2018 proposed health budget analysis

2018 PROPOSED HEALTH BUDGET ANALYSIS

PARTNERSHIPFOR ADVOCACYFOR IN CHILD ANDFAMILY 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


JhjhjRecurrent 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

Fe

b-1

5

Ma

r-1

5

Ap

r-1

5

Ma

y-1

5

Jun

-15

Jul-1

5

Au

g-1

5

Se

p-1

5

Oct-

15

No

v-1

5

De

c-1

5

Jan

-16

Fe

b-1

6

Ma

r-1

6

Ap

r-1

6

Ma

y-1

6

Jun

-16

Jul-1

6

Au

g-1

6

Se

p-1

6

Oct-

16

No

v-1

6

De

c-1

6

Jan

-17

Fe

b-1

7

Ma

r-1

7

Ap

r-1

7

Ma

y-1

7

Jun

-17

Jul-1

7

Au

g-1

7

Se

p-1

7

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


JhjhjRecurrent 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

5.45.54

5.38

3.58

5.58

5.95

5.66 5.635.78

4.13 4.143.95

0

1

2

3

4

5

6

7

2 0 0 6 2 0 0 7 2 0 0 8 2 0 0 9 2 0 1 0 2 0 1 1 2 0 1 2 2 0 1 3 2 0 1 4 2 0 1 5 2 0 1 6 2 0 1 7 2 0 1 8

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


PHCUOR


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 PHCUORcaption, the following budget lines are indirectlyrelated 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

4COUNTERPART FUNDING TO MATCH GRANTS FROM UNFPA,USAID,

BMGF & UNICEF2,400,000,000

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@ScaleFOCUSED 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

3Maternal 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

1PROCUREMENT OF RI VACCINES, DEVICES AND

OPERATIONAL COST8,895,468,504

NATIONAL PRIMARY HEALTH CARE

DEVELOPMENT AGENCY

2PROCUREMENT OF NON POLIO SIA VACCINE AND DEVICE

FOR OPERATION540,000,000


DEVELOPMENT AGENCY

3PROCUREMENT OF OUTBREAK (EMERGENCY) RESPONSE

VACCINE, DEVICES AND OPERATIONAL COST1,500,000,000


DEVELOPMENT AGENCY

4 PROCUREMENT OF HAJJ VACCINES 174,574,043NATIONAL PRIMARY HEALTH CARE

DEVELOPMENT AGENCY

5 POLIO ERADICATION INITIATIVE (PEI) 1,204,190,831NATIONAL PRIMARY HEALTH CARE

DEVELOPMENT AGENCY

6

HEALTH EMERGENCIES & CONTAGIOUS DISEASES

OUTBREAKS ( EG. MENINGITIS, MEASLES, YELLOW

FEVER, MONKEY FOX,ETC)

1,000,000,000FEDERAL MINISTRY OF HEALTH -

HQTRS

7 REVIEW OF THE NATIONAL HIV VACCINE PLAN 6,002,000NATIONAL 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

1,200,000,000FEDERAL 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)

1,433,289,400NATIONAL PRIMARY HEALTH CARE DEVELOPMENT

AGENCY

3Accelerated Reduction of Maternal Morbidity And Mortality Through

Safemotherhood29,768,000 FEDERAL MINISTRY OF HEALTH - HQTRS

4

MATERNAL, INFANT AND YOUNG CHILD FEEDING IN NIGERIA Including

Micronutrient Deficiency Control And Nutrition Information Surveillance

System


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

7Construction And Furnishing Of Neo-natal Wing Of Maternal And Childcare

Complex148,737,592 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)

1,433,289,400NATIONAL PRIMARY HEALTH CARE

DEVELOPMENT AGENCY

3CONSTRUCTION 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

5To Complete The Determination Of Baseline Studies On

Nutritional55,000,000

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 & LegislatureExecutive Presents & Legislator

review for approval

IMPLEMENTATION ExecutiveMinistries, Agencies &

Departments (MDAs)

MONITORING Executive & LegislatureMonitoring 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.

YearNational

(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 OfficeNo. 63B Sultan Road, Nassarawa GRA, Kano State, Nigeria Tel: +234 703 035 3438

drpc_nig

PACFaH@Scale

Contact: Abuja Office1b Lumsar Street,Off Gurara Street, Ibrahim Abacha Estate,Wuse Zone 4, Abuja


38

PACFaH@Scale - Advocating for Child and Family Health

PARTNERSHIPFOR ADVOCACYFOR IN CHILD ANDFAMILY HEALTH

2018 proposed health budget analysis

Health & Medicine