Stakeholders and local government leaders have renewed calls for stronger resource mobilisation to boost healthcare financing in Nigeria.
They also urged the government to raise allocations to the sector, ensure accountability, and reduce the heavy out-of-pocket spending by citizens.
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The call was made on Wednesday during the ongoing National Health Financing Policy Dialogue in Abuja.
The four-day forum, which began on 1 September and will run until 4 September, has brought together policymakers, experts, civil society, private sector players, and development partners to translate commitments into practical strategies for sustainable healthcare funding.
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Themed “Reimagining the Future of Health Financing in Nigeria,” the dialogue is expected to generate commitments aimed at reducing out-of-pocket spending, improving accountability and strengthening domestic funding for the health sector.
25 per cent allocation to health
Speaking at the event, the Executive Chairperson of Jalingo Local Government in Taraba State, Aminu Hassan, declared that councils are committed to prioritising healthcare, insisting that 25 per cent of local government budgets should be dedicated to health financing.
Mr Hassan explained that effective financing would require stronger collaboration between councils, state primary healthcare agencies, and national insurance institutions.
He warned that the health system will remain overburdened at state and federal levels if the grassroots level remains abandoned.
“We want to assure Nigerians that local governments are ready to put health as number one. 25 per cent of our budget should go into healthcare financing. If we get it right at the grassroots, it will reduce the burden on the states and the federal government,” he said.
Mr Hassan highlighted the need for capacity building, education, and sensitisation of local government leaders to ensure budget allocations for primary healthcare are properly implemented.
He added that some states have already set up basket funds and other innovative financing arrangements that could serve as models.
On health insurance, he cautioned that awareness remains low at the local level, with many leaders unclear on how the schemes work.
“Some of our chairmen do not even know the services insurance provides. That is why we are calling for awareness and capacity building,” he said.
He urged insurance agencies and primary healthcare bodies to engage communities more directly.
Mr Hassan further noted that digitalisation could improve confidence and accountability in health financing, saying local governments would do the needful to ensure funds are made available for services at the grassroots.
35 per cent allocation
In his remark, Samuel Gejere, a representative of the Association of Local Governments of Nigeria (ALGON) said the recent Supreme Court judgment granting financial autonomy to councils marks a new phase in grassroots governance.
Mr Gejere, the former Executive Chairman of Karu Local Government Area, Nasarawa State, explained that ALGON is pushing for an increase in local government allocation from 20.6 per cent to 35 per cent of the federation account, with health, agriculture, and security as top priorities.
According to him, more funds in the hands of local governments will enable direct investment in essential services.
He emphasised that councils must begin shifting from empowerment projects that have little impact on public health to sustainable investments that improve healthcare delivery.
“The narrative must change. Instead of distributing motorcycles or grinding machines, we must channel funds to areas that save lives and improve livelihoods. ALGON is committed to ensuring accountability and transparency in the use of health funds,” he said.
Insurance challenges persist
The Assistant Director General of the Katsina State Health Insurance Authority, Mohammed Safana, said insecurity, low enrolment, and poor funding remain major challenges to implementing health insurance in the state.
Mr Safana noted that while awareness of health insurance has improved significantly in recent years, affordability remains a barrier, with many families still unable to enrol.
He added that insecurity has also disrupted outreach efforts, as armed groups often prevent health workers from entering communities to register residents.
“Awareness grew from 2.5 per cent in 2019 to about 40 per cent in 2023, but people still cannot afford to join. In some places, bandits disrupted our enrolment drives and scared residents away,” he explained.
To improve accountability, he said Katsina introduced a “funds flow mechanism” that directs 50 per cent of capitation funds to medicines, 15 per cent to human resources, 15 per cent to laboratory supplies, 10 per cent to administration, and 10 per cent as reserve funds.
He also called for stronger legal frameworks, community ownership of health centres, and compulsory participation of the private sector in insurance schemes to guarantee sustainability.
Expanding National Health Financing
In his remark, Ogbe Oritseweyimi, the Secretary of the Basic Healthcare Provision Fund (BHCPF) Ministerial Oversight Committee Secretariat, stressed the need to balance resource mobilisation with accountability.
Mr Oritseweyimi explained that past reforms show that effective use of existing funds can improve outcomes, even before additional allocations are secured.
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He noted that while the law currently provides at least one per cent of the Consolidated Revenue Fund for the BHCPF, the target should be raised to two per cent and eventually five per cent.
“The higher the National Assembly can help us out with, the better it is for Nigerians. Even a small increase can have a big impact on healthcare outcomes if the money is properly utilised,” he said.
He, however, stressed that contributions should not be left solely to the federal government.
To build stronger ownership and accountability, he proposed that states and local governments also contribute their share at the point of federation allocation.
This, he said, would ensure that subnational leaders know their money is included and take greater interest in how funds are managed.
According to him, the BHCPF has already shown its potential, with facilities recording increased utilisation where funds have been properly channelled.
He added that new guidelines now provide for local government representation on state committees, ensuring stronger grassroots participation in health financing.
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