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Stakeholders believe attaining the 15% benchmark budgetary allocation for healthcare by governments in Africa is crucial to achieving adequate and sustainable healthcare delivery and the realization of the third sustainable development goal on the continent
By Adam Alqali
The third UN sustainable development goal seeks to ensure “healthy lives and promote wellbeing for all at all ages” by reducing global maternal mortality ratio to less than 70 per 100 000 live births and ending preventable deaths of newborns and under-five children to as low as 12 per 1000 live births, among others, by the year 2030.
Moreover, SDG goal 3 seeks to end the epidemics of AIDS, tuberculosis, malaria and neglected tropical diseases, combat hepatitis, water-borne diseases and other communicable diseases, as well as reduce (by one-third) premature mortality from non-communicable diseases through prevention and treatment and the promotion of mental health and well-being, by 2030.
However, the realization of the these lofty goals in Africa, according to stakeholders, will depend largely on the ability of countries on the continent to fulfill the obligations of the 2001 Abuja Declaration signed by member states of the African Union, which demand countries on the continent to commit, at least, 15% of their annual budgets to health.
“For countries in Africa including Nigeria to achieve the Sustainable Development Goals, they must implement the provisions of the Abuja Declaration which seeks for the allocation of 15% of annual budgets of member states to the health sector. Most countries are yet to achieve that including Nigeria whose budgetary allocation to health in 2016 is just 5%,” said Aminu Magashi Garba, coordinator of Africa Health Budget Network.
“Moreover, our spending per person per year on health which is supposed to be 86 dollars is less than 30 dollars per person per year, which is poor and looking at GDP allocation to health which is supposed to be 5% it is also less than 3% in Nigeria. So, looking at all the indicators we still have a long way to go and for us to reduce maternal and child mortality, the budget has to increase.”
Magashi, who argued that budgetary allocation to health does not necessarily translate to release of funds for the sector, therefore, called on NGOs and the media to track budgetary allocations to healthcare by ensuring allocated funds are always released as at when due, using scorecards, dashboards and report cards.
“If healthcare funds are released from the ministries of finance, as NGOs and media, we need to track them to ensure they get to the ministries of health and subsequently the primary healthcare development agencies as well as do follow up to ensure lifesaving drugs and vaccines are procured and utilized appropriately,” said Magashi.
The Abuja Declarations and Frameworks for Action on Roll Back Malaria was a pledge made by member states of the African Union (including Nigeria) during a conference held in Abuja, the Nigerian capital, in 2001. In the declaration, AU member states pledged to increase their annual budgetary allocation to health sector to at least, 15% as well as requested donor countries to also increase their support.
“Allocating 15% of annual budget to health is a pledge made by Nigeria, even though the 15% is still not enough considering the enormous challenges in the country’s health sector, I believe it is a good starting point,” said Chioma Kanu, a programmes officer at the Civil Society Legislative Advocacy Centre, CISLAC, while speaking during a media dissemination exercise for the analysis of the 2016 federal and Kano state health budgets, held recently in Kano.
“Moreover, the National Health Act was passed 2 years ago; however, the state governments are yet to domesticate it. Our governments should understand the need to spend more on health. The media and civil society should continue their advocacy on the need to increase budgetary allocation to health, by insisting governments abide by all the international and local obligations they have signed on to.”
Also speaking at the event, Aanu Rotimi, a programme officer at the Health Reform Foundation of Nigeria, HERFON, one of the implementing NGOs for the PACFaH project, said investment in health sector meant reduction in maternal and child mortality which she also said had direct bearing on the economic development of Nigeria.
“Current health indices in Nigeria are not impressive and to change the situation primary healthcare centers need to be given priority. Health is a right as such governments are under obligation to protect the healthy wellbeing of their people by committing, at least, 15% of their annual budgets to the health sector, as contained in the Abuja Declaration,” she said
Adama Kachalla is the project officer in charge of the PACFaH project at the Federation of Muslim Women Organisations of Nigeria, FOMWAN, which is also one of the implementing NGOs for the Partnership for Advocacy in Child and Family Health, PACFaH. She said child spacing, which was aimed at ensuring the healthy wellbeing of both the mother and her child, was also allowed in Islam adding that there were Quranic verses supporting it.
PACFaH, a 3-year project being implemented by 7 Nigerian indigenous NGOs is focused on four thematic areas including treatment of childhood pneumonia and diarrhea; family planning; routine immunization as well as nutrition. It is being anchored by the Development Research and Projects Centre, dRPC, a non-profit social enterprise.
Achieving sustainable healthcare delivery in Africa will no doubt require more commitment by governments across the continent in the form of not only abiding by regional and international instruments like the Abuja Declaration, which seeks increasing budgetary health allocations to 15%, as well as ensuring timely release of health funds and ensuring transparency and accountability in spending.