Before anything, let us look at the statistics of healthcare in Nigeria. Various statistics show that Nigeria has one of the worst health care delivery records in the world.
According to the World Health Organization (WHO), Nigeria is rated 187th out of 191 countries in terms of health care delivery. Nigeria has the 13th highest infant mortality rate and the 4th highest maternal death rate in the world.
WHO said one-third of more than 700 health facilities have been destroyed in the country and about 3.7 million people are in need of health assistance.
How did the country get here? The country got to this situation as a result of past and present Nigerian governments’ deliberate and consistent relegation of the healthcare sector to the bottom of National economics plans.
In 2014, Nigeria ranked 45 out of 53 African countries, in health spending. The data for health spending as a share of GDP showed that in 2014, Nigeria (at 3.7%) outperformed only Angola (3.3%) and South Sudan (2.7%), but lagged behind Ethiopia (4.9%). Nigeria’s total health expenditure is only higher than that of these countries because health spending in the country is about 75% private, and most of that is out of pockets of individuals. Of the 3.7% of GDP that Nigeria spent on health in 2014, only 0.9% of the fund came from the government. On this measure, Nigeria dropped to 52nd position out of 53 countries, even below South Sudan.
Despite these horrific statistics, the Nigerian government has not blinked or done anything differently.
Nigeria hosted the Heads of State of member countries of the African Union (AU) in 2001 who made the “Abuja Declaration” under which the leaders pledged to commit at least 15% of their annual budgets to improve their health sector.
In July 2013, Nigeria again hosted over 50 African Heads of State in a special summit that was tagged ‘The Abuja +12 meeting”, which reviewed the progress made on the promise of the Abuja Declaration on health funding.
Yet in the 2018 Budget proposal President Muhammadu Buhari presented on Tuesday to the National Assembly, he allocated N340.45 billion, representing 3.9 % of the N8.6 trillion expenditure plan to the health sector.
The allocation is less than the 4.16% and 4.23% made to the health sector by the same administration in the 2017 and 2016 budgets.
Details of the budget proposal revealed that health came 12th as Power, Works and Housing got the highest capital project proposal with N555.88 billion, almost 8 times that of health.
Despite the alarming death rate in the country and after signing an agreement 16 years ago to increase healthcare spending in the country to 15%, the Nigerian government still religiously and consistently budget less and less money to the health care sector with the highest in 2012 at 5.95% of the budget.
Since the Budget is a national plan which is deliberated before passing it into law, all these may be a secret population control strategy by the government as the federal government has severally declared the nation’s growth rate as unsustainable.
The population growth rate in Nigeria is 2.6% and its population is estimated to be 450 million by 2050. The country’s Minister of State for Budget and National Planning, Mrs Zaina Ahmed, said that the federal government has identified the high population growth rate as a risk factor while preparing the Economic Recovery and Growth Plan (ERGP) in 2017.
Government concern over the years has not resulted to any population control policy or law of any sort: Abortion is still illegal (that may never change because Nigerians are very religious); There is no child-bearing limit; there is no national birth control campaign. Nigeria adopted such a population reduction policy in 1988. It was met with predictable scepticism and condemnation. Nigerian society is a very delicate and complex one.
Specifically, the 1988 policy seeks to reduce fertility from the present level of 6 children/family to an average of 4 children/family, suggests an optimum marriage age of 18 years for women and 24 years for men, and advocates that pregnancies be restricted to the 18-35-year range and at intervals of 2 years. This was later abandoned.
This approach will be political suicide for any politician who dares to make such a policy today. Comparably under-funding healthcare will hurt their political aspirations less and barely affect their families who have access to foreign healthcare.
If this doesn’t explain the situation, how then do we explain a government’s indifference toward its country’s terribly alarming death rate and low life expectancy?