Abstract:

This is an exploratory study of the health budget allocation and performance of a State against the background of its health indices and preparedness for any public health emergency such as COVID-19. This is aimed to guide future health programming in the state. Three research instruments (Questionnaire, data collection, and interview guides) were used to collect data, key informant interviews with health planners and managers; synthesis of relevant literature reviews to identify relevant documents; and responses gathered from the public and civil servants. The findings identified eight (8) Ministries, Departments, and Agencies (MDA) under the State Ministry of Health, which is the policy-making body that monitors and coordinates/regulates all health activities in the State. The government budget, donor partners, out-of-pocket expenditures, and contributory schemes are sources of funds for Health. The State’s budgetary allocations for health shows an annual increment from reaching 15% in 2016 to 16% in 2017 and over 17% in 2018, surpassing the Abuja Declaration target of 15% of the state budget. In nominal terms, allocation to the health sector fluctuated between 2011 and 2016 and finally went down in 2018. There is no clearly cut-out budgetary provision for emergency preparedness for health events in the State’s health budget. The government has proactively made budgetary provisions for the challenges facing the health care system to facilitate efforts towards addressing them. However, it remains to be seen whether the poor health indices will get better in the long run.

References:

[1] Xu K, Soucat A & Kutzin J et al. (2018). Public Spending on Health: A Closer Look at Global Trends. Geneva: World Health Organization; 2018 (WHO/HIS/HGF/HFWorkingPaper/18.3). Licence: CC BY-NC-SA 3.0 IGO.

[2] Xu K, Soucat A & Kutzin J et al. (2018). Public Spending on Health: A Closer Look at Global Trends. Geneva: World Health Organization; 2018 (WHO/HIS/HGF/HFWorkingPaper/18.3). Licence: CC BY-NC-SA 3.0 IGO.

[3] Gottret, Pablo; Schieber, George. 2006. Health financing revisited: a practitioner’s guide (English). Washington, DC: World Bank. http://documents.worldbank.org/curated/en/874011468313782370/Health-financing-revisited-a-practitioners-guide.

[4] Xu K, Soucat A & Kutzin J et al. (2018). Public Spending on Health: A Closer Look at Global Trends. Geneva: World Health Organization; 2018 (WHO/HIS/HGF/HFWorkingPaper/18.3). Licence: CC BY-NC-SA 3.0 IGO.

[5] Rajan, D., Barroy, H, and Stenberg K., (2016). Budgeting for health. In: Schmets G, Rajan D, Kadandale S, editors. Strategizing national health in the 21st century: a handbook. Chapter 8. Geneva: World Health Organization. http://apps.who.int/iris/bitstream/handle/10665/250221/9789241549745-chapter8-eng.pdf?sequence=11&isAllowed=y.

[6] Save the Children, (2012). Health Sector Budget Advocacy: A guide for civil society organisations. https://www.who.int/pmnch/media/news/2012/201205_health_sector_budget_advocacy.pdf.

[7] Save the Children, (2012). Health Sector Budget Advocacy: A guide for civil society organisations. https://www.who.int/pmnch/media/news/2012/201205_health_sector_budget_advocacy.pdf.

[8] Cashin, C., (2016). Health financing policy: the macroeconomic, fiscal, and public finance context. Washington (DC): World Bank Group. http://documents.worldbank.org/curated/en/394031467990348481/Health-financing-policy-the-macroeconomic-fiscal-and-public-finance-context.

[9] Rajan, D., Barroy, H, and Stenberg K., (2016). Budgeting for health. In: Schmets G, Rajan D, Kadandale S, editors. Strategizing national health in the 21st century: a handbook. Chapter 8. Geneva: World Health Organization. http://apps.who.int/iris/bitstream/handle/10665/250221/9789241549745-chapter8-eng.pdf?sequence=11&isAllowed=y.

[10] Rajan, D., Barroy, H, and Stenberg K., (2016). Budgeting for health. In: Schmets G, Rajan D, Kadandale S, editors. Strategizing national health in the 21st century: a handbook. Chapter 8. Geneva: World Health Organization. http://apps.who.int/iris/bitstream/handle/10665/250221/9789241549745-chapter8-eng.pdf?sequence=11&isAllowed=y.

[11] WHO, (2018). Public Spending on Health: A Closer Look at Global Trends. WHO/HIS/HGF/HFWorkingPaper/18.3. http://apps.who.int/iris.

[12] Kress Daniel H., Su Yanfang and Wang Hong (2016). Assessment of Primary Health Care System Performance in Nigeria: Using the Primary Health Care Performance Indicator Conceptual Framework. Health Systems & Reform, 2(4):302–318, 2016 _ 2016 Bill and Melinda Gates Foundation ISSN: 2328-8604 print/2328-8620 online DOI: 10.1080/23288604.2016.1234861.

[13] Nigeria Demographic and Health Survey (2018). National Population Commission Abuja, Nigeria. The DHS Program ICF Rockville, Maryland, USA October 2019.

[14] Save the Children, (2012). Health Sector Budget Advocacy: A guide for civil society organisations https://www.who.int/pmnch/media/news/2012/201205_health_sector_budget_advocacy.pdf.

[15] International Budget Partnership, (May 2021). Managing COVID funds: The accountability gap. https://internationalbudget.org/covid/.

[16] Organization for Economic Cooperation and Development (10 May 2021). The territorial impact of COVID-19: Managing the crisis and recovery across levels of government https://www.oecd.org/coronavirus/policy-responses/the-territorial-impact-of-covid-19- managing-the-crisis-and-recovery-across-levels-of-government-a2c6abaf/.

[17] International Budget Partnership, (May 2021). Managing COVID funds: The accountability gap. https://internationalbudget.org/covid/.

[18] United Nations (April 2020). Policy Brief: The Impact of COVID-19 on Women https://reliefweb.int/sites/reliefweb.int/files/resources/policy-brief-the-impact-of-covid-19-on-women-en.pdf.

[19] International Budget Partnership, (May 2021). Managing COVID funds: The accountability gap. https://internationalbudget.org/covid/.

[20] International Budget Partnership, (May 2021). Managing COVID funds: The accountability gap. https://internationalbudget.org/covid/.

[21] Organization for Economic Cooperation and Development (10 May 2021). The territorial impact of COVID-19: Managing the crisis and recovery across levels of government https://www.oecd.org/coronavirus/policy-responses/the-territorial-impact-of-covid-19- managing-the-crisis-and-recovery-across-levels-of-government-a2c6abaf/.

[22] International Budget Partnership, (May 2021). Managing COVID funds: The accountability gap. https://internationalbudget.org/covid/.

[23] International Budget Partnership, (May 2021). Managing COVID funds: The accountability gap. https://internationalbudget.org/covid/.

[24] World Health Organization, (2022). Health Budget: Overview. https://www.who.int/health-topics/health-budget#tab=tab_1.

[25] International Budget Partnership, (May 2021). Managing COVID funds: The accountability gap. https://internationalbudget.org/covid/.

[26] International Budget Partnership, (May 2021). Managing COVID funds: The accountability gap. https://internationalbudget.org/covid/.

[27] National Bureau of Statistics (NBS) and United Nations Children’s Fund (UNICEF). (2017) Multiple Indicator Cluster Survey 2016-17, Survey Findings Report. Abuja, Nigeria: National Bureau of Statistics and United Nations Children’s Fund. https://www.unicef.org/nigeria/sites/unicef.org.nigeria/files/2018-09/Nigeria-MICS-2016-17.pdf.

[28] Enugu State Ministry of Budget and Planning (July 2018). Enugu State Health Expenditure Report, 2018. 2018 Second Quarter and Mid-Year Budget Implementation Report.

[29] Enugu State Ministry of Budget and Planning (July 2018). Enugu State Health Expenditure Report, 2018. 2018 Second Quarter and Mid-Year Budget Implementation Report.

[30] National Bureau of Statistics (NBS) and United Nations Children’s Fund (UNICEF). (2017) Multiple Indicator Cluster Survey 2016-17, Survey Findings Report. Abuja, Nigeria: National Bureau of Statistics and United Nations Children’s Fund. https://www.unicef.org/nigeria/sites/unicef.org.nigeria/files/2018-09/Nigeria-MICS-2016-17.pdf.

[31] Nigeria Demographic and Health Survey (2018). National Population Commission Abuja, Nigeria. The DHS Program ICF Rockville, Maryland, USA October 2019.

[32] Bein, Murad, and Coker-Farrell, Elizabeth Y., (Mar 2020). The association between medical spending and health status: A study of selected African countries Malawi Med J.; 32(1): 37–44. doi: 10.4314/mmj. v32i1.8. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7366161/.

[33] Enugu State Ministry of Budget and Planning (July 2018). Enugu State Health Expenditure Report, 2018. 2018 Second Quarter and Mid-Year Budget Implementation Report.

[34] International Budget Partnership, (May 2021). Managing COVID funds: The accountability gap. https://internationalbudget.org/covid/.

[35] Organization for Economic Cooperation and Development (10 May 2021). The territorial impact of COVID-19: Managing the crisis and recovery across levels of government 11 https://www.oecd.org/coronavirus/policy-responses/the-territorial-impact-of-covid-19- managing-the-crisis-and-recovery-across-levels-of-government-a2c6abaf/.

[36] International Budget Partnership, (May 2021). Managing COVID funds: The accountability gap. https://internationalbudget.org/covid/.

[37] International Budget Partnership, (May 2021). Managing COVID funds: The accountability gap. https://internationalbudget.org/covid/.

[38] International Budget Partnership, (May 2021). Managing COVID funds: The accountability gap. https://internationalbudget.org/covid/.

[39] International Budget Partnership, (May 2021). Managing COVID funds: The accountability gap. https://internationalbudget.org/covid/.

[40] International Budget Partnership, (May 2021). Managing COVID funds: The accountability gap. https://internationalbudget.org/covid/.