This analysis presents a review of the appropraition act based on the analysis of the 2016 health budget for Maternal and Newborn Health of the Federal Ministry of Health

1. 2016 Appropriation Act:
Analysis of allocations to MNH in
Health Budget:
Esther Agbon
Health Finance & Advocacy Advisor

2. MTEF Budget
Assumptions
• Bench mark price of
$58 per barrel
• Crude oil production of
2.2million barrels per
day
• Exchange rate of N190
to $1
Reality
• Current price of Crude
@ $45 per barrel
• Crude oil production
drops to 1.6 million due
to NDA vandalism
• Exchange rate @
parallel market – N350 -
N380

3. Focus of Analysis
• This analysis focuses on 3 key agencies with
direct roles for MNH
- FMOH HQ
- NPHCDA and
- NHIS
• The traditional tertiary hospitals, institutions
of learning and research centres are excluded

4. The Health Budget
14%
86%
Capital Recurrent
Total
Recurrent
89%
Total
Capital
11%
Proposed:N 257bn Enacted: N 250bn

5. 2016 Health Budget Deficit
• Additional
N659bn
required to
meet the Abuja
15%
commitment
Total Budget Abuja
declaration
2016 Health
Budget
Series1 6,060,677,358, 909,101,603,7 250,062,891,07
100%
15%
4%
2016 Health Budget

6. FMOH HQ Budget – N10.275bn
Capaital
51%
Recurrent
49%

7. Changes in allocations in FMOH HQ
Budget
Items Proposed Enacted
Blood related procurement, supplies,
equipment's, donation care etc.
(addition of 9 line items)
1,267,214,278 18,162,902
Upgrade, modernization & equipping
of 6 Tertiary Hospitals across
geopolitical zones
1,096,612,966 22,200,776
3% annual mobilization to VAMED E.
for PPP of Euro 400 million
(VAMED teaching hosp rehab. Proj)
2,614,772,831 1,655,465
Training for selected tertiary facilities
in six geopolitical zones
376,835,812 0
Training(ELS,LSS,procurement, etc) 0 84,911,607
Contraceptives, logistics &FP Training 0 797,406,909
IMNCH 0 20,404,623

8. Interesting new funding lines
Items N
Health Care Financing Equity and
Investment
18,894,706
Economic Analysis/Investment Case 986,701
NHA 2012-2014 ESTIMATION 2,411,936
STRENGTHENING MONITORING &
EVALUATION OF THE HEALTH SECTOR
7,347,342
Nutrition 1,099,404
Infant and young Child feeding 729,136

9. National Primary Health Care Development
Agency
12%
88%
Recurrent Capital
Approved 2016 Capaital Recurrent Total
15,694,635,719 2,050,738,213 17,745,373,932

10. NPHCDA’s Capital Budget Proposal
Line Item Amount
PROCUREMENT OF VACCINES AND DEVICES (SIA) 4,062,408,000
DEVELOP NATIONAL LOGISTICS SUPPLY CHAIN 3 HUB SYSTEM;
FINALIZE AND ADOPT
BEST RE-DESIGN OPTION FOR NATIONAL LEVEL (RUN HERMES
MODEL FOR
OPTIMIZATION, BRING IN ARCHITECTS TO DETERMINE
OPTIMAL HUB COLD STORE
REDESIGN), RECRUIT OR TRAIN STAFF TO FILL GAPS WITHIN
NEW SYSTEM, IMPLEMENT
REDESIGNS TO EQUIP THE THREE HUBS TO RECIEVE
INTERNATIONAL SHIPMENTS
11,611,346,700
previous budget lines for Community health, Primary Health
Care under one roof, and midwife service scheme have
been scrapped

11. Analysis of NPHCDA’s approved Capital
Budget
Line Item Nos N
Ongoing projects 11 14,375,816,843
New projects 37 1,318,818,876
Total Capital projects 48 15,694,635,719
*New construction projects 28 917,930,416

12. N12bn allocated for Vaccines
Trad Vaccines &
frieght,
1,017,495,128 Logistics, 76,973,426
Polio Eradication,
9,821,331,311
Measles, Yellow
fevr, others,
1,743,406,067
Hajj Vaccines,
220,473,202

13. Polio Eradication Budget
2014 2015 2016
POLIO ERAD. 3,650,775,386 2,568,442,234 9,821,331,311
Amount

14. Budget for Midwives Service Scheme
0
200,000,000
400,000,000
600,000,000
800,000,000
1,000,000,000
1,200,000,000
1,400,000,000
1,600,000,000
2014 2015 2016

15. Some General Hospital projects
supported by NPHCDA
• Dialysis centre at General Hospital Agenebode
– N10.5m
• Installation of Medical, Dental and
Opthalmological Equipment @ Ughelli General
Hospital- N35m
• Procurement of Radiology Equipment (Xrays) –
N14m
• Completion of 250 bed hosp, Okene – N250m

16. National Health Insurance Scheme
• Proposed Capital Budget of N852,870,015
• Enacted reduced to N127m
• Capital budget now disaggregated

17. Breakdown of NHIS Budget
Line Item N
UNIFIED MATERNAL & CHILD HEALTH
PROGRAMME
63,000,000
PROCUREMENT OF 2NOS SUV UTILITY
VEHICLES
35,198,109
PROVISION OF BOOKS AND PERIODICALS
FOR THE NHIS
31,500,000

18. Summary of findings
• Budget lines for Contraceptives/FP, IMNCH and MSS restored
• Contraceptives/FP budget still short of FP 2012 commitment
• Blood related donation and supply equipment by FMOH HQ
amounts reduced significantly
• 3% annual mobilization to VAMED reduced significantly
• NPHCDA capital budget reallocated to include rehabilitation
and construction of new PHCs
• NPHCDA capital budget to provide for General hospitals
• NHIS budget break down now available
• However, 1% CRF additional funding to implement NHAct not
included

19. Our Ask
Transparent budget
allocations
• Continue to make budget
lines for maternal neonatal
and child health spending
distinct
• Involve CSOs in budget
planning processes at the
MDA level
Adhere to funding obligations
• Abuja 15%
• $11.35m annual Family
Planning budget
commitment
• NHAct 1% of CRF

20. Make budget
development transparent
and participatory
#OpenMoH