Engaging NPHCDA Boss on 2016 Appropriation Act

Dr Ado J Muhammad

The Executive Director

National Primary Health Care Development Agency (NPHCDA)

Dear Sir;

Greetings and consider this intervention as a friendly advocacy in the spirit of collaboration and national development. Let me 1^st begin by congratulating you and the tireless NPHCDA team, Nigerians and development partners for ensuring Nigeria is free of Polio. Sunday 24^th July 2016 marked 2 years uninterrupted without recording any Polio case all over the federation. Let me also hasten to add that I have access to you as I could send you a text message or call your line or march to your office and I am confident you will attend to me and provide a response to my questions. Having said that, ones in a while we will need to broaden our discourse so that the common man who is not in the technical environment will also know what is happening and of course the women and children that we are all working for deserve to also participate in a public discourse.

My intervention today is about the 2016 appropriation act focusing on the finances earmarked for NPHCDA. We are glad that President Buhari has provided about N12.9 billion this year for Immunization which is about 45% of the overall capital budget. The Immunization budget in the NPHCDA budget that has a total allocation of about N17.4 billion gulfs about 88.4 % of  its capital budget and about 72.6% of the its overall budget. Below provides further breakdown of the funds;

• N9,821,331,311b -Polio Eradication Initiative (PEI – including OPV + devices procurement and operational costs)
• N1,743,406,067b – Non-Polio SIAs (Measles, Yellow fever campaigns, MNTE, etc, including vaccines and devices procurement and operational costs
• N1,017,495,128b – Traditional vaccines and devices procurement including freight and handling charges

Last year (2015) the funds for traditional vaccines was N2,615,000,000b which was more than what we have this year, although we haven’t recorded releases of  funds last year. It was also not a secret that last year because we haven’t recorded funds releases World Bank had to bail us out with a loan of $200 million which vaccines procured with that funds may last up to 3^rd quarter of 2016. Let me digress a bit to another budget code in the NPHCDA this year ‘Midwives Service Scheme (MSS)’ I have seen in the 2016 appropriation act N1,061,256,144b is earmarked for MSS, with a total of N2,050,738,213b for NPHCDA recurrent expenditure the MSS will gulp 51.7% of its  recurrent expenditure.

Sir, permit me to make reference to a study in 2015 “The Better Obstetrics in Rural Nigeria (BORN) Study; Evaluating the Nigerian Midwives Service Scheme” which I am confident you have a copy and read it already. It said among others that overall, the MSS did not have the expected large impacts. The researchers found a “12 percent increase in use of antenatal care in program clinics compared with clinics in communities not exposed to the program, and a 6 percent increase in overall use of antenatal care.” With respect to impact, “the program did increase access to skilled care, but this eroded over time, in part because of challenges in retaining and recruiting midwives. Such problems as difficulties associated with relocating to new areas, inadequate provision of housing accommodation, and irregular payment of salaries (which worsened over time) contributed to midwives wanting to leave the scheme. Uneven adherence by different levels of government (particularly at the state and local levels) to agreements regarding the scheme likely contributed to, and exacerbated, some of these problems.”

• Sir, with all humility, you owe it to ordinary Nigerians to explain what the N1, 061,256,144b earmarked for Midwives Service Scheme (MSS) this year will be used for? Is this money to clear previous year salary debt for the midwives or it is meant to pay their 2016 salaries? Also what is the fate of MSS beyond 2016?

• With respect to about N12.9 billion this year for Immunization, Nigerians will also like to know in the midst of all the international donor support this year from World Bank, GAVI, Japan, Bill Gates Foundation, what will our own appropriated money be used for and what will the donor funds be used for? And are we expecting funds releases this year as an improvement to lack of releases last year?

In line with your passion and commitment to accountability and transparency, I will like to humbly suggest to you and your team to hold a “Post 2016 Budget Dialogue” with civil society organizations, media and other relevant stakeholders to provide useful information about some of the issues highlighted in this article.

All comments to Dr Aminu Magashi Garba Coordinator Africa Health Budget Network & Publisher Health Reporters (healthweekly@yahoo.com)