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2018 proposed health budget analysis

Analysis of Nigeria's 2018 Proposed Health Budget

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2018 proposed health budget analysis

  1. 1. 2018 PROPOSED HEALTH BUDGET ANALYSIS PARTNERSHIP FOR ADVOCACY FOR IN CHILD AND FAMILY HEALTH
  2. 2. Interswitch - INTERNAL Agenda BUDGET PROPOSAL THE NIGERIAN ECONOMY HEALTH BUDGET PHCUOR OTHER HEALTH RELATED ALLOCATIONS PACFaH@Scale FOCUSED AREAS BUDGETTING PROCESS HEALTH BUDGET SHORTFALLS PACFaH@Scale 2
  3. 3. Interswitch - INTERNAL BUDGET PROPOSAL
  4. 4. Interswitch - INTERNAL 2017 Budget Appropriation and Performance 4 Budget Component Total (N) % Statutory Transfers 434,412,950,249 5.84 Debt Service 1,841,345,727,206 24.75 Recurrent Expenditure 2,987,550,033,436 40.15 Capital Expenditure 2,177,866,775,867 29.27 Total 7,441,175,486,758 Budget Component Total (N) % Jhjhj Recurrent Expenditure 252,854,396,662 81.97 Capital Expenditure 55,609,880,120 18.03 Total 308,464,276,782 2017 Health Budget Appropriation and Performance N336 billion Released in the First Quarter of 2017 for Capital Projects MINISTRIES Ministry of Power, Works and Housing - N90 billion. Defence and Security - N71 billion Ministry of Transport - N30 billion. Ministry of Agriculture - N30 billion Water Resources N12 billion Others - N103 billion 2017 Federal Budget and Performance PACFaH@Scale
  5. 5. Interswitch - INTERNAL 2018 Budget Assumptions & Revenue Projections 5 Fiscal Item 2018 AMOUNT AVAILABLE FOR FGN BUDGET 5,646,889,208,404 1 Share of Oil Revenue 2,441,563,319,652 2 Share of Dividend (NLNG) 29,917,415,730 3 Share of Minerals & Mining 1,170,985,667 4 Share of Non-Oil 1,385,281,578,205 Share of CIT 794,688,449,303 Share of VAT 207,862,890,147 Share of Customs 324,859,497,742 Share of Federation Acct. Levies 57,870,741,012 5 Independent Revenue 847,948,500,000 6 FGN's Share of Actual Bal. in Special Accts 9,297,994,473 7 FGN's Balances in Special Levies Accounts 17,213,444,629 8 FGN's Unspent Bal. of previous Fiscal Year - 9 FGN's Share of Tax Amnesty Income 87,840,000,000 10 FGN's Share of Signature Bonus 114,298,470,334 11 Recovery from Swiss. (US$320 Mill) - 12 Domestic Recoveries + Assets + Fines 374,000,000,000 13 Other FGN Recoveries 138,437,708,421 14 Grants and Donor Funding 199,919,791,292 Fiscal Deficit 2,948,777,905,500 FGN Expenditure 8,595,667,113,904 Fiscal Item 2018 1 Oil Production Volume 2.3 (mbpd) 2 Oil Price Benchmark 45($ Per barrel) 3 Exchange Rate 305 (N/US$) Fiscal Item 2018 Budget (N) 1 FG Revenue 5,646,889,208,404 2 Deficit 2,948,777,905,500 2018 Budget 8,595,667,113,904 Source – 2nd Quarter Budget Implementation Report (2017), Budget Office Budget Office of the Federation Source – OPEC Monthly Oil Market Report, Oct 11, 2017 Source – 2018-2020 Medium Term Fiscal Framework, Budget Office of the Federation PACFaH@Scale
  6. 6. Interswitch - INTERNAL 2018 Budget Proposal 6  A total of N8.6 trillion has been proposed for 2018;  Recurrent Expenditure – N3.49 trillion (40.57%);  Capital Expenditure – N2.43 trillion (28.19%);  Debt Services – N2.23 trillion (25.94%);  Statutory Transfers – N456.46 billion (5.30%). Source – 2018 Proposed Appropriation Bill PACFaH@Scale
  7. 7. Interswitch - INTERNAL Comparing 2017 Budget & 2018 (Proposed) Budget 7  2018 (proposed) budget increased by 1.17 trillion (15.74%); with the respective budget components also showing the following increase:  Statutory Transfers – N22.05bn (5.07%);  Debt Services – N392.49bn (21.32%);  Recurrent Expenditure – N506.73bn (16.96%);  Capital Expenditure - N249.80bn (11.47%).  Both Debt Services and Recurrent Expenditure received the highest increase in the proposed budget % 2017 Total (N) 2018 % 5.84 434,412,950,249 Statutory Transfers 456,458,654,074 5.30 24.75 1,841,345,727,206 Debt Service 2,233,835,365,699 25.94 40.15 2,987,550,033,436 Recurrent Expenditure 3,494,277,820,219 40.57 29.27 2,177,866,775,867 Capital Expenditure 2,427,665,113,222 28.19 7,441,175,486,758 8,612,236,953,214 5.07% 21.32% 16.96% 11.47% Statutory Transfers Debt Service Recurrent Expenditure Capital Expenditure PACFaH@Scale
  8. 8. Interswitch - INTERNAL THE NIGERIAN ECONOMY
  9. 9. Interswitch - INTERNAL Economic Reality of the last 3years ■ Nigeria had a change of government in 2015, from PDP to APC. ■ 2018 Budget is the third for the new government and has reason from N4.49 trillion in 2015 to N8.61 trillion; a 92% increase. ■ The Nigerian economy entered into a recession in Q2 2016 following two consecutive quarters of GDP contraction ■ This mounted pressured on Forex; between June & July 2016, Naira to Dollar exchange went from N197 to N305 per Dollar – the black market have since then exchanged for over N500. It currently exchange for N362. ■ While Nigeria climbed out of recession in July 2017, revenue has dropped and currently unable to meet its projections to fund the budget, largely due to dependence on oil. ■ As a result, the 2017 Budget is under-performing with just about 32% of allocated Capital Expenditure released for capital project implementation. ■ It is unlikely that 50% of 2017 Capital Expenditure budget would be implemented before the 2017 FY closes out, the implication is that further pressure will be on the 2018 Budget. 9PACFaH@Scale
  10. 10. Interswitch - INTERNAL Oil Production Government Revenue & Budget Funding 10 0 2 4 6 8 10 12 14 16 18 20 Jan-15 Feb-15 Mar-15 Apr-15 May-15 Jun-15 Jul-15 Aug-15 Sep-15 Oct-15 Nov-15 Dec-15 Jan-16 Feb-16 Mar-16 Apr-16 May-16 Jun-16 Jul-16 Aug-16 Sep-16 Oct-16 Nov-16 Dec-16 Jan-17 Feb-17 Mar-17 Apr-17 May-17 Jun-17 Jul-17 Aug-17 Sep-17 INFLATION Date mbpd 2015 1.839 2016 1.557 Q1 2017 1.511 Q2 2017 1.606 Q3 2017 1,789 Jul-17 1.711 Aug-17 1.804 Sep-17 1.855 Fiscal Item Approved 2017 Budget Actual Expected Annual (bn) Expected Jan- Jul 2017 (bn) Jan-Jul 2017 (bn) Variance % Variance 1 Total Gross Oil Revenue 5,334.449 3,111.759 1,950.129 (1,161.630) (37.330) 2 Total Gross Non-Oil Revenue 2,459.192 1,434.531 999.015 (435.516) (30.359) 3 Gross Revenue (Fed. Acct) 7,793.641 4,546.29 2,949.144 (1,597.146) (35.131) 4 Fed Acct. after All Deductions 6,785.074 3,957.961 1,974.294 (1,983.667) (50.118)  N336 billion Released in the First Quarter of 2017 for Capital Projects:  Ministry of Power, Works & Housing - N90bn  Defence and Security - N71bn  Ministry of Transport - N30bn.  Ministry of Agriculture - N30bn  Water Resources - N12bn  Others - N103bn Source – Fiscal Statistics (Revenue and Expenditure), National Bureau of Statistics. Source – Inflation Rates, Central Bank of Nigeria. PACFaH@Scale
  11. 11. Interswitch - INTERNAL Effect of Forex on Health Budget 11 Year Health Budget (N) 2016 250,062,891,075 2017 304,190,961,402 2018 340,456,412,880 Year Recurrent (N) 2016 221,412,548,087 2017 252,875,396,662 2018 269,343,260,225 Year Capital (N) 2016 28,650,342,987 2017 55,609,880,120 2018 71,113,152,655 Year Health Budget ($) 2016 1,269,354,777 2017 997,347,414 2018 1,116,250,534 Year Recurrent ($) 2016 1,123,921,564 2017 829,099,661 2018 883,092,656 Year Capital ($) 2016 145,433,213 2017 182,327,476 2018 233,157,878 FOREX 1$/197 1$/305 1$/197 1$/305 1$/197 1$/305  While the official Forex rate is currently at N305 to a dollar, it is important to note that the Black Market currently sells at N362 to a US Dollar. PACFaH@Scale
  12. 12. Interswitch - INTERNAL HEALTH BUDGET
  13. 13. Interswitch - INTERNAL 2018 Proposed National & Health Budgets Summary 13 Budget Component Total (N) % Statutory Transfers 456,458,654,074 5.30 Debt Service 2,233,835,365,699 25.94 Recurrent Expenditure 3,494,277,820,219 40.57 Capital Expenditure 2,427,665,113,222 28.19 Total 8,612,236,953,214 Budget Component Total (N) % Jhjhj Recurrent Expenditure 269,343,260,225 79.11 Capital Expenditure 71,113,152,655 20.89 Total 340,456,412,880 2018 Proposed Health Budget The 2018 Budget was Presented to the National Assembly on November 7, 2017 for review and approval. Just is being proposed for Health. 3.95% of the 2018 National Budget is being proposed for the Health Ministry, this falls far behind expectation as it relates to the Abuja Declaration where Though the 2018 Proposed Health Budget is MORE in value to 2017 Health Budget, but it is LESS in proportion! PACFaH@Scale
  14. 14. Interswitch - INTERNAL Comparing 2017 & 2018 Health Budgets 14 Budget Component 2017 2018 Recurrent Expenditure 252,854,396,662 269,343,260,225 Capital Expenditure 55,609,880,120 71,113,152,655 Total 308,464,276,782 340,456,412,880  While the Federal Government Budget improved by 15.74%, the 2018 Health Budget improved by less proportion - 10.37% (N31.99bn) from N308.46bn to N340.46bn.  Recurrent Expenditure increased by 6.12% (N16.5bn) from N252.9bn to N269.3bn; Capital Expenditure increased by 27.88% (N15.50bn) from N55.61bn to N71.11bn. That of the FG increased by 16.96% Recurrent & 11.47% Capital. 2017 Budget: $1.01Bn 2018 Budget: $1.12Bn 1USD/N305 252,854,396,662 55,609,880,120 269,343,260,225 71,113,152,655 0 50,000,000,000 100,000,000,000 150,000,000,000 200,000,000,000 250,000,000,000 300,000,000,000 Recurrent Expenditure Capital Expenditure 2017 & 2018 Health Budgets 2017 2018 PACFaH@Scale
  15. 15. Interswitch - INTERNAL Budget Trend – Health 15 Year Health Budget (N) National Budget (N) % Health 2013 282,501,464,455 4,987,220,425,601 5.66 2014 264,461,210,950 4,695,190,000,000 5.63 2015 259,751,742,847 4,493,363,957,157 5.78 2016 250,062,891,075 6,060,677,358,227 4.13 2017 308,464,276,782 7,441,175,486,758 4.14 2018 340,456,412,880 8,612,236,953,214 3.95 Year Health Budget (N) National Budget (N) % Health 2006 106,940,000,000 1,876,302,363,351 5.70 2007 122,399,999,999 2,266,394,423,477 5.40 2008 138,179,657,132 2,492,076,718,937 5.54 2009 154,567,493,157 2,870,510,042,680 5.38 2010 164,914,939,155 4,608,616,278,213 3.58 2011 235,866,483,244 4,226,191,559,259 5.58 2012 282,771,771,425 4,749,100,821,171 5.95 5.7 5.4 5.54 5.38 3.58 5.58 5.95 5.66 5.63 5.78 4.13 4.14 3.95 0 1 2 3 4 5 6 7 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 PACFaH@Scale
  16. 16. Interswitch - INTERNAL 5-Year Health Budget Trend – (Recurrent & Capital) 16 Year Health Budget (N) Recurrent % Recurrent Capital % Capital 2014 264,461,210,950 214,943,830,225 81.28 49,517,380,725 18.72 2015 259,751,742,847 237,075,742,847 91.27 22,676,000,000 8.73 2016 250,062,891,075 221,412,548,087 88.54 28,650,342,987 11.46 2017 308,464,276,782 252,875,396,662 81.97 55,609,880,120 18.03 2018 340,456,412,880 269,343,260,225 79.11 71,113,152,655 20.89 ■ There appear to be an increasing effort to reduce Recurrent Expenditure – in terms of proportion; though the Recurrent Expenditure value of the proposed 2018 Health Budget is higher, its percentage is the lowest in the last 5 years. ■ Similarly, Capital Expenditure budget is improving gradually. Capital Expenditure is 20.89% of the Health budget. This is also the highest capital budget in the last 5 years. Which Agencies under the Ministry of Health got the highest proportions of its Budget? PACFaH@Scale
  17. 17. Interswitch - INTERNAL Top Allocation to Ministry of Health Agencies 17 MDA TOTAL ALLOCATION FEDERAL MINISTRY OF HEALTH - HQTRS 29,797,829,674 NATIONAL PRIMARY HEALTH CARE DEVELOPMENT AGENCY 23,924,085,969 FEDERAL TEACHING HOSPITAL, ABAKALIKI 12,347,204,572 UNIVERSITY COLLEGE HOSPITAL IBADAN 11,084,965,697 UNIVERSITY OF NIGERIA TEACHING HOSPITAL, ENUGU 9,859,694,391 UNIVERSITY OF CALABAR TEACHING HOSPITAL 8,826,744,813 NNAMDI AZIKIWE UNIVERSITY TEACHING HOSPITAL, NNEWI 8,738,452,175 UNIVERSITY OF BENIN TEACHING HOSPITAL 8,483,420,686 FEDERAL MEDICAL CENTRE, NASARAWA STATE 8,270,738,885 OBAFEMI AWOLOWO UNIVERSITY TEACHING HOSPITAL 8,131,988,177 UNIVERSITY OF ILORIN TEACHING HOSPITAL, ILORIN 7,658,101,356 AMINU KANO UNIVERSITY TEACHING HOSPITAL 7,299,069,625 UNIVERSITY OF PORT-HARCOURT TEACHING HOSPITAL 7,053,487,514 AHMADU BELLO UNVERSITY TEACHING HOSPITAL 7,004,004,198 The top 3 Arms of the Federal Ministry of Health with the highest Budget are:  FEDERAL MINISTRY OF HEALTH - HQTRS  NATIONAL PRIMARY HEALTH CARE DEVELOPMENT AGENCY  FEDERAL TEACHING HOSPITAL, ABAKALIKI PACFaH@Scale
  18. 18. Interswitch - INTERNAL PHCUOR
  19. 19. Interswitch - INTERNAL National Primary Health Care Development Agency 19 Year NPHCDA Recurrent % Recurrent Capital % Capital 2014 19,433,516,695 1,928,254,072 9.92 17,505,262,623 90.08 2015 12,145,147,334 2,181,039,877 17.96 9,964,107,457 82.04 2016 17,745,373,932 2,050,738,213 11.56 15,694,635,719 88.44 2017 19,212,923,655 2,140,749,401 11.14 17,072,174,254 88.86 2018 23,924,085,969 2,140,749,401 8.95 21,783,336,568 91.05 ■ The Budget of the National Primary Health Care Development Agency (NPHCDA) has increased from N19.43bn in 2014 to N23.92bn – 23.11%. ■ Capital Expenditure received the largest chunk of the allocations; the 2018 proposed allocation is 91% of the total allocation. PACFaH@Scale
  20. 20. Interswitch - INTERNAL NHPCDA Budget Lines 20 CODE PROJECT NAME TYPE AMOUNT ERGP25112666 PROCUREMENT OF RI VACCINES, DEVICES AND OPERATIONAL COST NEW 8,895,468,504 ERGP25112672 POLIO ERADICATION INITIATIVE (PEI) NEW 1,204,190,831 ERGP25112677 PROCUREMENT OF NON POLIO SIA VACCINE AND DEVICE FOR OPERATION NEW 540,000,000 ERGP25112679 PROCUREMENT OF OUTBREAK (EMERGENCY) RESPONSE VACCINE, DEVICES AND OPERATIONAL COST NEW 1,500,000,000 ERGP25112684 PROCUREMENT OF HAJJ VACCINES NEW 174,574,043 ERGP25112686 DISEASE CONTROL AND OPERATIONAL COST FOR SURVELLANCE ACTIVITIES NEW 539,647,754 ERGP25112693 DISTRIBUTION, TRANSPORT AND MAINTENANCE OF COLD CHAIN SUPPLY SYSTEMS (NATIONAL TO STATES) NEW 1,428,523,456 ERGP25112703 MIDWIVES SERVICE SCHEME INCLUDING OUTSTANDING PAYMENT FOR SERVICES NEW 1,000,000,000 ERGP25112706 MONITORING AND EVALUATION OF PHC SYSTEMS AND SERVICES NEW 1,000,000,000 ERGP25112708 QUARTERLY BUDGET MONITORING AND EXPENDITURE TRACKING NEW 91,778,000 ERGP25112714 PARTNERSHIP FOR COMMUNITY SURVELLANCE AND PHC LABORATORY OPTIMIZATION NEW 33,084,500 ERGP25112718 COMPUTERRIZATION OF FINANCE, ACCOUNTS AND AUDIT MANAGEMENT SYSTEMS NEW 155,000,000 ERGP25112722 PHC PROJECT PLANNING,REVIEW AND OPERATIONAL RESEARCH NEW 106,809,000 ERGP25112724 COMMUNITY PARTNERSHIP FOR DELIVERY OF MINIMUM SERVICE PACKAGE NEW 289,963,400 ERGP25112731 PHC ICT INCLUDING DEVELOPMENT OF E-LEARNING SYSTEMS FOR SUSTAINABLE PHC NEW 791,007,680 ERGP25112737 RENOVATION AND INFRASTRUCTURAL UPGRADE OF NPHCDA ANNEX, ZONAL AND STATE OFFICES NEW 1,000,000,000 ERGP25112741 COMMUNITY ENGAGEMENT FOR IMPROVED MATERNAL, NEW BORN, CHILD HEALTH, NUTRITION AND PROCURE OF KITS AND COMMODITIES FOR COMMUNITY HEALTH INFLUENCERS, PROMOTERS AND SERVICERS(CHIPS) NEW 1,433,289,400 ERGP25112747 REVITALIZATION AND FUNCTIONALITY OF PHC FACILITIES NEW 1,000,000,000 ERGP25115136 EQUIPPING OF PHCs IN DASS, BOGORO & TAFAWA-BALEWA LOCAL GOVERNMENT AREAS NEW 600,000,000 PACFaH@Scale
  21. 21. Interswitch - INTERNAL Primary Health Care Under One Roof The ‘Bringing Primary Health Care Under One Roof’ (PHCUOR) initiative is part of a new Government reform designed to improve Primary Health Care Implementation. The PHCUOR concept takes into cognizance the diverse dynamics that exist between and among different states and the challenges that would emerge attempting to impose a single model across various unique ecosystems. PHCUOR is a policy to reduce fragmentation in the delivery of Primary Health Care (PHC) services which involves the integration of all PHC services under one authority. Fragmentation has been identified as the most significant problem facing PHC services, and significantly affects utilisation rates and health indices. 21 PHCUOR Budget Line While there is no budget line with PHCUOR caption, the following budget lines are indirectly related to the goal of PHCUOR:  Distribution, transport and maintenance of cold chain supply systems (national to states)  Monitoring and evaluation of PHC systems and services  Partnership for community surveillance and PHC laboratory optimization  Community partnership for delivery of minimum service package  Renovation and infrastructural upgrade of NPHCDA annex, zonal and state offices  Community engagement for improved maternal, new born, child health, nutrition and procure of kits and commodities for community health influencers, promoters and servicers(chips)  Equipping of PHCs IN Dass, Bogoro & Tafawa-Balewa Local Government Areas. PACFaH@Scale
  22. 22. Interswitch - INTERNAL OTHER HEALTH RELATED ALLOCATIONS
  23. 23. Interswitch - INTERNAL Other Health Related Allocations 23 NO. BUDGET LINE ALLOCATION (N) 1 NATIONAL AGENCY FOR THE CONTROL OF AIDS (NACA) 4,268,224,497 2 STATE HOUSE MEDICAL CENTRE 1,030,458,453 3 COUNTERPART FUNDING INCLUDING GLOBAL FUND/HEALTH 3,500,000,000 4 COUNTERPART FUNDING TO MATCH GRANTS FROM UNFPA,USAID, BMGF & UNICEF 2,400,000,000 5 NHIS FGN CONTRIBUTION 59,261,285,701 6 DRUGS & MEDICAL SUPPLIES 1,826,891,467 7 PURCHASE OF HEALTH / MEDICAL EQUIPMENT 1,180,981,808 8 CONSTRUCTION / PROVISION OF HOSPITALS / HEALTH CENTRES 3,421,259,209 9 REHABILITATION / REPAIRS - HOSPITAL / HEALTH CENTRES 305,217,664 10 MEDICAL EXPENSES 2,914,585,535 TOTAL 80,108,904,334 PACFaH@Scale
  24. 24. Interswitch - INTERNAL PACFAH@Scale FOCUSED AREAS
  25. 25. Interswitch - INTERNAL PACFaH@Scale Focused Areas – Budget Line (2011 – 2018) 25 FOCUSED AREA 2011 2012 2013 2014 2015 2016 2017 2018 1 Routine Immunization 8,180,299,435 11,384,520,766 8,479,399,324 5,902,124,474 5,253,964,338 12,882,960,595 12,521,276,231 13,320,235,378 2 Family Planning 797,406,909 1,088,038,230 1,200,000,000 3 Maternal New-Born Child Health (MNCH) 365,223,826 244,658,668 272,518,208 3,481,396,220 739,200,000 1,190,105,565 1,494,731,826 2,253,470,043 4 Nutrition 100,375,044 25,000,010 136,331,203 38,302,439 11,653,493 1,951,659,141 1,584,622,887 8,645,898,305 11,654,179,444 8,888,248,735 9,421,823,133 5,993,164,338 14,882,126,562 17,055,705,428 18,358,328,308
  26. 26. Interswitch - INTERNAL PACFaH@Scale Focused Areas – 2018 Budget 26 NO FOCUSED AREA 2018 1 Routine Immunization 13,320,235,378 2 Family Planning 1,200,000,000 3 Maternal New-Born Child Health (MNCH) 2,253,470,043 4 Nutrition 1,584,622,887 18,358,328,308 PACFaH@Scale
  27. 27. Interswitch - INTERNAL PACFaH@Scale Focused Areas - Routine Immunization 27 NO MNCH BUDGET LINE AMOUNT (N) AGENCY 1 PROCUREMENT OF RI VACCINES, DEVICES AND OPERATIONAL COST 8,895,468,504 NATIONAL PRIMARY HEALTH CARE DEVELOPMENT AGENCY 2 PROCUREMENT OF NON POLIO SIA VACCINE AND DEVICE FOR OPERATION 540,000,000 NATIONAL PRIMARY HEALTH CARE DEVELOPMENT AGENCY 3 PROCUREMENT OF OUTBREAK (EMERGENCY) RESPONSE VACCINE, DEVICES AND OPERATIONAL COST 1,500,000,000 NATIONAL PRIMARY HEALTH CARE DEVELOPMENT AGENCY 4 PROCUREMENT OF HAJJ VACCINES 174,574,043 NATIONAL PRIMARY HEALTH CARE DEVELOPMENT AGENCY 5 POLIO ERADICATION INITIATIVE (PEI) 1,204,190,831 NATIONAL PRIMARY HEALTH CARE DEVELOPMENT AGENCY 6 HEALTH EMERGENCIES & CONTAGIOUS DISEASES OUTBREAKS ( EG. MENINGITIS, MEASLES, YELLOW FEVER, MONKEY FOX,ETC) 1,000,000,000 FEDERAL MINISTRY OF HEALTH - HQTRS 7 REVIEW OF THE NATIONAL HIV VACCINE PLAN 6,002,000 NATIONAL ACTION COMMITTEE ON AIDS (NACA) 13,320,235,378 PACFaH@Scale
  28. 28. Interswitch - INTERNAL PACFaH@Scale Focused Areas - Family Planning 28 NO MNCH BUDGET LINE AMOUNT (N) AGENCY 1 IMPROVE FAMILY PLANNING SERVICES THROUGH CONTRACEPTIVES USE INTERVENTIONS AND COUNTERPART FUNDING 1,200,000,000 FEDERAL MINISTRY OF HEALTH - HQTRS PACFaH@Scale
  29. 29. Interswitch - INTERNAL PACFaH@Scale Focused Areas - MNCH 29 NO MNCH BUDGET LINE AMOUNT (N) AGENCY 1 National Tuberculosis (TB) & Leprosy Control Program: Renovation of Identified 6 MDR-TB (1 Per Geo-political Zone) Including Provision of Generators-15KVA; Procurement of 2nd Line Anti-TB Drugs For 2,000 MDR Failure Patients Including PSM Costs-bedaquiline Based Regimen;… 466,007,238 FEDERAL MINISTRY OF HEALTH - HQTRS 2 Community Engagement For Improved Maternal, New Born, Child Health, Nutrition and Procure of Kits and Commodities for Community Health Influencers, Promoters and Servicers(chips) 1,433,289,400 NATIONAL PRIMARY HEALTH CARE DEVELOPMENT AGENCY 3 Accelerated Reduction of Maternal Morbidity And Mortality Through Safemotherhood 29,768,000 FEDERAL MINISTRY OF HEALTH - HQTRS 4 MATERNAL, INFANT AND YOUNG CHILD FEEDING IN NIGERIA Including Micronutrient Deficiency Control And Nutrition Information Surveillance System 30,000,000 FEDERAL MINISTRY OF HEALTH - HQTRS 5 Maternal and Child Healthcare 114,690,000 NATIONAL HEALTH INSURANCE SCHEME 6 Extension of Maternal & Child Health Unit 19,297,813 UNIVERSITY OF BENIN TEACHING HOSPITAL 7 Construction And Furnishing Of Neo-natal Wing Of Maternal And Childcare Complex 148,737,592 FEDERAL MEDICAL CENTRE, TARABA STATE 8 REVIEW WORKSHOPS FOR CORE HIV/AIDS HEALTH COMMODITIES erg 3,680,000 NATIONAL ACTION COMMITTEE ON AIDS (NACA) IMNCH strategy - articulation of policy and strategy plans of newborn in child health in line with SDG targets on integrated management of childhood illnesses (IMCI) follow up, Integrated Supportive Supervision (ISS) and Kangaroo Mother Care (KMC) 8,000,000 FEDERAL MINISTRY OF HEALTH - HQTRS 2,253,470,043 PACFaH@Scale
  30. 30. Interswitch - INTERNAL PACFaH@Scale Focused Areas - Nutrition 30 NO MNCH BUDGET LINE AMOUNT (N) AGENCY 1 MATERNAL, INFANT AND YOUNG CHILD FEEDING IN NIGERIA Including Micronutrient Deficiency Control And Nutrition Information Surveillance System 30,000,000 FEDERAL MINISTRY OF HEALTH - HQTRS 2 Community Engagement For Improved Maternal, New Born, Child Health, Nutrition And Procure Of Kits And Commodities For Community Health Influencers, Promoters and Servicers(CHIPS) 1,433,289,400 NATIONAL PRIMARY HEALTH CARE DEVELOPMENT AGENCY 3 CONSTRUCTION OF NUTRITIONAL REHABILITATION CENTER (FOR VICTIMS OF INSURGENCY AT N/EAST) 40,000,000 ABUBAKAR TAFAWA BALEWA UNIVERSITY TEACHING HOSPITAL BAUCHI 4 Construction And Furnishing Of Nutrition And Dietetics Block 11,365,000 FEDERAL MEDICAL CENTRE, MAKURDI 5 To Complete The Determination Of Baseline Studies On Nutritional 55,000,000 FEDERAL SCHOOL OF MEDICAL LABORATORYB JOS 6 CO-FUNDING TO UNICEF FOR THE PROCUREMENT OF READY-TO- USE THERAPEUTIC FOOD TO BE DISTRIBUTED TO 6 GEOPOLITICAL ZONES Including Establishment Of CMAM Sites 1,110,186,200 FEDERAL MINISTRY OF HEALTH - HQTRS 7 National Food Safety Sensitization Workshop, Development Of Food Safety ongoing Manuals And The Development Of Foodborne Illness Sentinel Sites 10,000,000 FEDERAL MINISTRY OF HEALTH - HQTRS 1,584,622,887 PACFaH@Scale
  31. 31. Interswitch - INTERNAL BUDGETING PROCESS HEALTH BUDGET SHORTFALLS
  32. 32. Interswitch - INTERNAL 2018 Budget Shortfall 32 Abuja Declaration – 15% Expected to be allocated to HEALTH, Nigeria has proposed 3.96%. Conspicuously missing in 2018 Proposed Budget is provision for the National Health Act (NHA, 2014) which mandates the Federal Government to allocate 1% of its Consolidated Revenue Fund (CRF) to implement the provisions of the Act. Abuja Declaration (2001) National Health Act (2014) PACFaH@Scale
  33. 33. Interswitch - INTERNAL Effective Budgeting Process ■ An effective Budgeting process should go through 3 Phases: – The Enactment Phase – The Implementation Phase – The Monitoring Phase – The Auditing Phase 33 NIGERIA LAY MUCH EMPHASIS ON THE ENACTMENT PHASE BUT LITTLE ATTENTION TO THESE OTHER PHASES ENACTMENT IMPLEMENTATION MONITORING AUDITING E F F E C T I V E B U D G E T I N G P R O C E S S PACFaH@Scale
  34. 34. Interswitch - INTERNAL Roles in the Budgeting Process 34 PHASE RESPONSIBILITY REMARK ENACTMENT Executive & Legislature Executive Presents & Legislator review for approval IMPLEMENTATION Executive Ministries, Agencies & Departments (MDAs) MONITORING Executive & Legislature Monitoring Teams of MDAs and National Assembly Committees AUDITING Executive & Legislature Internal Audits of MDAs and Office of the Auditor-General of the Federal (who reports to the National Assembly) PACFaH@Scale
  35. 35. Interswitch - INTERNAL Budget Implementation Gaps 35 97% OF 2016 CAPITAL BUDGET ALLOCATION WAS IMPLEMENTED – THE BEST IN THE LAST 7 BUDGET YEARS. Year National (Trillion) Health (Billion) Capital Exp. (Billion) Implemented (Billion) Implemented (Percent) 2016 4,695.19 250.06 28.65 27.81 97.26 2015 4,493.36 259.75 22.68 16.45 72.52 2014 4,695.19 264.46 49.52 20.47 41.34 2013 4,987.22 282.50 60.05 34.78 57.93 2012 4,749.10 282.77 60.92 45.00 73.87 2011 4,484.74 257.87 38.79 32.17 82.93 PACFaH@Scale
  36. 36. Interswitch - INTERNAL Budget Monitoring & Auditing ■ Budget Monitoring must occur every other time of the year to ensure capital projects are being implemented appropriately. ■ This responsibility is primarily for the MDAs Monitoring and Inspection teams. The National Assembly also carry out this oversight function through their committees. ■ Budget Auditing should take place either bi-annually or at the end of the budget year. This is usually the responsibility of the Office of the Accountant-General of the Federation. The findings in the report should be promptly attended to so as to demonstrate government’s leadership and commitment to accountability and transparency. 36PACFaH@Scale
  37. 37. Interswitch - INTERNAL 37 drpcnig development Research and Projects Centre Contact: Kano Office No. 63B Sultan Road, Nassarawa GRA, Kano State, Nigeria Tel: +234 703 035 3438 drpc_nig PACFaH@Scale Contact: Abuja Office 1b Lumsar Street, Off Gurara Street, Ibrahim Abacha Estate, Wuse Zone 4, Abuja
  38. 38. Interswitch - INTERNAL 38 PACFaH@Scale - Advocating for Child and Family Health PARTNERSHIP FOR ADVOCACY FOR IN CHILD AND FAMILY HEALTH

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  • DrGarbaAudu

    May. 31, 2018
  • charadee26

    Aug. 25, 2018

Analysis of Nigeria's 2018 Proposed Health Budget

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