Nigeria’s Basic Healthcare Provision Fund Failing To Provide Basic Healthcare For Nigerians
At the behest of the COVID-19 pandemic, the stark reality of NIgeria’s situation was how its weak, poorly funded and manpower-lacking healthcare system would cope. It soon became clear that the millions, heck, billions of naira spent on the healthcare sector in the last few decades were wasted.
We went on save-our-soul calls to foreign governments and bodies, including the United Nations, European Union, American government, Chinese government and many others. While the pandemic was out of the blues, our structural lack was bare for all to see and without it, we were doomed for failure. States went on frantic constructions of isolation centres. Some stadiums like the Onikan Stadium and some others were converted to makeshift isolation centres.
Abandoned and billion-naira hospital infrastructure were revisited, and for once, health workers earned close to what they desired, albeit, just a few of them. As the case incidence increased in areas of high population density like Lagos and Kano, the sad absence of primary healthcare centres became an albatross that hung on our heads. Did we learn a lesson? Time will tell. But Nigerians lost loved ones, including some very important political personalities like the deceased former Chief of Staff to the President, Abba Kyari.
Sad as some deaths may be, it passed a key message of existential decay and defaults to the leaders and they increased the budget allocated to the Health ministry, even if it is still a far cry from expectations. Some years ago, the First Lady, Mrs. Aisha Buhari said the State House Clinic lacked needles and syringes and other simple hospital wares.
It was an open revelation of the level of rot in the healthcare sector. Like the State House Clinic, Nigerian primary healthcare centres are in a state of coma. While some state governments have attempted to help the development of some of them, it is still a mile away from good.
Of Nigeria’s over thirty-thousand PHCs, slightly more than six thousand, amounting to 20% of the centres are operating in good standards, yet billions are being allocated to the Basic Healthcare Provision Fund since 2018.
About The BHCPF
The Basic Healthcare Provision Fund is an instrument of the National Health Act (NHA) and it is to make funding provisions for the healthcare sector, in the areas of PHCs and insurance policies. Since 2014 that it was signed to the NHA, it was first appropriated in 2018 as part of the Consolidated Revenue Fund (CRF).
In 2018, the BHCPF was 1% of the CRF and was funded by donations from international organisations like Bill and Melinda Gates Foundation and others. The sum of N55bn was provided to the CRF basket for the BHCPF in addition with millions of dollars from international bodies.
Big Figures, Small Impacts
In 2019, the sum of N51.22bn was allocated on the budget to fund basic healthcare provision and in 2020, it was reduced to N44bn. These monies are meant to fund the National Health Insurance Scheme (NHIS) in each state and at the federal level and it’s also meant for the upgrade of the PHCs across the 774 local governments in the country.
States are believed to have their allocations of these funds but a vast majority of them don’t spend these monies for the right purposes. The BHCPF is also meant to help the promotion of community health and help in the battle against female genital mutilation. All of these problems are still very much existent despite the billions spent, or reportedly spent, as the case may be.
Currently, the NHIS says just 3% of Nigerians are on the scheme with many others not knowing about it at all. States receive these monies in droves and do little to no awareness for members of the public, while the PHCs and other specialist hospitals are still terribly decayed.
The BHCPF was reduced further in the 2021 budget with just N35.03bn allocated to it. How this will be spent, with results to show for it must be a watchword of the government as currently, the masses who should be beneficiaries are not getting a feel of the billions spent.
In the 2021 budget, the BHCPF is way lower than the statutory transfer allocated to the National Assembly. As things stand, the sum of N128bn has been allocated to the NASS and this is the highest of the statutory transfers by the federal government. The healthcare system needs a recovery and unburderning system that will help ease the problems of Nigerians.
As it stands, several surveys conducted by Accountable Nigeria show that the people are not enjoying most of these services and are not even aware of their existence. Health insurance is still largely unknown by Nigerians and the PHCs are not in good states and are not mostly well-staffed, hence hardly used. Healthcare is still an expensive necessity to most Nigerians and families and well wishers of patients suffering from life-threatening diseases resort to crowdfunding, and it i regardless of societall strata.
The basic healthcare provision fund has not provided basic healthcare for Nigerians, with 75% of out-of-pocket patients still visiting hospitals. The PHCs that provide anything close to free medical services also charge some fees, and their legality is not crystal clear yet. Like every segment of the Nigerian budget, we hear the figures but we hardly ever see the effect.