CSJ Publishes Sokoto State 2023 Pre-Budget Memorandum To Up Advocacy for PHC Funding

The Centre for Social Justice (CSJ) has published a pre-budget memorandum for Sokoto State ahead of the 2023 fiscal year.

The document presents the key inputs of Civil Society Organisations (CSOs) into the Health Sector MTSS 2023 – 2025. This will equally serve as the input of CSOs to the 2023 State Government budget for the health sector. The primary focus is on Primary Health Care (PHC) as an entry point for Universal Health Coverage (UHC).

One of the rationales for the memorandum is that the Sokoto State Fiscal Responsibility Law (SSFRL) requires the State Government to prepare the Medium Term Expenditure Framework (MTEF)-  three-year rolling plan containing the macroeconomic framework, fiscal strategy paper, expenditure and revenue framework, consolidated debt statement and statement describing the nature and fiscal significance of contingent liabilities. However, after preparing the MTEF, every Ministry, Department and Agency of the State Government (MDA) is expected to submit its Medium Term Sector Strategy (MTSS), which should focus on the medium term goals of their sectors and will feed into the broad goals of the MTEF.

The new book details the objectives of the MTSS exercise and the scheme for ranking priority projects and programs that will be part of the MTSS. It examines the rationale for the exercise, the linkages between MTSS and the annual budget and reviews the sectoral goals, objectives, targets and strategies for the Health MTSS.

Section Two is focused on health indicators and major challenges in Sokoto State related to the minimum core obligation of the State and Primary Health Care (PHC). Section Three reviews existing budget commitments and emerging issues using the Abuja Declaration (to commit 15% of overall budget resources to health care) and the provisions of the scenarios of the Sokoto State Strategic Health Development Plan II (SSSHDP II) as benchmarks. The benchmarking exercise shows that the State did not meet the Abuja Declaration obligations and there is a funding gap in the demands of the three scenarios of SSSHDP II.

The Section reviewed Local Government funding commitments in the seven focal LGAs (Binji, Yabo, Sokoto North, Sokoto South, Gwadabawa, Tambuwal and Wurno.) while analyzing the whole of government and health in all policies approaches to improving health care, especially PHC.

Section Four is on the Basic Health Care Provision Fund (BHCPF) and it shows that the State has started well in the two gateways of the State Primary Health Care Development Agency (SPHCDA) and the Sokoto State Contributory Health Care Management Agency (SOCHEMA). Steps have been taken to access the fund and provide services to the people.

Section Five discusses the sustainability of healthcare services. It affirms that sustainability is to a great extent dependent on the quantum and sources of healthcare financing. Section Six discusses the possibility of health insurance filling the funding and sustainability gap and draws attention to the SOCHEMA Law and the National Health Insurance Authority Act which provides for compulsory and universal health insurance in Sokoto State and across the Nigerian Federation. It makes a case for awareness creation and sensitization and eventual full enforcement of the Law.