Africa-Press – Nigeria. Nigeria can no longer outsource its health, prosperity and future to foreign benevolence or external goodwill, but must build on strong domestic ownership and accountability.
This caution comes on the heels of donor fatigue and diminishing foreign support for Nigeria’s health sector, a situation experts say must prompt the country to leverage internal and local approaches to expanding its financing sources.
For years, Nigeria has remained dependent on development partners for support in its fight against infectious diseases, maternal mortality, and infrastructure deficits.
However, Dr Salma Ibrahim Anas worries that available data only points to the fragility of Nigeria’s current financing model, meaning that the country will face grave health emergencies if and when its donors totally withdraw.
She warned that despite the marginal growth in the country’s health spending, funding remains fundamentally insufficient for its teeming population, leading to a high out-of-pocket health expenditure; a situation that perenially traps and impoverishes millions of Nigerians.
Dr Anas, who is the Special Adviser to President Tinubu on Health, voiced her concerns recently at the Annual Conference of the Association of Nigerian Health Journalists, ANHEJ, in Abuja, where she also noted that the situation threatens the country’s projection for attaining Universal Health Coverage.
According to research, Nigeria’s healthcare spending per capita has gone from $67.91 in 2020 to $90.92 in 2022. Although this appears to be a significant leap, experts say it actually masks the systemic crisis of out-of-pocket spending.
“Data representing our current health financing situation only illuminates the fragility of our current financing model. Over the last three years, we have seen marginal growth in our health spending, yet it remains fundamentally insufficient, reiterates Dr Anas.
“A significant portion of the remaining financing comes from external grants. This precarious balance creates severe risks that affect our aspiration for attaining Universal Health Coverage in Nigeria.
“Experts project a 15% to 20% reduction in foreign grants to Nigeria, which immediately creates a financial chasm that threatens to unravel decades of progress in the health sector, she worries.
With donor funds targeting programs such as HIV, Tuberculosis, Malaria, and routine immunisation, there is fear that the moment the funding stream slows, Nigeria will witness services break down, stock-outs of essential health commodities, leaving vulnerable communities at risk.
However, Dr Anas believes the only solution to bridging the gap is Domestic Resource Mobilisation, DRM, a model described as a necessity for self-reliance.
But to achieve this, the government needs to track every Naira disbursed to the National Health Insurance Authority, NHIA, and the Primary Health Care Development Agency, NPHCDA, gateways.
“To ensure that the health sector has the financial resources it needs to deliver on the UHC aspirations for the Nigerian people as promised in the Renewed Hope Agenda, the Federal Ministry of Health and Social Welfare, in concert with the Legislature and our agencies, had focused on mobilizing and increasing the funding available to the health sector as the bedrock of the Nigeria Health Sector Renewal Investment Initiative, NHSRII.
“The Legislature has been instrumental in advocating for the increase of the Basic Healtncare Provision Fund, BHCPF, from the statutory 1% to 2% of the Consolidated Revenue Fund, CRF. This single legislative commitment, when fully enacted and funded, will instantly double the fiscal space for health for our poorest citizens.
To help domestic mobilisation and monitoring of financial commitments, Dr Anas said the government must deploy digital platforms to track every fund.
“Donor fatigue is real, and the inevitable graduation of Nigeria from various aid programs is approaching. This forces us to confront a fundamental truth: The health and prosperity of our nation must no longer be predicated on external benevolence, but on robust domestic ownership and accountability,” Dr Anas explains.
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