According to the report on the health sector expenditures and institutional reviews released by the Nigeria Governors’ Forum, 36 states rely on external funding for 16% of their health budgets.
The state-level report obtained on Monday noted that “State governments depend on 16% of their health budgets from external sources, including aid, grants, and loans. Less than a quarter of States, according to the report, sought loan options to finance their capital projects in the sector, with grants and international aid programs accounting for the majority of their non-discretionary capital funding sources.
According to the reports, the lack of interest in pursuing the above financing options was due to restrictions on securing loans or disinterest.
Total health expenditure by the 36 States of the federation was N505 billion in 2022 – at 7% of their total spending – up from N484 billion in 2021.
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In 2023, the 36 States budgeted N923.31 billion for the sector, an increase of 83% from the total actual expenditure in 2022. The report notes that budget performance for the sector averages around 63% year-on-year, indicating that the actual spending for 2023 may fall well below the N923.31 billion target.
State governments spend N14 billion annually on health, with significant variations from state to state.
According to the report, only 15 states had a medium-term health sector strategy (MTSS) covering at least the 2024 budget year.
Evidence demonstrated that the health ministries’ internal use of alternative planning documents and frameworks to determine the sector’s resource allocation was one.
Some of these alternative tools, the report said provide a prescription of the activities, outputs, and outcomes similar to what is attainable in the MTSS, although driven at the health ministry level.
In terms of healthcare prioritisation, the report said 61.83% of the aggregate health budget of the 36 states from 2021-2023 was allocated to public health services and health administration, leaving 38.17% for hospital services (26.17%), outpatient services (10.5%), medical products appliances and equipment (1.22%), and health research and development (0.28%).
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