2016 health budget analysis
TRANSCRIPT
HEALTH BUDGET
ANALYSIS
StatiSense
This study is supported by the Partnership for Advocacy
in Child and Family Health (PACFaH) Project in Nigeria
The Partnership for Advocacy in Child and Family Health Project (PACFaH)
Nigeria is a pilot project supported by the Gates foundation as an innovative
initiative to learn about the potential for engaging Nigerian civil society
organizations in Nigeria. The project is implemented by 8 Nigerian civil society
groups working together to encourage government to plan for and increase
funding to the 4 most important sectors in child and family health in Nigeria.
The 4 areas are:
ABOUT PACFaH PROJECT IN NIGERIA
1. Routine Immunization
2. Family Planning
3. Ending childhood killer diseases through Amoxicillin as first line treatment
for Pneumonia and ORS - Zinc as treatment for childhood diarrheal diseases
4. Nutrition
Budget analysis and budget tracking is a key component of the work of the
PACFaH NGOs. Data from budget analysis and tracking is expected to be
used by the NGOs as the evidence base for claims, arguments and demands
during advocacy visits. Advocacy visits are expected to take place at
national and state levels.
AAFP Association for The Advancement of Family Planning HERFON Health Reform Foundation of Nigeria
CHRI Commonwealth Human Rights Initiative FOMWAN Federation of Muslim Women's Associations in Nigeria
CISLAC Civil Society Legislative Advocacy Centre PSN Pharmaceutical Society of Nigeria
CS-SUNN Civil Society Scaling-Up Nutrition in Nigeria dRPC development Research and Projects Centre
INTRODUCTION
Analysis of the approved 2016 Health Budget focusing
on:
• Federal Ministry of Health (FMoH) Budget
• Budgets of Selected Strategic Ministries
• FMoH Recurrent & Capital Expenditure Budgets
• FMoH HQTRS BUDGET & OTHER 96 MDAs
• Budget Lines for FP, RI, Nutrition, and MNCH
• Trend analysis of Health Budget (2006 – 2016)
• Other Health considerations in the Budget
• NHA (2014) and Other Government’s Commitment
3.c Increase substantially health financing and the
recruitment, development and training and retention of
the health workforce in developing countries, especially in
LDCs and SIDS.
2016 APPROVED HEALTH BUDGET
Ministry of Health
Total Personnel Total Overhead Total Recurrent Total Capital Total Allocation
217,472,115,158 3,940,432,929 221,412,548,087 28,650,342,987 250,062,891,075
FEDERAL GOVERNMENT BUDGET % FEDERAL MINISTRY OF HEALTH BUDGET %
Capital 1,587,598,122,031 38 Capital 28,650,342,987 11
Recurrent 2,646,389,236,196 62 Recurrent 221,412,548,087 89
Total 4,233,987,358,227 Total 250,062,891,075
The Federal Government Budget to the Ministry
of Health is 4.13% of the National Budget
FMoH Recurrent Expenditure is 89% of its Budget
while that of the Federal Government is 62%.
FMoH Capital Expenditure is 11% of its Budget
while that of the Federal Government is 38%.
SELECTED STRATEGIC MINISTRIES TO THE FMoH
Strategic Ministry (2016) Total Budget % of FG Budget
Interior 513,655,831,566 8.48
Works, Power & Housing 456,936,811,202 7.54
Education 403,168,214,689 6.65
Agriculture 75,806,548,275 1.25
Petroleum Resources 60,641,827,493 1.00
Water Resources 53,300,177,864 0.88
Environment 19,473,373,106 0.32
Health 250,062,891,075 4.13
Strategic Ministry (2015) Total Budget % of FG Budget
Interior 156,220,022,460 3.48
Power/Works/Housing 61,904,818,992 1.38
Education 483,183,784,654 10.75
Agriculture 40,659,020,717 0.90
Petroleum Resources 59,051,178,743 1.31
Water Resources 23,446,953,562 0.52
Environment 17,499,334,341 0.39
Health 259,751,742,847 5.78
FMoH RECURRENT & CAPITAL EXPENDITURE BUDGETS
Ministry of Health
Total Personnel Total Overhead Total Recurrent Total Capital Total Allocation
217,472,115,158 3,940,432,929 221,412,548,087 28,650,342,987 250,062,891,075
MDATOTAL
ALLOCATIONTOTAL
RECURRENT% REC
TOTAL CAPITAL
% CAP
NATIONAL PRIMARY HEALTH CARE DEV. AGENCY 17,745,373,932 2,050,738,213 11.56 15,694,635,719 88.44
FEDERAL MINISTRY OF HEALTH - HQTRS 10,275,698,200 5,061,445,844 49.26 5,214,252,356 50.74
FEDERAL MEDICAL CENTRE, NGURU YOBE 1,966,021,992 1,682,191,787 85.56 283,830,205 14.44
NIGERIA CENTRE FOR DISEASE CONTROL ABUJA 252,281,264 3,774,264 1.50 248,507,000 98.50
FEDERAL MEDICAL CENTRE ABEOKUTA 3,565,129,900 3,368,200,208 94.48 196,929,691 5.52
AMINU KANO UNIVERSITY TEACHING HOSPITAL 5,146,305,121 4,952,654,628 96.24 193,650,494 3.76
FEDERAL MEDICAL CENTRE, GOMBE 3,110,633,575 2,928,239,458 94.14 182,394,117 5.86
NATIONAL HOSPITAL 6,924,181,488 6,746,575,021 97.43 177,606,467 2.57
FEDERAL MEDICAL CENTRE, UMUAHIA 3,991,763,036 3,816,131,397 95.60 175,631,639 4.40
NATIONAL ORTHOPAEDIC HOSPITAL DALA KANO 1,766,765,182 1,592,981,661 90.16 173,783,521 9.84
Top Capital Expenditure to MDA
FMoH HQTRS BUDGET & OTHER 96 MDAs
31 MDAs do not have Capital Expenditures Budget:Nigeria Centre for Disease Control Abuja, Federal Staff Eye Clinic Abuja, PHS-Ibadan, NHETC-Lagos, NHETC-Maiduguri, NHETC-Zaria, ONCHO-Kaduna, PHS-Abuja, PHS-Yola,PHS-Jalingo, PHS-Maiduguri, PHS-Damaturu, PHS-Kano, PHS-Katsina, PHS-Dutse, PHS-Ilorin, PHS-Sokoto, PHS-Abeokuta, PHS-PortHarcourt, PHS-Calabar, PHS-Lagos-ikeja-Tincan-Apapa-Idiroko, PHS-Warri, NHETC-Enugu, ONCHO-Bauchi, ONCHO-Enugu, ONCHO-Ibadan, ICH-LUTH, ICH-UBTH, ICH-UCH, ICH-ABUTH, ICH-Enugu
TOTAL ALLOCATION TOTAL RECURRENT TOTAL CAPITAL
FMoH 10,275,698,200 5,061,445,844 5,214,252,356
96 MDAs 239,751,897,772 216,302,422,145 23,436,090,630
5,061,445,844 5,214,252,35610,275,698,200
216,302,422,145
23,436,090,630
239,751,897,772
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
TOTAL RECURRENT TOTAL CAPITAL TOTAL ALLOCATION
FMoH 96 MDAs
COMPARISON OF BUDGETS: FMoH HQTRS vs 96 MDAS
FMoH RECURRENT & CAPITAL EXPENDITURE BUDGETSYEAR TOTAL RECURRENT TOTAL CAPITAL AGGREGATE TOTAL RECURRENT % CAPITAL %
2006 67,777,199,998 39,162,800,002 106,940,000,000 63.38 36.62
2007 71,228,994,574 51,171,005,425 122,399,999,999 58.19 41.81
2008 88,812,937,132 49,366,720,000 138,179,657,132 64.27 35.73
2009 103,764,216,256 50,803,276,901 154,567,493,157 67.13 32.87
2010 111,908,323,964 53,006,615,191 164,914,939,155 67.86 32.14
2011 202,338,852,916 33,527,630,328 235,866,483,244 85.79 14.21
2012 225,760,885,287 57,010,886,138 282,771,771,425 79.84 20.16
2013 222,453,995,179 60,047,469,275 282,501,464,455 78.74 21.26
2014 214,943,830,225 49,517,380,725 264,461,210,950 81.28 18.72
2015 237,075,742,847 22,676,000,000 259,751,742,847 91.27 8.73
2016 221,412,548,087 28,650,342,987 250,062,891,075 88.54 11.46
0
50,000,000,000
100,000,000,000
150,000,000,000
200,000,000,000
250,000,000,000
Recurrent
Capital
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
CAPITAL PROJECTS – FP, RI, NUTRITION & MNCH BUDGET LINESA total of 693 Projects will be executed with N28.65Bn, being the Capital expenditurebudget. Below are budget lines for Family Planning, Routine Immunization, Nutrition,
and Maternal New-born Child Health (MNCH).
PROJECT NAME TYPE AMOUNT AGENCY
Development of costed implementation plan for Nigeria FP blue print New 1,217,662
FMoH-Hqtrs
Training of family planning (FP) service providers New 1,827,224
Counterpart fund for the procurement and national distribution of contraceptive commodities based on 2016 forecast
New 791,000,000
Training of Community Health Extension Workers (CHEWS) on Long
Acting Reversible Contraceptives (LARC)New 1,827,224
Last mile distribution of contraceptive commodities New 1,534,799
TOTAL ALLOCATION 797,406,909
FAMILY PLANNING
PROJECT NAME TYPE AMOUNT AGENCY
Development of National Vaccine Policy New 3,281,461 FMoH- Hqtrs
Polio Eradication Initiative (PEI - including OPV + devices procurement and operational costs)
Ongoing
9,821,331,311
NPHCDA
Hajj vaccines 220,473,202
Non-Polio SIAs (Measles, Yellow fever campaigns, MNTE, etc, including vaccines and devices procurement and operational costs
1,743,406,067
Traditional vaccines and devices procurement including freight and handling charges
1,017,495,128
Cleaning and distribution of vaccines and devices 76,973,426
TOTAL ALLOCATION 12,882,960,595
ROUTINE IMMUNIZATION
CAPITAL PROJECTS – FP, RI, NUTRITION & MNCH BUDGET LINES
PROJECT NAME TYPE AMOUNT AGENCYCompletion of Nutrition and Dietetics Block New 9,292,500 FMC, Makurdi
Nutrition New 1,099,404 FMoH- Hqtrs
Implementation of National Policy on Food Safety and its
Implementation Strategy (NPFSIS)New 354,725 FMoH- Hqtrs
Establishment of Sentinel Sites for Surveillance of Food Borne
DiseasesNew 314,185 FMoH- Hqtrs
Development of Policy Documents on MNDC New 592,679 FMoH- Hqtrs
TOTAL ALLOCATION 11,653,493
NUTRITION
PROJECT NAME TYPE AMOUNT AGENCYIntegrated Maternal Newborn And Child Health (IMNCH) Ongoing 20,404,623 FMoH- Hqtrs
Training of Health Workers on Maternal Perinatal Death Surveillance And
Response (MPDSR). Technical Support To States: Northern Zone - Kaduna.
Southern Zone - Ibadan
New 769,627 FMoH- Hqtrs
Unified Maternal & Child Health Programme (UMCHP) New 63,000,000 NHIS
Extension of Maternal & Child Health Unit New 12,623,554 UNIBENTH
Infant and Young Child Feeding New 729,136 FMoH- Hqtrs
Furnishing of Completed Maternal & Childcare Complex-labour Ward Wing New 18,952,184 FMC, Taraba
Supply and Installation of Medical Infant Incubators New 5,386,500 FMC, Abakaliki
Supply and Installation of Standard Medical Infant Warmer New 2,154,600
To conduct research to map out Childhood Mortality and establish the
Geo-political Patterns across The CountryNew 1,311,015 NIMR, Yaba
Training of 300 Community Based Health Professionals to Support
Community Based Research into Pregnancy, Childbirth and Childhood
Related Disorders.
New 1,048,812 NIMR, Yaba
International Conferences on Nursing and Midwifery Issues. New 824,868 FMoH- Hqtrs
Update Training of Nurse/Midwives on Life Saving Skills (LSS) New 1,644,502 FMoH- Hqtrs
Midwives Service Scheme (MSS) Ongoing 1,061,256,144 NPHCDA
TOTAL ALLOCATION 1,190,105,565
MATERNAL NEW-BORN CHILD HEALTH (MNCH)MNDC - Micronutrient Deficiency Control
FMoH BUDGETS TREND (2006 – 2016)
Past Value (2006) Present Value (2016) n (No. of years)
FMoH 106,940,000,000 250,062,891,075 11
FG 1,876,302,363,351 6,060,677,358,227 11
WHILE THE FMoH HAS GROWN BY 8.03% SINCE 2006, THE NATIONAL BUDGET HAS
PERFORMED BETTER, IT HAS ACHIEVED A GROWTH RATE 11.25%.
Year Health Budget National Budget % 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
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 4.13Note items for increases
FMoH BUDGETS TREND (2006 – 2016)
5.7
5.45.54
5.38
3.58
5.58
5.955.66 5.63
5.78
4.13
0
1
2
3
4
5
6
7
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
% Health Budget
Past Value (2006) Present Value (2016) n (No. of years)
106,940,000,000 250,062,891,075 11
While the FMoH has grown by 8.03% since 2006, the national budgethas performed better, it has achieved a growth rate 11.25%.
OTHER HEALTH CONSIDERATIONS
Beside the allocation to the Federal Ministry of Health, there are other
provisions for health in the 2016 approved Budget.
MINISTRY AGENCY / BUDGET LINE CAPITAL (N)
Service-Wide Votes NHIS (Military Retirees) 2,544,110,811
Service-Wide Votes Outstanding Payments to Health Professionals 3,000,000,000
Service-Wide Votes National Assembly Clinic 1,000,000,000
Service-Wide Votes Counterpart Funding including Global Fund/Health 3,500,000,000
Presidency State House Medical Centre 2,825,597,362
SGF National Action Committee on Aids (NACA) 4,207,757,600
TOTAL 17,077,465,774
The sum of N17.08Bn is on Other Health Consideration. This
is 60% of the Capital Expenditure of the FMoH.
There are Recurrent expenditures on Health across
Ministries, Departments and Agencies as outlined below.
OTHER HEALTH CONSIDERATIONS
CODE LINE ITEM TOTAL
Recurrent
22020307 DRUGS & MEDICAL SUPPLIES 681,568,313
22021004 MEDICAL EXPENSES 1,295,875,214
21020201 NHIS 54,119,661,791
SUB-TOTAL (RECURRENT) 56,097,105,318
Capital220216005 HEALTH AND FITNESS 4,500,000
23010122 PURCHASE OF HEALTH/MEDICAL EQUIPMENT 4,789,972,448
SUB-TOTAL (CAPITAL) 4,794,472,448
GRAND TOTAL 60,891,577,766
FMoH
N250.06bn
Other Considerations
N17.08bn
Recurrent
N56.10bn
ZIP
N6.51bn
ZIP – Zonal Intervention Projects
NHIS – Pension contributions of MDAs Excluded Drugs & Medical Supplies, Medical Expenses and NHIS budgets for FMoH, NACAand State House Medical Centre – earlier considered.
Capital
N4.79bn
2016 Health Budget N334bn 5.52%
NHA (2014) & OTHER FEDERAL GOVT’S COMMITMENTS
• Provision for National Health Act, 2014 – 1% of
Consolidated Revenue Fund (CRF)
• Abuja Declaration of April 2001 – 15% of National
Budget to Health
• London Family Planning Summit (2012) - $11.35m yearly
commitment to Family Planning
SUPPOSED BUDGET
National Health Act, 2014 N38.6Bn
Abuja Declaration of April 2001 N909Bn
London Family Planning Summit (2012 $11.35m
Evidence from the 2016 Budget shows that government did not meet
or consider any of the commitments below –
BUDGET MONITORING & EVALUATION
NGOs can focus on whether
amounts for specific projects,
such as a school or a road,
have been used for the
intended purpose.
They also can assess the quality
of the spending to see if the
policy goals associated with
the budget allocation are
being met, and if government
funds are being used
effectively.
BUDGET EXECUTION:IMPLEMENTATION, MONITORING, &
CONTROL
This budget stage presents avaluable opportunity for
budget groups to obtain
information on the
effectiveness of particular
budget initiatives, as well as to
advance accountability.
When available in a timelymanner, audit reports often
document a litany of mis-
expenditure, mal-expenditure,
and procurement irregularities.
NGOs should attempt to
spread such information widely
and use it to advance reforms.
OUTCOME ASSESSMENT & REPORTINGAUDITS AND PERFORMANCE
EVALUATIONS
Reference –
Budget Office of the Federation. http://www.budgetoffice.gov.ng/1
A Guide to Budget Work for NGOs. http://www.internationalbudget.org/2
National Health Act, 2014 3
Analyst: Wale Micaiah
m: 08078001800
w: www.statisense.com
Freely share, freely use and
freely acknowledge the
source – © Wale Micaiah
This is an Intellectual
Property of
Wale Micaiah
Supported by PACFaH