BEYOND THE PASSAGE OF 1% CONSOLIDATED REVENUE FUND FOR BASIC HEALTHCARE PROVISION FUND IN 2018 BUDGET (dRPC – PAS, MAY 2018)
Stakeholders in Nigeria’s health sector have persistently campaigned for the full implementation of the National Health Act 2014 which stipulates that not less than 1% of Consolidated Revenue Fund (CRF) is set aside for Basic Health Care Provision Fund (BHCPF). For four years, intra and inter-bureaucratic turf politics stood in the way of actualizing the implementation of a legitimate law of the nation. After four years of vigorous campaign, the 8th National Assembly included the 1% CRF in the approved 2018 Health budget. This memorable feat is worthy of commendation by all civil society advocates, campaigners and champions whose sturdy commitment to the cause of a better funded health system made it a reality. The Partnership for Child and Family Health at Scale (PACFaH@Scale), a major voice in the advocacy for the 1% CRF for Health, join other Nigerians to commemorate this auspicious milestone. We call on President Muhammadu Buhari to give assent to the 2018 Appropriation Bill in the overall interest of Nigerians.
Without this key step in providing affordable healthcare for all, especially the vulnerable, achievement of the Universal Health Coverage (UHC) will not be possible. We, therefore, call on all tiers of government to continue to commit funds for line items on the annual health budget despite the passage of the 1% CRF. We also call on the state Houses of Assembly to domesticate the NHAct as statutory provision to complement their routine health budgets.
Assent to the 1% CRF is a step in the righ direction in view of the prevailing undignifying health indicators in the country. With a population fast approaching 200million, more than 50% are under 65 years of age . One out of every 10 children under the age of 10 years dies annually (i.e. 2300 children < 10 years die daily). And, In 2015 alone , survey shows that 814 out of 100,000 mothers giving birth die in Nigeria compared to 319 in Ghana (i.e. in Nigeria, 145 mothers die daily due to pregnancy issues). Currently, life expectancy @ birth in Nigeria is 54 years, while in our neighbor, Ghana, it is 62 years, and in Niger Republic, it stands as 61 years. Additionally, Out of pocket expenses reach 70% in the country.
Despite these challenges and and discouraging health indices when compared to even smaller African nations, Nigeria’s spending in health is lower as seen in the budgetary trends in the last few years. Budget provisions to the health sector in the last four years showed decreasing and disturbing trajectory. From 5.78% allocation in 2015, budget provisions downed to 4.13% in 2016, 4.14% in 2017 and, dipped to 3.95% this year.
We appeal to President Muhammdu Buhari to as a matter of national priority assent to the provision which is vital to promoting equity, efficiency, access, quality accountability and sustainability in PHC services. We believe that if assented to, and promptly released, the 1% CRF will trigger the provision of high quality PHC services and create equitable access to all Nigerians, complement governments 3-year ERGP (2018 – 2020) for health, and encourage other tiers of government to contribute to PHC funding to ease the burden on secondary and tertiary referral services.
We also recommend that the BHCPF should be prioritized (and not politicized), and that government should allow implementation of the BHCPF in accordance with the enabling Act. We are also calling on the federal government to empower the National Steering Committee on BHCPF, and widen its membership to include more stakeholders (CSOs, DPs, states), as well as mandate the committee to set up pragmatic and applicable Monitoring and Accountability Framework for the BHCPF and the NHAct as a whole.
We also urge the Media to sustain advocacy momentum for BHCPF, seek for full implementation of BHCPF according to the law, hold FG, stakeholders and the National Council on Health accountable for the responsibility of protecting, promoting, improving and maintaining health of Nigerians and educate Nigerians on provisions and benefits of the BHCPF and the NHAct.
We wish to equally call on CSO to continue their commitment to supporting and engaging governments at various levels and ensuring that the BHCPF is assented to and operational for 2018.
We call on the Civil Society Organizations to come together to advocate for presidential assent as well as develop inclusive strategies for more CSOs to monitor and follow up with the implementation at both national, states and local government levels. CSOs must be strong in being part of the verification/monitoring/tracking, approvals, releases, utilization, due diligence and accountability and inclusiveness as being the ingredients necessary to achieve the Universal basic healthcare delivery..