Health Archives - Centre for Social Justice

2026 HEALTH BUDGET POLICY BRIEF

Center for Social Justice — Fri, 13 Feb 2026 15:08:50 +0000

ADVOCACY MEMORANDUM ON THE 2026 FEDERAL HEALTH BUDGET PROPOSALS

2026 HEALTH BUDGET POLICY BRIEF (133 downloads )

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Review of the 2024 Federal Health Budget Proposal

Center for Social Justice — Mon, 18 Dec 2023 09:46:56 +0000

In the 2024 Federal Health Budget, the total sum allocated out of the overall expenditure of ₦27,503,404,073,861 is ₦1,228,100,390,765 inclusive of the ₦ 125,737,146,031 provided for the Basic Health Care Provision Fund (BHCPF). This is 4.47% of the proposed budget expenditure. This is slightly less than one-third of the 15% Abuja Declaration commitment. However, there are other provisions related to health in the budget vis, Provisions for the National Health Insurance Scheme fund of MDAs (₦120,096,348,469), NHIS for Military Retirees (₦4,025,476,074), NHIS for Corps Members (₦5,000,000,000), Counterpart Funding Including Global Fund/Health (₦7,416,508,000), GAVI/Immunization Counterpart Funding (₦137,210,720,045), Presidential Committee on Health Sector Reform (₦500,000,000), and another Presidential Committee on Health Sector Reform (₦500,000,000). These add up to an extra ₦274,749,052,588.00. This increases the health vote to ₦ 1,502,849,443,353.00 being 5.46% of the proposed overall expenditure. This is just 36.43% of the Abuja Declaration. 1 15% of the overall budget vote would have amounted to ₦4,125,510,611,079.15. The extant health vote leaves a funding gap of ₦2,622,661,167,726.15.

For a population of 220 million, the federal allocation amounts to N6,831 for every citizen of Nigeria. In United States dollar terms, the allocation translates to N2.003bn at N750 for 1 USD. This allocation is against the background of Nigeria’s 70% out-of-pocket health expenditure. Nigeria’s challenging macroeconomic indicators; inflation rate of 28.2% year on year, actual exchange rate of about N800 to 1 USD, and population growth that is equal to the economic growth rate—raise questions about the sufficiency of this level of funding. The 2023 federal health budget was in the sum of N1,268, 060,820,220,3 converted to the USD at the official exchange rate of N435.57 to 1 USD, amounting to $2.911billion. Essentially, the actual value of the 2024 proposal is less than the 2023 vote.

Furthermore, in the spirit of the law, plan, policy and budget continuum, the allocation seems insufficient to meet Nigeria’s Universal Health Coverage framework
implementation.

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Review of the 2024 Federal Health Budget Proposal (1336 downloads )

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RIGHT TO HEALTH MANUAL

Center for Social Justice — Fri, 18 Aug 2023 12:20:27 +0000

The right to health is an empowering right that greatly facilitates the realisation and enjoyment of other human rights and fundamental freedoms. It is a part of the most fundamental of the fundamental human rights which is the right to life as it supports the fulcrum upon which other rights rotate. Nigeria is bound by national and international standards on the right to health and these include, at the international level, the standard setting Universal Declaration on Human Rights (UDHR), the International Covenant on Economic, Social and Cultural Rights
(ICESCR), Convention on the Elimination of All forms of Discrimination against Women (CEDAW), Goal 3 of the Sustainable Development Goals (SDGs) and the regional African Charter on Human and Peoples Rights (ACHPR). Others include the Alma-Ata Declaration on Primary Health Care clarified in the Declaration of Asanta.6 The states and local governments, being parts of the Federal Republic of Nigeria are bound by these standards. At the national level, there is the constitutional obligation under the Fundamental Objectives and Directive Principles of State Policy on adequate medical and health facilities for all persons;7 National Health Act of 2014, National Primary Health Care Development Agency Act,8 National Health Insurance Scheme Act,9 National Health Policy of 2016 and the National Strategic Health Development Plan (NSHDP) 2018-2022.

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RIGHT TO HEALTH MANUAL (678 downloads )

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PROPOSALS FOR THE FULL IMPLEMENTATION OF THE NATIONAL HEALTH ACT

Center for Social Justice — Wed, 16 Aug 2023 11:06:09 +0000

The National Health Act (NHA) was made to provide a legal framework for the regulation, development and management of the National Health System and to set standards for rendering health services in the Federation and for related matters. The National Health System established under the Act has as part of its objectives the protection, promotion and fulfilment of the right of Nigerians to have access to health care services as it seeks to provide for persons living in Nigeria, the best possible health services within the limits of available resources. The National Health System sets out the rights and obligations of health care providers, health workers, health establishments and users. It promotes a spirit of cooperation and shared responsibility among all providers of health services in the Federation. These provisions of the Act are in tandem with Nigeria’s treaty obligations (especially, under the International Covenant on Economic, Social and Cultural Rights) to take steps, to the maximum of available resources, with a view to achieving progressively the full realization of the right to health. The NHA has a number of other provisions which potentially will improve the realization of the right to health of Nigerians. These include the mandate of the Federal Ministry of Health (FMoH) under S.2 (2) to prepare strategic medium-term health and human resource plans annually for the exercise of its powers and the performance of its duties under the Act. The FMoH is to ensure that the national health plan forms the basis for budget preparation and other government planning exercise as may be required by law. The FMoH is to ensure the continuous monitoring, evaluation and analysis of health status and performance of the functions of all aspects of the National Health System; promote adherence to norms and standards for the training of human resources for health; conduct and facilitate health systems research in the planning, evaluation and management of health services; collaborate with the states and local governments to ensure that appropriate mechanisms are set up for the implementation of the National Health Policy; determine the minimum data required to monitor the status and use of resources; etc.

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PROPOSALS FOR THE FULL IMPLEMENTATION OF THE NATIONAL HEALTH ACT (678 downloads )

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A Draft Bill for the Establishment of a Health Development Bank

Center for Social Justice — Wed, 16 Aug 2023 10:52:22 +0000

The Centre for Social Justice (CSJ) has introduced a draft bill known as the Health Development Bank of Nigeria Establishment Bill 2023 that will be forwarded to the National Assembly for consideration. The bill aims to create the Health Development Bank of Nigeria, a visionary institution poised to address the persistent challenges facing the nation’s healthcare sector.
The proposed bill underscores the urgent need for a comprehensive strategy to bolster health institutions, enhance infrastructure, and advance healthcare services throughout Nigeria. At its core, the bill outlines the establishment and functioning of the Health Development Bank, presenting a detailed framework for its objectives, sources of funding, functions, and operational structure.
It is a Bill for an Act to establish the Health Development Bank of Nigeria to provide medium- and long-term sustainable credit facilities to health institutions in Nigeria, to facilitate and promote the establishment, improvement and upgrade of health infrastructure and services and for other related matters

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A Bill for the Establishment of a HEALTH DEVELOPMENT BANK of Nigeria (478 downloads )

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The Case for a Health Development Bank of Nigeria

Center for Social Justice — Wed, 16 Aug 2023 10:27:37 +0000

This advocacy memorandum makes a case for the establishment of a Health Development Bank of Nigeria. This is premised on the poor funding of the health sector across the tiers of government; the low absorptive capacity of the Federal Ministry of Health; the equipment, infrastructure and technology needs of the sector and the need to tie investments to results. Others are responding to health tourism; repositioning the pharmaceutical, medical devices and equipment industry; facilitating private sector service delivery; the need to develop critical human resources for health competencies; enhancing sustainability and credibility of health financing; and improving health sector contribution to job creation, taxes and GDP. The Health Bank will provide equity capital and funds by way of single digit interest loans to Nigerian public and private health institutions, establishments and organizations for short, medium and long-term investments in the health sector at such rates and upon such terms as may be determined by the Board of Directors in accordance with best practices in development banking policy.

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Why Nigerian Needs a Health Development Bank (429 downloads )

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HEALTH SECTOR REFORM AGENDA FOR THE BOLA AHMED TINUBU ADMINISTRATION

Center for Social Justice — Tue, 18 Jul 2023 08:55:43 +0000

The Centre for Social Justice has proposed a comprehensive health sector reforms agenda for the Bola Ahmed Tinubu administration, outlining critical challenges and recommendations to improve the Nigeria health system. The proposed health sector reforms address various aspects of the sector, aiming to enhance accessibility, funding, accountability, infrastructure, and human resources for health.

Rising inflation is identified as a significant challenge impacting the health sector. CSJ highlights the need to ensure that resources available to the sector keep pace with the inflationary spiral. Additionally, the recent removal of fuel subsidy presents both downsides and upsides. While projected savings are significant, the reform has led to increased costs across various sectors, including healthcare. The health sector must advocate for its needs and ensure that it receives appropriate resources from the government’s proposed palliative measures fund.

The unification of the exchange rate is recognized as a positive step, offering potential benefits such as increased revenue for the government and a boost to exports. However, there are downsides, including increased costs of drugs, medicines, and human resources for health due to the depreciation of the naira. The health sector must find ways to mitigate the negative effects and provide alternatives for affordable healthcare access, particularly for the poorest individuals and families and those reliant on out-of-pocket expenditure.

Insufficient funding is a critical issue in the health sector, with poor public funding, population growth surpassing economic growth, and a fiscal crisis contributing to high out-of-pocket health expenditure. CSJ proposes attracting non-budgetary funds through private sector incentives and tapping into other public resources, such as legislator constituency project funds, to increase sector funding.

The full implementation of the National Health Insurance Authority Act (NHIAA) is emphasized as a crucial step towards reducing out-of-pocket health expenditure and achieving Universal Health Coverage (UHC). The NHIAA mandates health insurance for every resident of Nigeria and seeks to pool funds for UHC realization. The Act also establishes a social health insurance (SHI) scheme, including the Vulnerable Group Fund (VGF). CSJ recommends ensuring the NHIAA is made functional and collaboration between the National Health Insurance Authority and state health insurance agencies to activate the mandatory health insurance scheme.

The implementation of the Basic Health Care Provision Fund (BHCPF) under the National Health Act is reviewed, with the need for transparency and public audits of funds disbursed and managed. It calls for a review of the implementation guidelines to ensure that not less than 90% of the fund is dedicated to service delivery. CSJ emphasizes accountability and engagement mechanisms, calling for the preparation and presentation of an annual report on the state of health in Nigeria to the President and National Assembly. This would go a long way in health sector reforms.

Improvements to health infrastructure, including funding for upgrades and equipment, are proposed to address Nigeria’s loss of approximately $1 billion annually in health tourism. CSJ makes an investment case for the establishment of a Health Development Bank of Nigeria to provide medium- and long-term funding for health infrastructure and equipment at single-digit interest rates. This could be one of the ground breaking health sector reforms.

The availability of human resources for health is identified as a significant challenge, with Nigeria facing a low doctor-to-patient ratio and high levels of health worker emigration. CSJ recommends increasing government investments in medical human resource development and exploring agreements with destination countries to invest in health workforce development in Nigeria.

The comprehensive health sector reforms agenda proposed by the Centre for Social Justice covers critical challenges and offers recommendations to address the issues plaguing the Nigerian healthcare system. Implementing these reforms would contribute to improved healthcare access, funding, transparency, infrastructure, and human resources for health under the Bola Ahmed Tinubu administration.

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HEALTH SECTOR REFORM AGENDA FOR THE BOLA AHMED TINUBU ADMINISTRATION (742 downloads )

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Adamawa State Pre 2023 Budget Health Memorandum

Center for Social Justice — Fri, 02 Jun 2023 13:08:54 +0000

This memorandum is divided into seven sections. Section 1 is the background, provides the rationale for the exercise and reviews key sectoral goals, objectives, targets and strategies. Section 2 reviews Adamawa specific health indicators and their implications. Section 3 reviews the health budget commitments of the State including the actuals and their compliance with the Abuja 15% Declaration. It also reviews whether the State has set and costed a Minimum Service Package for PHC and the whole of government and health in all policies approach. Section 4 is on the implementation of the Basic Health Care Provisions Fund in the State while Section 5 reviews the sustainability of the current health care financing model. Section 6 is on the operation of health insurance in Adamawa while Section 7 is on recommendations. The following recommendations for Adamawa State flow from the review and analysis in this Memorandum.
Develop a New Strategic Health Development Plan.
Prepare a Health MTSS.
Mainstream the Plan, Policy and Budget Continuum in Health.
Adopt a Whole-of-Government, Health-in-all Policies Approach.
Stakeholder Engagement and Popular Participation in Preparation of MTSS.
Adopt a Whole of Society Approach to Health.
Increase Funding to the Sector and Invest in Value for Money.
Moratorium on New Capital Projects.
Invest in Transparency and Accountability.
Prepare and publish Annual State of Health Report.
Ensure Maximum Benefits from BHCPF.
Full Implementation of Adamawa State Contributory Health Care Management
Agency Law and the National Health Authority Act.

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Adamawa State Pre 2023 Budget Health Memorandum (595 downloads )

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ADVOCACY MEMO ON THE SOKOTO STATE HEALTH INSURANCE SCHEME

Center for Social Justice — Tue, 09 May 2023 16:58:41 +0000

This Policy Brief engaged the Sokoto State Health Insurance Scheme with the objective of providing policy recommendations to increase health insurance care coverage in the State. The first section discussed the concept of health insurance and its various forms while the second section discussed Universal Health Coverage (UHC) and its components. In the third section, the study established a link between health insurance coverage and UHC as the former is a tool for attaining the latter. Section four discussed the arguments for compulsory health insurance to include achieving UHC, financial risk protection, equity in health care financing, realization of the minim core obligation on the right to health, etc. In section 5, the study reviewed the key provisions in the law setting up SOCHEMA and section 6 analyzed the linkage between the new National Health Insurance Authority Act (NHIA) and the law setting up SOCHEMA. Section 7 reviewed the performance of the State in accessing the Basic Health Care Provision Fund (BHCPF) while section 8 reviewed the funding of SOCHEMA. In the penultimate section, it draws conclusions from the earlier sections. The tenth section is the strategies and recommendations for improving health insurance coverage in Sokoto which are summarized as follows.
Effective Implementation of Compulsory Health Insurance Coverage
(a) The political leadership should activate the Scheme by commencing the remittance of 10 percent of their monthly basic salary as required by Law;
(b) Negotiate with Organized Labor and commence the remittance of the 15 percent of worker’s basic salaries (10 percent by Employer and 5 percent by Employee) as required by Law;
(c) Start budgeting and fully releasing to SOCHEMA the one percent of Consolidated Revenue Fund of the State and Local Governments as required by Law and;
(d) The Scheme should set realistic and realizable targets and timelines for its full implementation.
Take steps to Implement the Recommendations to Sokoto State in the Assessment Report on “State of Primary Health Care Service Delivery in Nigeria 2019-2021”: Following its findings, recommendations to improve the implementation of BHCPF in the States of the Federations were categorized into “Quick Wins” and “Other key Recommendations”. For Sokoto State (see page 159 of the report), they include (but not limited to):
(a) Completing all required trainings, establishing the health facility management committees, and regularizing the primary health facility bank accounts in all wards so that facilities can commence accessing BHCPF;
(b) Provision of equity funds for the NHIS gateway of the BHCPF; conduct the quarterly gateway forum meetings of the SPHCDA and the SOCHEMA to strengthen the BHCPF implementation.
Start and deepen Sensitization on the Benefits of Health Coverage.
Simplify the Cost-Benefit Analysis of Health Insurance Plans.
Reduce the Bottlenecks of Registering and enrolling under the Scheme.
Improve and Optimize the Expected Benefits of Health Insurance Coverage to
retain enrollees.
Ensure Transparency and Accountability in the Scheme.
Deploy the Best Human Resources in the Management of SOCHEMA.
Provide Incentives for Compliance by Enrollees and other Stakeholders.
Reduce Extreme Poverty and Restructure the Economy for Productivity and
Value Addition.

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ADVOCACY MEMO ON THE SOKOTO STATE HEALTH INSURANCE SCHEME (475 downloads )

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Imo State Pre 2023 Budget Health Memorandum

Center for Social Justice — Tue, 09 May 2023 16:39:03 +0000

This Memorandum is divided into seven sections. Section 1 is the background, provides the rationale for the exercise and reviews key sectoral goals, objectives, targets and strategies. Section 2 reviews Imo State specific health indicators and their implications. Section 3 reviews the health budget commitments of the State including the actuals and their compliance with the Abuja 15% Declaration. It also reviews whether the State has set and costed a Minimum Service Package for PHC and the whole of government and health in all policies approach. Section 4 is on the implementation of the Basic Health Care Provisions Fund in the State while Section 5 reviews the sustainability of the current health care financing model. Section 6 is on the operation of health insurance in Imo State while Section 7 is on recommendations.
The following recommendations for Imo State flow from the review and analysis in this Memorandum.
Prepare a New Strategic Health Development Plan 2023-2027.
Prepare a Health MTSS.
Mainstream the Plan, Policy and Budget Continuum in Health.
Adopt a Whole-of-Government, Health-in-all Policies Approach.
Ensure Stakeholder Engagement and Popular Participation in Preparation of
MTSS and Annual Budget.
Adopt a Whole of Society Approach to Health.
Implement the Minimum Service Package for Primary Health Care.
Increase Funding to the Sector and Invest in Value for Money.
Moratorium on New Capital Projects.
Invest in Transparency and Accountability.
Prepare and present Annual State of Health Report.
Ensure Maximum Benefits from BHCPF.
Full Implementation of ISHIS Law and the National Health Authority Act.

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Imo State Pre 2023 Budget Health Memorandum (658 downloads )

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