Nigeria’s Basic Health Care Provision Fund (BHCPF) - Eternal vigilance is the price of liberty

The Nigerian health sector has, for quite some time, been advocating for improved funding of the sector. Inadequate funding of the health sector is not peculiar to Nigeria. It was against this background that African Heads of State and Government, under the auspices of the African Union (AU), met in April 2001 in Abuja and pledged to set a target of allocating at least 15% of their annual budget to improve the health sector. The situation has not significantly improved in Nigeria and in most African countries as Nigeria sometimes allocates as low as 5% of its annual budget to health and spends about that same percentage on General Government Health Expenditure (GGHE) in relation to General Government Expenditure (GGE). Moreover, past Nigerian National Health Accounts (NHA) studies conducted (1998-2002, 2003-2005, 2006-2009, and 2010-2014) have revealed that the burden of health expenditure on the household through out-of-pocket expenses is generally as high as 70% of Total Health Expenditure (THE).

It is heartwarming to note that the efforts of stakeholders yielded dividends with the enactment and signing into law of the National Health Act 2014 The Act provides under Section 11 (1) that: “There is established the Basic Health Care Provision Fund ….” According to Section 11 (2) of the Act, the Basic Health Care Provision Fund (BHCPF) shall be financed from the following sources:

• Federal Government annual grant of not less than one percent of its Consolidated Revenue Fund;
• Grants by international donor partners; and
• Funds from any other source.

It has been almost three (3) years now since the BHCPF was established but funds are still being awaited. We appreciate the fact that Government’s revenue situation has been very weak especially in the last two years and we patriotically look forward to significant improvements soon. However, we hope that Government will make allocation of requisite funds for the Basic Health Care Provision Fund a top priority in the 2018 Annual Budget.

In anticipation of funds, the Federal Ministry of Health (FMOH), the National Health Insurance Scheme (NHIS), and the National Primary Health Care Development Agency (NPHCDA) have collaborated to develop Guidelines for the Administration, Disbursement, Monitoring and Fund Management of the Basic Healthcare Provision Fund 2016 This proactive action is very commendable.

While fully supporting and optimistically looking forward to the statutory transfer and release by the Federal Government of not less than one percent of the Consolidated Revenue Fund into the Basic Health Care Provision Fund, we must remember – as a popular saying goes – that “eternal vigilance is the price of liberty”. We must not be like pro-democracy groups and NGOs who fought for democracy and subconsciously went to sleep when the return to democracy became a reality in 1999. We must be very vigilant of the administration, disbursement, utilization, and management of the Fund by relevant agencies and bodies such as the NHIS, NPHCDA, State and Federal Capital Territory Primary Health Care Boards, Local Government and Area Council Health Authorities, and the Committee to be appointed by the National Council on Health.

It is important that funds are released into the BHCPF, but of great importance also is the transparent, effective and efficient management of the funds to achieve Universal Health Coverage (UHC). Eternal vigilance is the price expected from all of us as stakeholders. 

Thank you.