Assessment of Health Budgetary Allocation and Expenditure Toward Achieving Universal Health Coverage in Nigeria

Abstract

Context: The implementation of the Universal Health Coverage (UHC) promotes access to quality health care delivery through cost-effective initiatives to ensure good health and wellbeing without discrimination. This study examines government finance, budgetary allocation, and expenditure as key health development indicators towards achieving the UHC in Nigeria. Evidence Acquisition: Data analyzed in the study were gotten from journal articles, reports and other secondary sources. Searches were conducted in PubMed, Google Scholar, and WHO Library Database with pre-determined search terms. Further publications were identified through snowballing of citations and references. We reviewed only papers written in English with no date restrictions placed on searches. Results: Within the period of analysis, the annual national health budgetary allocation in Nigeria has been below the 2001 Abuja declaration of allocating 15% of the national budget to health. Our analysis also revealed that if the Abuja declaration was implemented, additional allocations of NGN 4.99 trillion should have been injected into the health sector between 2014 and 2020. In addition, Nigeria also lags behind relative to some other low-and middle-income countries in terms of government expenditure to the health sector in achieving the UHC. Conclusions: The inadequate budgetary allocation in Nigeria to healthcare has significantly influenced recurrent and capital health expenditure. It is worthy to note that the insufficient allocation will continue to significantly affect capital expenditure which is a large determinant of the development of any health system. With the current state of healthcare budget allocation in Nigeria, efforts need to be intensified to ensure the achievement of UHC. In the face of achieving UHC, reviewing the system of healthcare financing and ensuring prudent allocation of resources while shifting the focus from out-of-pocket payments for health is essential. We also recommend increase in political commitment towards improving the health of the populace so as to ensure health systems goals of efficiency, equity, quality of care, sustainability, financial risk protection for all citizens are achievable.

Changing patterns of gender inequities in childhood mortalities during the Sustainable Development Goals era in Nigeria: findings from an artificial neural network analysis

“…In a recent study, the annual health budget for Nigeria was noted to have reduced from 7.2% in 2014 to 4.4% in 2020. 52 The incessant cuts in government healthcare spending have severely affected maternal and childcare services in Nigeria. It is important to highlight that there is a progressive donor fatigue in funding population health programmes which may undermine the child survival gains in the future.…”

The Status of Emergency Obstetric and Newborn Care in Post-Conflict Eastern DRC: A Facility-Level Cross-Sectional Study.

“…The DRC government expenditure on health (USD 12-13 per capita) is one the lowest in SSA (66), with a health budgetary allocation (4-5%) far below the 2001 Abuja declaration target of at 15% of the national budget to be allocated to health to ensure universal care coverage (67,68). Also, studies in DRC showed other factors related to persistent fragility that create bottlenecks in the functioning of the health system, including dependence on user fees and fragmented/vertical multi-donor inputs, ine cient budget preparation approaches, unmonitored budget execution, and poor governance (69)(70)(71). Previously identi ed barriers to the delivery of EmONC in post-con ict SSA included systemic and human resource factors such as limited infrastructures and procurements, insigni cant and erratic pay, and poor living and working conditions (45).…”

Primary Healthcare in Nigeria Amidst Disease Outbreaks: The Need for Improvements

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