Nigeria’s Federal Government Starts Strategic Health Budget Alignment With States

In a bid to significantly improve healthcare deliverables across the country, the federal government has commenced the process of getting the states to align with its budget reforms in the health sector.

It said the aim was to ensure coordination, improved funding of the health sector and better health outcomes for Nigerians.

Coordinating Minister of Health and Social Welfare Mohammad Ali Pate, who was represented by the Permanent Secretary of the ministry, Ms. Daju Kachollom, said the federal government saw the need to drive ongoing reforms in the health sector down to the lowest level of governance.

While declaring the 3-Day Retreat of Federal Ministry of Health and Social Welfare Reforms, cascading to the Subnational level, jointly organised by the Ministry and its partners – Result for Development and Bill and Melinda Gates Foundation – in Abuja, on Monday, Pate said the effort could greatly improve strategic budgeting and budget performance in Nigeria’s health sector.

“Cascading the gains of budget process reform at the sub-national level can greatly improve strategic budgeting and budget performance in Nigeria’s health sector, which will lead to better health outcomes,” he said.

While tracing origin of the pilot scheme,  Daju Kachollom said: “We found out that during the course of time that budget processes in the health sector do not align and so at the Fourth National Council of Health which was held in Ado-Ekiti, last year, we came up with the idea, along with our partners- Result for Development and Bill and Melinda Gates Foundation that we should cascade down the budget for Health as is being done at the national to the subnational level.”

She noted that three states, Lagos, Kano and Kaduna were first chosen by the sponsor of the reform programme – Bill and Melinda Gates Foundation as a pilot scheme which would be extended to other states.

She explained that under the health budget initiative, the ministry first prepares a mock budget which is aligned with proposals from the Planning and Statistics unit before arriving at the final budget.

According to Kachollom, the aim of the initiative is to ensure a better health outcome for Nigerians.

“In the Renewed Hope Agenda of Mr. President, health is very key sector, and it is our duty at the Federal Ministry of Health and Social Welfare that budget reform is cascaded down to the subnational and the local government levels.

“This will ensure that adequate infrastructure, manpower, and training are provided and to also ensure that the budget is adequate to provide for the healthcare needs of the people.”

He further said the whole idea of the initiative was to ensure better health outcomes for the Nigerian population.

Speaking further on the budget reform, Kachollom said: “Having made significant progress in its budget process reforms over the last 5 years, the FMOH felt it was time to support states in achieving the same.

“It is worthy to note that the budget formulation process at the Federal level begins with the Federal Ministry of Budget and Economic Planning. The Budget and Economic Planning Ministry takes the first step by coming up with a Medium-Term Revenue Framework (MTRF).

“They then engage stakeholders, including, the ministry using their Medium-Term Sector Strategies (MTSS) to arrive at a Medium Term Expenditure Framework (MTEF), which informs the allocation of envelopes to Ministries, Departments and Agencies (MDAs).

“The Budget Call Circular follows the approval of the MTEF and Fiscal Strategy Paper. Ahead of the Call Circular, the Planning and Budgeting (P&B) Committee ensures the development of Annual Operational Plans and Mock Budget by the Ministry DAPs based on the sector’s strategic plan. The Mock Budgets are then reviewed by DAPs in preparing the budgets for submission. This is how the FMOH goes about ensuring strategic budgets.

Country Representative of Result for Development, Felix Obi, who was represented by the Programme Officer, Kemi Adeniyi, spoke on what gave rise for the reform, saying that, “an assessment was conducted sometime in 2018 and it was discovered that our strategic plan in the health sector doesn’t align with our budget.”

She said the new reform being undertaken by the Ministry allows for better collaboration between the Budget and Planning departments in a way that the objective of the government in the health sector is achieved.

Commissioner of Health in Lagos, Prof. Akin Abayomi, who led the state ministry officials to the retreat, described the initiative as very apt as it will help add value to what the states are doing to deliver quality healthcare services to the people.

Onyebuchi Ezigbo

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