20 “hidden” destinations of purported health spendings in 2020 proposed budget

Medical Doctors attending to patients used to illustrate the story health
Doctors attending to patients used to illustrate the story

About N5 billion will go to service major construction works in the nation’s health sector in the 2020 proposed budget, but development experts, working around accountability process in public budgeting, worry that this may come to waste because the projects they are nominated to develop are not captured in the vision of the Ministry of Health, the regulatory institution for health development in the country.

In the proposed budget, a minimum of 20 health-related projects got generous appropriation but only for construction purposes and without regard for how such health facilities will be subsequently manned, staffed and remunerated, since the Ministry of Health which has these responsibilities has been bypassed by this budgetary arrangement.

“How do you allow a whopping N5 billion in public spending to create projects when you make no provisions or appropriation on how to staff them or give them functional meaning?” Nkem Ilo, chief executive at Public and Private Development Centre [PPDC], lamented in an interview with Dataphyte.

Over the years, construction is a notorious subhead through which corruption has been enabled in the Nigerian contracting and procurement process, and Ms Ilo, whose organisation is a leading voice for transparency and accountability in the Nigerian civic sector, worries that the same fate that had befallen most abandoned projects “invariably awaits” these 20 nominated projects in the 2020 proposed budget.

Ms Ilo’s position is shared by Segun Elemo, the executive director  at Paradigm Leadership Support Initiative [PLSI], who worries as well that unless the “integrity deficit driving budgeting process in the country” is courageously addressed, the “problem of budget padding” will always lead to wasteful investments” such as placement of projects in wrong or unrelated agencies.

“This is what is responsible for the series of uncompleted or abandoned projects in the country, and it is all because of the absence of needs-assessment and political underhand in project allocation,” Mr Elemo said.

Influential project monitoring reports from bodies like UDEME (PTCIJ), TRACKA (BudgIT) and Value for Money (PLSI) corroborate the concern about government profligacy through multiple spending around single projects spread across or hidden in many agencies that were ultimately not completed or abandoned by MDAs.

20 Nominated Silent Destinations for Hiding Projects

The 2020 proposed budget offers the best illustration of this art of hiding projects in “silent” institutions.  In this particular case, whereas the key reference was for health spending, the nominated hidden outlets are 20 non-health institutions otherwise called Ministries, Departments and Agencies or MDAs.

Ministry / AgencyCodeName of projectAmountCategory
BORDER COMMUNITIES DEVELOPMENT AGENCY (BCDA) HQTRS23020106CONSTRUCTION / PROVISION OF HOSPITALS / HEALTH CENTRES41500000Construction
BORDER COMMUNITIES DEVELOPMENT AGENCY (BCDA) HQTRSERGP22144844CONSTRUCTION OF PRIMARY HEALTH CENTRE WITH SOLAR POWERED BOREHOLE AND50000000Construction
OVERHEAD TANK IN DELTA STATE
BORDER COMMUNITIES DEVELOPMENT AGENCY (BCDA) HQTRSERGP23139483CONSTRUCTION OF PRIMARY HEALTH CENTRE WITH SOLAR POWERED BOREHOLE AND41500000Construction
OVERHEAD TANK
BORDER COMMUNITIES DEVELOPMENT AGENCY (BCDA) HQTRSERGP28139464CONSTRUCTION OF SOLAR POWERED BOREHOLE AND OVERHEAD TANK IN PRIMARY15000000Construction
HEALTH CENTER AT ADA
BORDER COMMUNITIES DEVELOPMENT AGENCY (BCDA) HQTRSERGP28139469CONSTRUCTION OF SOLAR POWERED BOREHOLE AND OVERHEAD TANK IN PRIMARY15000000Construction
HEALTH CENTER ATAUKE
CROSS RIVER RBDAERGP28113603HEALTH SERVICES AND OTHER DISEASE SENSITIZATION WORKSHOP.5000000Health Promotion
FEDERAL COLLEGE OF ANIMAL HEALTH AND PRODUCTION TECHNOLOGY - IBADAN23020106CONSTRUCTION / PROVISION OF HOSPITALS / HEALTH CENTRES25000000Construction
FEDERAL MINISTRY OF NIGER DELTA HQTRS23020106CONSTRUCTION / PROVISION OF HOSPITALS / HEALTH CENTRES250000000Construction
FEDERAL MINISTRY OF NIGER DELTA HQTRSERGP1130412CONSTRUCTION/EQUIPPING OF HEALTH CENTRES IN ABIA , AKWA-IBOM, BAYELSA,50000000Construction
CROSS-RIVERS, DELTA, EDO, IMO, ONDO & RIVERS STATES
FEDERAL MINISTRY OF NIGER DELTA HQTRSERGP25104152HEALTH CENTRES IN ABIA , AKWA-IBOM, BAYELSA, CROSS RIVERS, DELTA, EDO, IMO,100000000Construction
ONDO & RIVERS STATES
FEDERAL MINISTRY OF NIGER DELTA HQTRSERGP25136024CONSTRUCTION OF OBIEKWELE HEALTH CENTRE AT NDOKWA/UKWAI FEDERAL27500000Construction
CONSTITUENCYCONSTRUCTION OF OBIEKWELE HEALTH CENTRE AT NDOKWA/UKWAI FEDERAL
CONSTITUENCY
FEDERAL MINISTRY OF NIGER DELTA HQTRSERGP25136040CONSTRUCTION OF UCHI PRIMARY HEALTH CENTRE25000000Construction
FEDERAL MINISTRY OF NIGER DELTA HQTRSERGP25142416CONSTRUCTION OF HEALTH CENTER AT AKWA OBIO INWANG, ENEYO SOUTH WARD,27500000Construction
AKPABUYO LOCAL GOVERNMENT AREA, CROSS RIVER STATE
FEDERAL MINISTRY OF WATER RESOURCES - HQTRSERGP28111126CONSTRUCTION OF SANITATION AND HYGIENE FACILITIES IN INSTITUTIONS; SCHOOLS AND HEALTH CENTRES61982742Construction
FEDERAL MINISTRY OF WORKS AND HOUSINGERGP27141016SLUM UPGRADE; COMPLETION OF CLASSROOM BLOCKS, PRIMARY HEALTH CARE, SKILL ACQUISITION CENTRE, BOREHOLES, ELECTRIFICATION, 500/300 KVA TRANSFORMERS PROVISION, HANDPUMPS AND UPGRADING OF ROADS, DRAINAGES AND EROSION CONTROL IN DAMATURU LGA-YOBE STATE,PROVISION OF PERIMETER FENCE AT FEDERAL UNIVERSITY DUTSE AND THE SIX (6) GEOPOLITICAL ZONES AND COMPLETION/RENOVATION OF CLASSROOMS BLOCKS ACROSS FEDERAL CONSTITUENCIES2774587978Construction
MINISTRY OF HUMANITARIAN AFFAIRS, DISASTER MANAGEMENT AND SOCIAL DEVELOPMENT23030105REHABILITATION / REPAIRS - HOSPITAL / HEALTH CENTRES150000000Rehabilitation/Repairs
NATIONAL CENTRE FOR WOMEN DEVELOPMENT23010122PURCHASE OF HEALTH / MEDICAL EQUIPMENT2375402Medical Equipment
NATIONAL INSTITUTE FOR SECURITY STUDIES23010122PURCHASE OF HEALTH / MEDICAL EQUIPMENT39643816Medical Equipment
NATIONAL INTELLIGENCE AGENCY23030105REHABILITATION / REPAIRS - HOSPITAL / HEALTH CENTRES969917851Rehabilitation/Repairs
NATIONAL LOTTERY TRUST FUNDERGP25126535PURCHASE OF MEDICALS AND HEALTH EQUIPMENT35000000Medical Equipment

In the proposed budget, an agency like the Border Communities Development Agency is to construct and provision hospitals/health centres and provide solar-powered borehole facilities, totalling about N150 million. Yet nowhere in the appropriation is there a vision of the human resource component of the personnel that will run the projects if they ever get completed and meet the specific health standards that the Ministry of Health which has been sidelined solely has discretion for.

The Ministry of Niger Delta also proposes the same spending jamboree of constructing and providing hospitals/health centres in the oil-producing states cohorts totalling about half a billion Naira, again without a vision of the human resource component of the personnel that will run the projects, if it ever gets completed.

The National Intelligence Agency, NIA, the country’s spy outfit, leads the trail in grabbing the lion’s share of this hidden spending with almost a billion Naira [N969.9million] in generous gifting for the “rehabilitation/repairs of hospital/health”.

Overall, the 2020 proposed budget provides for health-related expenditures worth N171 billion (N171,146,082,086) which are not within the regulatory purview of the health ministry, according to DATAPHYTE analysis. Details of these additional health spendings in the 2020 proposed budget are listed in the table below.

ComponentProposed
Construction / Provision of Hospitals / Health Centre7774719768
Counterpart Funding Including Global Fund/Health/ Refund to GAVI5500000000
Drugs & Medical Supplies2535885383
GAVI / Immunization22734412586
Medical Consulting194060190
Medical Expenses4304210164
National Agency for the Control of AIDS (NACA)2244381813
NHIS Contribution by FGN82705001987
NHIS (Military Retirees)11737075338
Purchase of Health / Medical Equipment26637411831
Rehabilitation / Repairs - Hospital / Health Centre4055919099
State House Medical Centre723003927
TOTAL171146082086

As the table above illustrates, some of the funds are genuinely targeted to address special health issues such as immunization and HIV/AIDs. Other important health allocations in the budget are the national health insurance scheme; the allocation of N2.24 billion to the National Agency for the Control of AIDS (NACA); the N82.7 billion Federal Government’s contribution to the National Health Insurance Scheme (NHIS) and the special budget of N723 million to the State House Medical Centre.

In the same vein, some N11.74 billion NHIS fund is allocated to military retirees, as well as the GAVI Immunization project worth N22.73 billion, plus “the Global Fund Counterpart funding, including refund to GAVI” with the budget of N5.5 billion.

The chart below shows the categorization of these health budgets to non-health agencies.

The chart shows that allocation for hospitals (or health centre) is N7.77 billion (N7,774,719,768); N2.53 billion for Drugs and medical supplies; N194.06 million for Medical Consulting; and N4.3 billion for Medical Expenses.

The purchase of health/medical equipment across ministries had  N26.64 billion. A total of N4.05 billion (N4,055,919,099) for rehabilitation/repairs of Hospitals and Health Centres.

Implications of the extra 171.15 billion

DATAPHYTE’s first analysis of the allotted funds to the Health sector through the Ministry of Health showed the federal government proposed N427.3 billion. This is only 4.14 per cent of the proposed budget for 2020 as budgetary allocation to the Federal Ministry of Health. The report decried the government’s N44.50 billion allocation to the Basic Health Care Fund (BHCF) as against the right allocation which was estimated to be N103.3 billion. This estimate is a 1% measure of the 2020 Consolidated Revenue Fund (CRF) of N10.33 trillion.

The N44.50 billion allocation to BHCF violates the National Health Act (2014). The Act stipulates that at least one per cent of the Consolidated Revenue Fund (CRF) must be allocated to BHCF.

The sum of extra health budgets in related and unrelated MDAs, as shown above, is 171,146,082,086. This amount added to the Ministry of Health’s budget of N424,022,751,254 would come to N594.17 billion (595,168,833,340).

Even if this is considered an increase in federal government’s total commitment to health from 4.14 per cent to 5.75 per cent, yet the value is quite low for Nigeria considering the troubling health indicators.

 

A brief overview of these other MDAs shows that The Nigeria Building and Road Research Institute got over one billion naira. Also, the Nigeria Intelligence Agency received N969 million. The federal Ministry of Niger Delta got N480 million.

The Border Communities Development Agency (BCDA), N163 million. The new Ministry of Humanitarian Affairs also got N150 million to rehabilitate hospital. Other agencies were: the EFCC with N12 million. Nigeria Atomic Energy Commission got N100 million.

Overall, the budgeting process in the country still requires a more robust needs assessment. Despite the incessant budget scrutiny by civil society organizations, the Nigerian government continues to allocate projects funds to wrong ministries and agencies of government. This violates the basic principles of budgeting and public contracting and might explain the unending corruption in the implementation of government projects.

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