2018 proposed health budget analysis

2018 PROPOSED HEALTH
BUDGET ANALYSIS
PARTNERSHIP
FOR ADVOCACY
FOR IN CHILD AND
FAMILY HEALTH

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

BUDGET
PROPOSAL

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
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

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

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

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

THE NIGERIAN
ECONOMY

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

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

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

HEALTH BUDGET

2018 Proposed National & Health Budgets Summary
13
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
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

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

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

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

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

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

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

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

OTHER HEALTH RELATED
ALLOCATIONS

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

PACFAH@Scale
FOCUSED AREAS

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

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

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
DEVELOPMENT AGENCY
3
PROCUREMENT OF OUTBREAK (EMERGENCY) RESPONSE
VACCINE, DEVICES AND OPERATIONAL COST
1,500,000,000
DEVELOPMENT AGENCY
4 PROCUREMENT OF HAJJ VACCINES 174,574,043
DEVELOPMENT AGENCY
5 POLIO ERADICATION INITIATIVE (PEI) 1,204,190,831
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

PACFaH@Scale Focused Areas - Family Planning
28
1
IMPROVE FAMILY PLANNING SERVICES THROUGH
CONTRACEPTIVES USE INTERVENTIONS AND
COUNTERPART FUNDING
1,200,000,000
FEDERAL MINISTRY OF HEALTH -
HQTRS
PACFaH@Scale

PACFaH@Scale Focused Areas - MNCH
29
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
4
MATERNAL, INFANT AND YOUNG CHILD FEEDING IN NIGERIA Including
Micronutrient Deficiency Control And Nutrition Information Surveillance
System
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)
2,253,470,043
PACFaH@Scale

PACFaH@Scale Focused Areas - Nutrition
30
1
MATERNAL, INFANT AND YOUNG CHILD FEEDING IN NIGERIA
Including Micronutrient Deficiency Control And Nutrition
Information Surveillance System
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
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
1,584,622,887
PACFaH@Scale

BUDGETING PROCESS
HEALTH BUDGET
SHORTFALLS

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

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

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

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

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
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
PACFaH@Scale - Advocating for Child and Family Health
PARTNERSHIP
FOR ADVOCACY
FOR IN CHILD AND
FAMILY HEALTH

2018 proposed health budget analysis

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2018 proposed health budget analysis