Budget Accountability for Maternal health

It was interesting getting the reactions of maternal and child health advocates at the meeting convened by ActionAid to discuss budgetary allocation to Integrated maternal and child health (IMNCH) in the 2014 Appropriation Act for Health. It turned out that participants were shocked at the amounts allocated to issues considered germane to mitigating the impact of maternal and child mortality in Nigeria.

For instance the National Primary health Care Development Agency (NPHCDA) which received an allocation of N17billion for capital projects introduced over 150 new constituency projects that would cost not less than N7billion. Constituency projects are primarily construction of primary health centres. Not only were the projects irregularly distributed across the country but the focus was more on constructing facilities rather than provision of services. As a budget advocate I am worried by the fact that this magnitude of projects would be introduced in one fiscal year. 

Having being involved in the pre enacted budget proposal advocacy I was excited to see NPHCDA’s proposed total budget of  N11billion increased to N19bn, but became very disappointed when I discovered that over 7bn would be channelled to constituency projects.

MCH Budget Accountability Stakeholders meeting

I am wary about constituency projects because these are projects within the purview of the politicians and as a representative of the agency commented during the meeting, these constituency projects defies the developmental plan which the agency set out to accomplish. For instance some of these constituency projects would be cited in Local government areas or wards that already have those facilities ideally this should not be, but because the political leader want to score points with the people they will take projects to areas that already have them.  The analysis further revealed how imbalanced project distributions were with Delta state having 38 projects and Osun and Yobe left with none.

Routine immunization was allocated N2.1b for a population of about 26million children between 0-5 years, this leaves one wondering whether our budgeting and planning actually reflects demographic information.

The full analysis can be downloaded here   https://docs.google.com/presentation/d/1VRSyzRAgiZwciFaT7S3J8ZYoNz-joE38u4L9wVnqBEg/edit?usp=sharing