In December 2020 Dr Osagie Ehanire, the minister of health, held a press briefing to present the country’s health roadmap for 2021. He outlined government measures to fulfil the objectives of the National Strategy Health Development Plan II (NSHDP II) 2018-22, as well as President Muhammadu Buhari’s Health Sector Next Level Agenda (HSNLA), which is a nine-point, medium-term plan launched in 2019 to improve the country’s health services.

The NSHDP II focuses on strengthening the health system as a whole, with a particular emphasis on primary care. The HSNLA seeks to accelerate progress towards UHC, among other initiatives. In particular, the government’s health care agenda aims to implement mandatory universal health insurance across all states; operationalise the Basic Health Care Provision Fund (BHCPF); recruit and deploy around 50,000 community health extension workers; upgrade government teaching hospitals; partner with the private sector to build high-quality hospitals; reduce gaps in the country’s health-related UN Sustainable Development Goals by at least 60%; address the imbalance between primary, secondary and tertiary health care provision; collaborate with the private sector to create attractive job opportunities; and lift some 100m Nigerians out of poverty by 2030.

Looking ahead to 2030, the NPHCDA has outlined an agenda that includes upgrading primary health services; leveraging technology such as telemedicine and drones to improve data management, supply chains and vaccine rollouts; and scaling up efforts to encourage positive behavioural changes that affect health.

To achieve these wide-ranging goals, the federal government allocated 5% of the 2022 budget to health care, or N820.2bn. Of this, N711.3bn was earmarked for the FMH – 4.3% of the entire budget – N54.9bn for vaccine and immunisation programmes, and N54bn for the BHCPF. The 2022 FMH budget is up 29% on the ministry’s 2021 budget of N549.8bn, which itself was 25% more than the revised 2020 budget of N441bn. The FMH’s 29% increase in 2022 compares favourably to the overall budget expenditure increase of 12.5%, and the N194.6bn in earmarked capital expenditure is the highest ever for the sector. However, the country has yet to reach the 15% budget allocation for health targeted by African Union member states under the 2001 Abuja Declaration.

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