States remain less prepared for health emergencies despite rising budget – SBM

States in Nigeria are less prepared for future infectious diseases and other emergencies even as health budgetary allocations are increasing, raising concerns about the country’s readiness for a possible health crisis.

This is according to a recent report by SB Morgen Intel, a Lagos-based research and data analytics firm.

According to the report, states’ budgets for health have shown some improvements, moving from an average of 4.65 percent in 2021 to 9.29 percent in 2023. This is however lower than the average 11.80 percent recorded in 2020.

“30 states increased their health budget allocations between 2021 and 2023,” the report stated.

“Cross River leads with an impressive 22.1 percent allocation, followed by Kaduna (15.8%) and Bauchi (15.0%). In stark contrast, Bayelsa (3.4%), Ekiti (2.5%) and Ebonyi (0.5%) have allocated the smallest percentages of their budgets to healthcare,” it added.

The report showed that Bayelsa and Delta stand out as the only states that have consistently increased their health budget percentages both from 2020 to 2021 and from 2021 to 2023.

Despite increasing allocation of health budget across various states, the overall health landscape in Nigeria remains concerning, with states falling below 39 points, indicating failure.

Many states continue to grapple with deepening health challenges exacerbated by inadequate infrastructural improvements and the migration of health professionals.

“This underscores the urgent need for sustained, strategic investments in healthcare infrastructure, human resources and service delivery across all states to enhance Nigeria’s overall health preparedness,” SBM noted.

Lagos leads HPI as northern states lag

Lagos has again emerged as the top-ranking state in the health preparedness index (HPI) having a cumulative 25.09 points as northern states fall behind, SBM said.

Following Lagos closely is Ogun State with 23.23 points, improving from 4th place in 2021 to 2nd in 2023.

But these scores, according to the report, are graded as ‘fail’, raising concerns about the country’s health sector in response to varying health challenges.

“Ekiti made a significant leap from 13th to 3rd place with a score of 23.04. Bayelsa and Ondo round out the top five with scores of 22.99 and 22.86, respectively, moving from 11th to 4th and 2nd to 5th places,” the research and intelligence firm said.

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At the other end of the spectrum, several states in the northern region continue to be plagued with significant health challenges.

Yobe came last in the ranking with 11.83 points, followed by Kebbi, Sokoto, Gombe and Zamfara having 11.93, 12.18, 12.67 and 13.04 points respectively.

In calculating the HPI, SBM Intel used each state’s overall health infrastructure and outcomes. These indicators include health budget per capita, average household size, human development index (HDI), and doctor-to-population ratio.

Others are infant/child mortality rate, life expectancy at birth, and immunisation coverage among children aged 12-23 and 24-35 months.

According to the report, the state’s health budget per capita and the percentage of the total budget allocated to health each carry a weight of 10 points.

The ratio of doctors to patients is given the highest importance, with 30 points, followed by infant mortality at 25 points. Household size is also considered, albeit with a lower weight of 5 points.

Poverty, insecurity straining access to healthcare

Rising levels of poverty, insecurity and conflict continue to strain the already struggling health sector.

The increasing cost of healthcare is limiting people’s access. This is even as Nigerians are battling with rising inflation which is weakening purchasing power.

With 133 million Nigerians multi-dimensionally poor, access to healthcare becomes almost impossible, reducing the states’ health preparedness index.

“Multidimensional poverty, rising inflation, and declining incomes have made healthcare increasingly inaccessible for many Nigerians,” SBM Intel said.

“Conflicts and insecurity in various parts of the country have disrupted healthcare delivery and displaced populations, further straining health resources,” it added.

Exit of pharmaceutical giants stoking drug prices

The recent exodus of pharmaceutical giants like GlaxoSmithKline is pushing the prices of drugs high, slipping them off the reach of many.

Drug manufacturers are closing up due to the harsh business environment in the country as rising energy costs, exchange rate fluctuations and soaring inflation dwindle their incomes.

“Economic hardships have led to the exodus of pharmaceutical companies from Nigeria, resulting in skyrocketing drug prices,” said SBM Intel.

Beyond the exit of multinationals, Nigeria is equally faced with an increasing exodus of health professionals.

More than 16 thousand health workers have left the country in the past five years according to Ali Pate, coordinating minister of health and social welfare.

“The country is experiencing a significant brain drain in the health sector, with medical professionals leaving in droves due to poor working conditions, dilapidated infrastructure and inadequate compensation,” the report stated.