Given the stark realities of the grave implications of the recurring low budgetary allocation to the critical health sector – from one administration to another – there is cause for serious concern. In fact, that of the 2024 budget, put at N1.38 trillion of the total N27.5 trillion, translates to a meagre 5.03 per cent!

That of course, is a far cry from the 15% agreed for the health sector of African countries through the Commitment of the African Union (AU) leaders, popularly referred to as the ‘Abuja Declaration’ back in 2001. That was some 23 years ago. Quality, affordable and accessible healthcare delivery therefore, goes beyond mere lip service.

Though tagged as ‘Budget of Renewed Hope’, the opposite scenario of the dashed hopes of millions of Nigerians, especially concerning the health status of the vulnerable groups made up of pregnant women, children and the aged might play out if urgent steps are not taken to reverse the trend.

For 2024, the service vote amounts to N155.65 billion, the health capital budget is put at N434.79 billion; recurrent at N667.38 billion, and statutory transfer to the basic healthcare fund at N125.74 billion.

But all these equate to a drop of water in an ocean of mass misery because of other related factors. These include the low number of medical personnel to people, worsened by the large number of doctors and nurses that have since relocated to foreign shores, lack of requisite equipment to enhance prompt and adequate attention to the sick and the inadequate primary healthcare centres at the rural areas, across the country.

For the children, millions are battling daily with malnutrition, from low quality or inadequate food nutrients that have resulted in stunting, wasting, and underweight. This is due to lack of essential minerals such as iron, calcium, zinc, potassium, folate, cyanocobalamin, as well as the vital vitamins of A, D and C.

Globally, the situation is so dire that in June 2022, UNICEF warned that almost eight million children under-5 across 15 crisis-hit countries were at risk of death from severe wasting. On the significant factor of medical personnel to the country’s population, the World Health Organisation (WHO) estimates that at least 2.5 medical staff (physicians, nurses and midwives) par 1,000 people are needed to provide adequate coverage with primary care interventions (WHO, World Health Report 2006).

But in 2021, the Nigeria Medical Association (NMA) lamented that less than half of the over 80, 000 doctors registered with the Medical and Dental Council of Nigeria (MDCN) were practising in the country

The first bold step to take is for President Bola Tinubu and the state governors to muster the political will to make healthcare delivery a matter of priority in Nigeria, giving the country’s doctor to-population ratio of 1 to between 4,000 and 5,000. This is abysmally low and indeed, far below the WHO recommendation. Listed as the main causes of death among children aged under-5 in Nigeria in 2019, diarrheal diseases took up to 17.14%, lower respiratory infection affected 16.74%, malaria eliminated (12.37%) and meningitis(4.23%).

But one other important issue to be tackled is that of public enlightenment on the preventive measures of undernutrition as well as other health-related issues. It is important for parents to ensure that their children do not miss or skip meals. Instead, they should aim to eat three small meals a day and two to three snacks a day for those whose appetite is poor.

They should also take drinks after meals, not before or during as that can fill you up. A healthy and balanced diet is vital for maintaining health and fitness.

But how many parents can afford three meals per day for members of their families amidst the current economic hardship? This should be food-for-thought for Mister President, the state governors, the lawmakers and political appointees, many of who are still living large at this time that calls for their patriotic sacrifice.

Ordinarily, the federal and state governments are allowed to set up hospitals and other health facilities. This is enshrined in section 17(3)(d), which guarantees “adequate medical and health facilities for all persons.” Effective healthcare delivery is therefore, usually a function of the quality, accessibility and affordability of the service.

Unfortunately, currently most of the Public Health Centre (PHC) facilities in Nigeria lack the capacity to provide essential health-care services.

So, what is the way forward? The first bold step to take is for President Bola Tinubu, and the state governors to muster the political will to make healthcare delivery a matter of priority in Nigeria. They should therefore, allocate at least 15 percent of the country and states’ annual budgets to the health sector.

They should also key into the Maternal, Newborn, and Child Health Programme (MNCH2), which is a five year country-led, UK government funded, health programme across six northern states which began in June 2014 and is in line with Millennium Development Goals 4 and 5.

With all these in place, there will be adequate funds to build and maintain infrastructure, provide healthcare services and drugs will be affordable to Nigerians. Eventually, health will become their wealth in a cleaner environment, unlike now that the policies are deliberately made to make the poor poorer; to enrich the already rich political elite.

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