Nigeria not among African countries promoting health budget transparency – Report

Nigeria is still a huge laggard among top economies in Africa in terms of healthcare budget information to its citizens, the Africa Budget Health Network, ABHN, a group of African civil society organisations working on health budget advocacy, has said.

The group said Nigeria was conspicuously not among four countries out of 27 in sub-Saharan Africa covered by a 2015 Open Budget Survey to determine countries in African that provided substantial budget information.

The only four countries, which polled scores above 60 per cent in the survey included South Africa, Malawi, Uganda and Ghana, the group said at the end of the Women Deliver conference in Copenhagen, Germany.

While 13 others provided minimal, scant or no budget information, the group said seven of those countries could increase budget transparency at almost no cost by publishing documents that government was already producing.

To determine whether African countries were meeting up with the need for accountability in the healthcare sector, the ABHN based its survey on five sub-heads, namely transparent allocation to health, transparent spending on health, spending linked to health outcomes, budget information clearly communicated to the public and public participation in the budget process.

From the scorecard of the 27 countries featured in the survey, South Africa leads the pack, scoring high on all sub-heads for good practice, followed by Namibia, which was adjudged in good practice in four sub-heads, except in public participation in the budget process.

Four other countries, including Uganda, Ghana, Malawi and Kenya were noted to be engaging in good practice in three categories and one area each for either requiring progress or completely inadequate.

Uganda and Malawi were found to be inadequate in the areas of budget information clearly communicated to the public and progress required in public participation in the budget process, while Kenya required progress in the area of spending linked to health outcomes and in adequate attention to transparent spending on health.

In the West African sub-region, only Ghana recorded average performance score with progress required in the area of transparent spending on health, with inadequate attention paid to public participation in the budget process.

Nigeria’s attention to transparent spending on health, spending linked to health outcomes and public participation in the budget process were adjudged inadequate, while progress was required on transparent allocation to health.

The country was said to be engaging in good practice only in the area of budget information clearly communicated to the public, while all the other countries performed poorly in majority of the categories covered by the survey.

The ABHN therefore implored African governments to “#ValueOurHealth” by increasing access to budget information and providing more opportunity for public engagement on health issues by the citizenry in the budgeting process.

A report from a study by the African Union high level panel led by former South African President, Thabo Mbeki, said Africa loses about $50 billion annually to illicit financial flows (IFFs).

The ABHN said if the $50billion was provided for Africa and not diverted elsewhere through illicit financial flows, Africa would have better health spending for women and children.

The recent Panama Papers investigation called for urgent actions to strengthen accountability for how public money was spent, the group said, pointing out that transparency and participation were key drivers of accountability and improved decision-making to deliver investment required for women and children to reach their full potential.

“African civil society organisations want to know how much is spent on women and children’s health. As a health body, it is concerned with the possibility of same amount of funds redirected towards providing and sustaining adequate healthcare,” Aminu Garba of ABHN said.

“It has been shown that public participation and open budgets can improve the health of its citizens because those budgets will be more influenced by the priorities of the people who use health services every day.

In the 2016 “Budget of Change” approved last week, out of a total N6.06 trillion appropriation, a total of N250.06 billion, or 4.14 per cent, was allocated by the Nigerian government to the health sector for the year.