A report by the Nigeria Governors’ Forum (NGF) has revealed that the 36 states allocated just 1.22% of their health budgets to medical equipment and appliances between 2021 and 2023.
The state-level review noted that 61.83% of health budgets during the period was directed toward public health services and health administration. The remaining 38.17% was split between hospital services (26.17%), outpatient services (10.5%), medical products and equipment (1.22%), and health research and development (0.28%).
Health Spending Trends
Total health expenditure by states rose from ₦484bn in 2021 to ₦505bn in 2022, representing 7% of total state spending.
In 2023, states budgeted ₦923.31bn for health, an 83% increase from 2022’s actual expenditure.
Despite these increases, budget performance averaged 63%, indicating actual spending may fall short of the 2023 target.
Variations in Health Sector Spending
State governments allocate an average of ₦14bn annually to healthcare, with significant differences across states.
Only 15 states implemented a Medium-Term Health Sector Strategy (MTSS) covering the 2024 budget year.
Some states used alternative planning frameworks to guide resource allocation.
The report highlighted disparities in the ratio of capital to recurrent spending in the sector, with an average split of 33% to 67%. However, states like Ebonyi (85% capital:15% recurrent) and Rivers (72% capital:28% recurrent) bucked the trend by prioritizing capital investments.
Challenges and Recommendations
The NGF report cited issues with expenditure classifications, noting that some items like drugs and personal protective equipment (PPE) were miscoded as capital expenses.
Additionally, 16% of state health budgets relied on external funding from grants, loans, and international aid. The report pointed to limited uptake of loan options, possibly due to difficulties in securing loans or a lack of interest.
The report called for full implementation of the programme segment of the National Chart of Accounts (NCOA) to improve tracking and classification of health expenditures by services and disease categories.
Peoplesmind
