The document summarizes a meeting to analyze Nigeria's 2014 health budget allocation. Key points include: - The total health budget was N264 billion, a N2 billion increase from the proposed amount. However, per capita spending on health remains low at N29,000. - Allocations to the National Primary Health Care Development Agency (NPHCDA) and Federal Ministry of Health (FMOH) focus on programs for women and children's health. However, funding remains inadequate compared to population needs. - Additional funds from SURE-P were allocated, but long-term funding relies too heavily on infrastructure over service provision and training. Advocacy is needed to influence priority setting and budget planning.

1. Objectives of the meeting
• To share ActionAid budget analysis on health
with key stakeholders in the sector
• To identify and create a learning platform
among interested stakeholders
• Map 2014 budget monitoring initiatives by
stakeholders
• Facilitate a platform for budget planning and
advocacy

2. 2014 Appropriation on Health

3. Background
• The 2014 Appropriation act was signed into
law in May 2014
• A total of N4.67tn appropriated for as against
N4.62 proposed
• FMOH received N264bn, 2bn increase from
the proposed N262bn

4. 2013 Context
• Dwindling resources from oil due to oil theft
• Striking health workers
• Slow implementation due to delayed passage
of 2013 budget
• 11300 frontline health workers employed
• 10,000 benefit from conditional cash transfers
• Guinea worm control and wild polio virus
contained

5. 2013 Context
• Commendation from United Nations towards
achieving MDG 5
• 65 percent reduction in maternal mortality
between 2000 and 2013
• increased skilled birth attendants from 17
percent in 2000 to 60 percent in 2013
• Nigeria is not listed in UNDP report of top 20
countries with accelerated performance

6. Objective of the study
• To compare health funding vis a vis international
commitments on health by Nigeria Government
• To review 2014 appropriation act a view to
ascertaining if the government is progressively
addressing key programs for vulnerable groups in
society including women and chidren
• To make recommendations highlighting key areas
and alternatives that will impact on poor and
vulnerable groups

7. Scope of the analysis
• The analysis is limited to four Key MDAs
including NPHCDA, FMOH HQ and NHIS and
• Agencies with relatively higher allocations
within the Ministry

8. Proposed Vs Enacted
Health 2014 proposal 2014 Enacted
Total health budget 262,742,351,874 264,461,210,950.00
Personnel 210,519,482,396 208,543,188,775.00
Overhead 5,883,484,772 6,400,641,451
Capital 46,339,384,706 49,517,380,725

9. Is Govt progressively funding health
commitment?
The
percapita
spending
on health
for a
population
of 160m
Nigerians
is ju
N29,000

11. FMOH HQ
• Total budget N11.89bn
• Capital N5.7bn (47%)
• Introduced 16 new projects
• Has 30 ongoing projects
• N3bn to be spent directly on issues that
benefit integrated maternal neonatal and
child health (IMNCH) including guinea worm
eradication ( attached worksheets)

13. National Primary Health Care
Development Agency (NPHCDA)

14. National Primary Health Care
Development Agency (NPHCDA)
• NPHCDA,s budget primarily targets IMNCH
issues
• From an initial proposed N11bn by Executives
• N19bn got approved
• 20 ongoing projects
• 150+ new projects introduced – mainly on
construction of health centres across the
country (N7bn)

16. Cumulative summary allocation on
key areas
Budget Area Amount
R.Immunizatonn( MDG)
2,156,300,000
MSS 1,441,821,640
COMM HEALTH 1,000,080,000
NSHDP/PHC REVIEW 1,502,196,929
POLIO ERADICATION 3,650,775,386
Construction of Health centres N7bn

17. National Health Insurance Scheme
NHIS BUDGET %
Recurrent 68,931,674.00 2.3
Capital 2,974,192,365 97.7
Total 3,043,124,039

18. NHIS MCH Budget
• N2,3993,253,000 to support Maternal and
Child health insurance programme (MDG)
• Grossly inadequate for the population of child
bearing women and children 0-5 years.

19. Additional Funds from SURE-P
Item AmountRemarks
MATERNAL & CHILD
HEALTH 12,050,000,000
NHIS
FMH-POLIO
ERADICATION
PROGRAMME
4,120,000,000
Is this operational
cost?
NPHCDA POLIO ERAD,
PROGRAMME
2,500,000,000
COUNTERPART FUND
FOR HIV/AIDS
PROGRAMME
8,000,000,000
MDA not specified

20. Emerging Issues
• Reduction in mainstream funding to MDA and
increased funding from SURE – P
• Too much focus on infrastructure as against
skills acquisition, training and service
provision
• Poor budget planning between executives and
Legislature resulting in

21. Conclusion
• The 2014 budget came in to force in the
middle of the year
• To what extent can this budget be
implemented
• Considering most forth coming general
election
• now is the time to monitor performance

22. Matters Arising
• Funding implication for MCH
- adequate, underfunded or underspending
- Advocacy
- Getting involved in the budget planning from the start
- Setting MCH priorities/influencing the budget
- - advocacy to Legislators
• Organizing for change
- Capacity development on budget analysis for stakeholder
- Strategic planning meeting