President Bola Tinubu has been urged to initiate a review of the Basic Health Care Provision Fund (BHCPF) to allow direct transmission of funds to the Local Government Areas (LGAs) to checkmate the capture of their health funds by State governments.
His government is also advised to increase funding for the health sector through improved participation of health sector stakeholders in the budget process at national and subnational levels.
These recommendations are contained in a report released by public policy experts – Nextier SPD – which x-rayed Nigeria’s fragile health system and the need to address the power relations which sustain and reproduce the dysfunctional health system.
The report, titled ‘BBC’s Documentary on SCOAN: A Satire on Nigeria’s Health System’ anchored on the multitudes of Nigerians who flock religious houses for miraculous healing instead of seeking medicare in health centres, was authored by Dr. Chukwuma Okoli, an Associate Consultant at Nextier and a Lecturer at the Political Science Department at Nnamdi Azikiwe University, and Dr. Ndu Nwokolo, a Partner at Nextier and an Honorary Fellow at the School of Government at the University of Birmingham, UK.
They pointed out that while the allegations in the BBC documentary against Synagogue Church of All Nations (SCOAN), and its founder, Prophet T.B. Joshua have been contested in various quarters, what is clear is that there is an army of sick people who are exploited in many ways because of poor access to affordable and quality healthcare services in Nigeria.
Okoli and Nwokolo therefore, further recommended that “Nigerian government should improve budget implementation and performance of the Ministries, Department and Agencies (MDAs) in the health sector.
“There is a need for the government, in collaboration with religious bodies, to deepen regulation of activities of religious centres airing supposed healing miracles across media outlets.
“Health-focused Civil Society Organisations should expand their focus to include advocating for early release and efficient utilisation of funds to the health sector.”
Nextier recalled that in December 2023, President Tinubu promised to bring health to the front burner by prioritising Nigeria’s health sector through massive investments and increased allocation of funds to the sector in the 2024 budget.
This is against the background that Nigeria’s score on the Universal Healthcare Coverage (UHC) Service Coverage Index (SCI), which measures the level of coverage of essential health services, is 42 out of 100.
Meanwhile, a breakdown of the budget passed by the National Assembly in the last five years shows that the amount allocated to the health sector annually has remained far below the pledged 15% of the annual budget.
According to Nextier: “One remarkable output of the National Health Act 2014 is the establishment of the Basic Health Care Provision Fund (BHCPF) to enhance funding of the health system with at least 1% of the Federal Government’s Consolidated Revenue Fund (CRF), in addition to contributions from donors, the private sector, and other sources.
“However, these and other reforms in the sector are yet to yield the desired results in the health sector because reforms are yet to address the power relations that shape fund allocation and utilisation in the health system.
“This power relations manifests in budget politics, bureaucratic politics and local government administration. The power dynamics in budget politics mean that the amounts allocated to the health sector in the annual budget at the national and sub-national levels are decided by powerful elites in government whose interests may not be addressed by increased funding to the sector.”
The report concluded that “many citizens suffer poor access to quality and affordable healthcare. This has exposed some to seek help for their health challenges in alternative places, including some religious centres where some are exposed to exploitation and manipulation.
“To actualise its healthcare promises, the current administration must address the power relations which sustain and reproduce the dysfunctional health system.
