cure­ment and op­er­a­tional costs).

• N1,743,406,067bn - Non-Po­lio SIAs (Measles, Yel­low fever cam­paigns, MNTE, etc, in­clud­ing vac­cines and de­vices pro­cure­ment and op­er­a­tional costs.

• N1,017,495,128bn - Tra­di­tional vac­cines and de­vices pro­cure­ment in­clud­ing freight and han­dling charges.

Last year (2015) the funds for tra­di­tional vac­cines was N2,615,000,000 bn which was more than what we have this year, al­though we haven’t recorded re­leases of last year’s funds. It was also not a secret that last year, be­cause we haven’t recorded funds re­leases, the World Bank had to bail us out with a loan of $200 mil­lion and vac­cines pro­cured with that funds may last up to 3rd quar­ter of 2016.

Let me di­gress a bit to another bud­get code in the NPHCDA this year, ‘Mid­wives Service Scheme (MSS)’ I have seen in the 2016 ap­pro­pri­a­tion act that N1,061,256,144bn is ear­marked for MSS, with a to­tal of N2,050,738,213bn for NPHCDA re­cur­rent ex­pen­di­ture the MSS will gulp 51.7% of its re­cur­rent ex­pen­di­ture.

Sir, per­mit me to make ref­er­ence to a study in 2015 “The Bet­ter Ob­stet­rics in Ru­ral Nige­ria (BORN) Study; Eval­u­at­ing the Nige­rian Mid­wives Service Scheme” which I am con­fi­dent you have a copy and read it al­ready. It said among oth­ers that over­all, the MSS did not have the ex­pected large im­pacts.

The re­searchers found a “12 per­cent in­crease in use of an­te­na­tal care in pro­gramme clin­ics com­pared with clin­ics in com­mu­ni­ties not ex­posed to the pro­gramme, and a six per­cent in­crease in the over­all use of an­te­na­tal care.”

With re­spect to im­pact, “the pro­gramme did in­crease ac­cess to skilled care, but this eroded over time, in part be­cause of chal­lenges in re­tain­ing and re­cruit­ing mid­wives. Such prob­lems as dif­fi­cul­ties as­so­ci­ated with re­lo­cat­ing to new ar­eas, in­ad­e­quate pro­vi­sion of hous­ing ac­com­mo­da­tion, and ir­reg­u­lar pay­ment of salaries (which wors­ened over­time) con­trib­uted to mid­wives want­ing to leave the scheme. Un­even ad­her­ence by dif­fer­ent lev­els of govern­ment (par­tic­u­larly at the state and lo­cal lev­els) to agree­ments re­gard­ing the scheme likely con­trib­uted to, and ex­ac­er­bated some of th­ese prob­lems.”

• Sir, with all hu­mil­ity, you owe it to or­di­nary Nige­ri­ans to ex­plain what the N1, 061,256,144bn ear­marked for Mid­wives Service Scheme (MSS) this year will be used for? Is this money to clear pre­vi­ous year salary debt for the mid­wives or it is meant to pay their 2016 salaries? Also what is the fate of MSS be­yond 2016?

• With re­spect to about N12.9 bil­lion this year for im­mu­niza­tion, Nige­ri­ans will also like to know in the midst of all the in­ter­na­tional donor sup­port this year from the World Bank, GAVI, Ja­pan, Bill Gates Foun­da­tion, what will our own ap­pro­pri­ated money be used for and what will the donor funds be used for? And are we ex­pect­ing funds re­leased this year as an im­prove­ment to lack of re­leases last year?

In line with your pas­sion and com­mit­ment to ac­count­abil­ity and trans­parency, I will like to humbly sug­gest to you and your team to hold a “Post 2016 Bud­get Di­a­logue” with civil so­ci­ety or­gan­i­sa­tions, me­dia and other rel­e­vant stake­hold­ers to pro­vide use­ful in­for­ma­tion about some of the is­sues high­lighted in this ar­ti­cle.

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

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