Review of the 2024 Federal Health Budget Proposal

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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