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OPINION

Fiscal Strain: Is Underfunding Crippling Nigerian Hospitals?

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By Abujah Racheal

When the Federal Government appropriated N218 billion for health capital projects in 2025, hospitals across Nigeria anticipated long-overdue renovations, diagnostic equipment upgrades, and infrastructure expansion.

However, what the hospitals received instead was N36 million, representing just 0.

0165 per cent utilisation, the lowest capital release performance in Nigeria’s health sector in at least a decade.

For frontline workers at General Hospital, Calabar, Cross River, the consequences are both immediate and visible

The facility, recently upgraded with a redesigned reception, consulting rooms, a pharmacy, and an emergency theatre, is meant to serve as a vital bridge between primary and tertiary care.

Yet, modern infrastructure has not translated into improved service delivery.

In spite of being earmarked for major improvements under the 2025 health capital allocation, the hospital received only a fraction of the expected funds.

Essential equipment remains unused, procurement processes have stalled, and members of staff improvise daily. Across Nigeria, similar stories are unfolding.

Capital Without Cash – Allocation vs Actual Release 2016–2025

An analysis of federal budget data from 2016 to 2025 shows that in 2016, 53 per cent of the N28.7 billion appropriated for health capital was released.

In 2017, the release improved to 65 per cent, while in 2018 and 2019, implementation hovered between 55 and 60 per cent.

In 2020, during the COVID-19 pandemic, utilisation stood at 50 per cent; in 2021, implementation peaked at 70 per cent, with N93.8 billion released from N134 billion appropriated.

Nonetheless, the decline began in 2022, when utilisation dropped to 45 per cent.

In 2023, it fell further to 30 per cent, and in 2024, only 15.06 per cent of the original ₦434.8 billion allocation was released.

By 2025, the system effectively worsened, delivering less than 0.02 per cent of the intended funds.

Experts describe the shift from 70 per cent implementation in 2021 to 0.0165 per cent in 2025 as more than fiscal strain; they say it is a structural breakdown.

Dr Emmanuel Sokpo, Country Director of the Network for Health Equity and Development, raised deeper concerns about transparency.

Sokpo questioned how capital financing sourced from loans, grants, and development partners was reflected in official budget execution records.

He said that without consolidated disclosure of loan-backed infrastructure projects, counterpart funding, and external grants,

Sokpo said it became nearly impossible to assess the true volume of resources entering the health sector.

Observers say the lack of clarity raises difficult questions: Is the low release due to cash-flow constraints? Is debt servicing crowding out capital spending? Are funds being reallocated through virement? Or are administrative bottlenecks stalling disbursement?

As of press time, no detailed public breakdown explained the 2025 shortfall.

Dr Uzodinma Adirieje, Programmes Director of Afrihealth Optonet Association, described the situation as a national development emergency.

Adirieje warned that chronic underinvestment erodes Nigeria’s demographic dividend and weakens national resilience.

Experts say the implications extend beyond infrastructure–Nigeria’s proposed 2026 health allocation of N2.9 trillion represents just 4.98 per cent of the N58.47 trillion national budget, far below the 15 per cent commitment under the 2001 Abuja Declaration.

Meanwhile, out-of-pocket expenditure remains among the highest in Africa, with citizens reportedly paying up to 95 per cent of health costs directly.

In Nasarawa State, Mrs Halima Audu delayed her child’s vaccination after her local Primary Health Centre ran out of vaccines due to procurement delays.

In Bendeghe Ekiem, Cross River, Nurse Anikan Mark said infrastructure expansion projects had halted.

Experts warn that such gaps increase risks of preventable deaths, treatment delays, and catastrophic household spending.

The Health Sector Reform Coalition Nigeria called for a legislative investigation into the 2025 capital release.

Its chairman, Dr Mohammed Lecky, described the near-total non-release as “one of the most alarming failures in recent health governance history.”

A health economist, Dr Abigail Banji, advocated for legally binding cash-backed budgeting, ring-fenced capital funds, milestone-based releases, and independent audits.

Predictable funding, Banji said it was critical not only for healthcare delivery but for national productivity and security.

While Nigeria struggles with execution, Rwanda and South Africa have demonstrated consistent fiscal discipline in meeting the Abuja benchmark.

Dr Emmanuel Agogo noted that allocating funds on paper was insufficient.

Without disciplined implementation, infrastructure investments risk remaining symbolic.

From 70 per cent implementation in 2021 to 0.0165 per cent four years later, Nigeria’s health capital financing has entered uncharted territory.

Stakeholders warn that unless transparency improves, fiscal discipline strengthens, and cash-backed budgeting becomes mandatory, capital allocations may continue to exist only on paper.

And in hospitals like Calabar’s General Hospital, where equipment sits idle and patients are asked to supply basic materials, the cost of “capital without cash” is paid daily, in delayed care, financial hardship, and diminished trust in the system.

Dr Aminu Magashi, Coordinator of the African Health Budget Network (AHBN) and a health economist, proposed reforms to stabilise Nigeria’s health financing.

Magashi called for cash-backed budgeting and ring-fenced capital funds, including allocations for the Basic Healthcare Provision Fund, vaccine procurement, essential life-saving drugs and commodities, alongside performance-linked releases to ensure that funds were available and tied to project milestones.

He emphasised integrated fiscal governance and transparency measures, including clear disclosure of loans, grants, and counterpart funding, complemented by regular budget-tracking meetings.

He also recommended donor alignment, treating health allocations as first-line charges, and mobilising domestic revenue, such as allocating at least 50 per cent of sin-tax proceeds to healthcare.

Magashi argued that the aforementioned steps would establish a predictable, transparent, and resilient system capable of supporting infrastructure, service delivery, and broader national development.

By the foregoing, it has become imperative for the National Assembly, fiscal authorities, and health policymakers to urgently enforce cash-backed budgeting, guarantee transparent capital releases, and ring-fence funds for infrastructure, vaccines, and essential life-saving commodities.

Ultimately, health advocates warn that without immediate reform, Nigeria’s health budget will remain a promise on paper, and citizens will continue to pay the price in care delayed, costs transferred, and trust eroded. (NAN)

OPINION

Osun Election: Will Nigeria’s Political Class Learn?

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As Nigeria gradually enters the political season ahead of the 2027 general elections, there is a growing temptation among politicians to return to the familiar playbook: aggressive campaigns, endless promises, political propaganda, ethnic calculations, religious sentiments and the mobilisation of money and machinery.

But if the political class is paying attention, the recent Osun election should offer a sobering lesson.

Elections are no longer simply contests between political parties or exercises in political arithmetic. They are increasingly becoming referendums on performance, credibility, organisation and the relationship between politicians and the people.

The Osun experience should therefore be more than another election victory or defeat to be celebrated by one camp and rationalised by another. It should be a warning to every politician preparing for 2027.

The first lesson is that the people are watching.

For too long, Nigerian politicians have behaved as though voters can be permanently manipulated with slogans, inducements and election-day theatrics. But voters are becoming more discerning. They may still respond to material incentives, but they also remember who governed well, who failed, who showed up and who disappeared after collecting their votes.

The second lesson is that political structures cannot replace public trust.

A party may possess powerful godfathers, influential leaders, vast resources and impressive campaign machinery, but these cannot indefinitely compensate for a credibility deficit. Political structures are important, but they work best when they are reinforced by genuine voter confidence.

The third lesson is that incumbency is not an automatic guarantee of victory.

Those who occupy political offices must understand that public office comes with a political bill that eventually falls due. Roads, schools, healthcare, jobs, security, salaries, infrastructure and the general welfare of citizens are not merely governance issues; they increasingly shape electoral decisions.

The politician who assumes that occupying government gives him an irreversible advantage may discover, rather painfully, that voters have the final word.

There is also a lesson for opposition parties. Winning elections requires more than criticising the government. Nigerians are increasingly interested in alternatives. Opposition parties must articulate credible programmes, build strong grassroots structures and demonstrate that they have the competence and discipline required to govern.

Perhaps the most important lesson is that 2027 cannot be approached as politics as usual.

Nigeria is facing an electorate that is younger, more digitally connected and increasingly vocal. Social media has changed political communication. Citizens can challenge official narratives in real time. Political mistakes can become national conversations within minutes. Candidates can no longer depend entirely on traditional campaign rallies and carefully managed media appearances.

The political class must also recognise that Nigerians are tired of being treated as statistics during elections and forgotten citizens afterwards.

The road to 2027 will undoubtedly produce the usual alliances, defections, endorsements and political realignments. There will be new coalitions and old rivalries. There will be attempts to weaponise identity, manipulate emotions and redefine political narratives.

But the real question is whether politicians will learn from Osun.

Will they understand that voters deserve respect? Will they realise that performance matters? Will political parties begin to prioritise competence over loyalty? Will candidates campaign on ideas rather than insults? Will politicians understand that democracy is not simply about winning elections but earning the legitimacy to govern?

These are the questions the Osun election should force the political class to confront.

The 2027 election is approaching. The campaign season may only be beginning, but the lessons have already arrived.

The politicians who choose to ignore them may do so at their own peril.

Nigeria’s voters are watching. And this time, they may be keeping a much longer memory.

Kokome, a communications strategist and public affairs analyst, writes from Lagos via kokomejohn@yahoo.com

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OPINION

Two Hundred Days in Power: Some Lessons to Learn From General Murtala Mohammed

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By John Chibuzo Emmanuel

The realm of Nigerian politics today is a chessboard where our bones and dripping blood are recklessly tossed from one end to another. This is why one of the most quoted phrases in the history of our nation is “politics is a dirty game.

” Well, from the days of Azikiwe right to the days of Asiwaju, from Balewa to Buhari, from Gowon to Goodluck, from Obafemi to Obasanjo, corruption scandals have never ceased to dominate our headlines.

Achebe summed it all up when he lamented: “The trouble with Nigeria is simply and squarely a failure of leadership.

There is nothing basically wrong with the Nigerian character. There is nothing wrong with the Nigerian land or climate or water or air or anything else. The Nigerian problem is the unwillingness or inability of its leaders to rise to the responsibility, to the challenge of personal example which are the hallmarks of true leadership” (Achebe 1).

And in these trying times of ours, when the blood of our children flow in the thick green forest, when the cries of our raped mothers do nothing but chase away the watching birds that perch on the tall trees, when the screams of our brave soldiers that echo in the forests serve as their untimely and only goodbye; we must remember General Murtala Muhammad. In this era when inhumanity has replaced our sense of religion and empathy, we must not forget a man who truly loved, lived and died for Nigeria. We must not forget the bravest and most fearless leader to have walked the brown earth of this barren land endowed with the greatest mineral deposits. Do not laugh at this paralyzing but profound and truthful paradox.

It is indeed a national tragedy that the most distinguished and excellent individuals in our short history have either been relegated to the background of oblivion, persecuted by the majority, or slaughtered on the altar of envy. It is a national tragedy that our school children know nothing of their history or heroes. It is even a greater tragedy that they are being robbed of noticeable examples of distinguished leadership from our history. The painful consequence of this is that we have come to accept stupidity and ideological bankruptcy in politics as our national guiding principles.

Mothers in the marketplace, children in malpractice-ridden schools, students in dilapidated institutions, brave soldiers dying in the thick enclaves of Sambisa, intellectuals tired from years of doing battle with the federal and state governments, do not forget General Murtala Muhammad. Do not forget General Murtala for he is a reminder of all we can achieve if we eradicate the different manifestations of corruption unique to our lives.

General Murtala was born on November 8, 1938, and became one of the youngest generals throughout the history of Nigeria. At the age of thirty-six he took over the reins of government from General Yakubu Gowon on July 29, 1975, through a bloodless coup d’etat, and ruled the country for just two hundred days before he was assassinated by Lieutenant Colonel Bukar Suka Dimka on February 13, 1976.

However, in his two hundred days of power, he implemented some of the most impactful and iconoclastic social and economic reforms ever seen in the history of this country. In his two hundred days of power, he sacked more than ten thousand corrupt and incompetent civil servants. In his two hundred days of power, he conceived and began implementing a vision of a central capital city other than Lagos. This city is now known as the city of Abuja.

In his two hundred days in power, he championed African Liberation Movements throughout Africa as well as opposed apartheid and neo-colonialism virulently. In his two hundred days of power he did what even democratically elected leaders have always hesitated to attempt: decentralization of the national executive. He decentralized his executive powers into a military triumvirate consisting of himself, Olusegun Obasanjo and Theophilus Danjuma.

In his two hundred days in power, the University of Jos—my alma matter—became a degree awarding institution. In his two hundred days of power he set Nigeria on the path of democracy before his tragic and untimely end. In his two hundred days in power he taught Nigerians the definition of true leadership.

No wonder Achebe once popularly wrote: “On the morning after Murtala Muhammed seized power in July 1975, public servants in Lagos were found “on seat” at seven thirty in the morning. Even the “go-slow” traffic that had defeated every solution and defied every regime vanished overnight from the streets.” How can one man wield such a positive influence in our national culture?

General Murtala Muhammed never allowed his ideas to rot in the bureaucratic files of government “experts”. For this, his signature phrase “with immediate effect” has become one of the most used and sadly, abused phrases by Nigerian politicians.

Do you know that the expression “fellow Nigerians” which has been bastardized by Nigerian leaders today was a term he coined and used to address ordinary Nigerians on the street whom he truly cared for? Do you know that upon his ascension to power he cut down the heavy security and military convoys that have come to characterize modern Nigerian politics? Do you know that in his two hundred days of power corrupt military officers and even military governors faced the wrath of the law just like every other Nigerian citizen on the streets? Do you know that all this was achieved by a man of just thirty-seven years?

If we forget Murtala Muhammad, we forget the dream of the poor hawker on the street, the prayer of the sun bathed keke driver, the hope of the unemployed graduate on the verge of suicide, or the resilience of the Northern girl child in her quest for education. If we forget Murtala Muhammad, we forget the Nigerian dream. The dream of living a peaceful and happy life.

On this historic day, we must remember General Murtala Muhammed and all he stood for so that we can eternally realize and regret the depth of our profound ignorance if we make a mistake on the 2027 ballot box. We cannot afford to make a mistake in the ballot box unless we want to eternalize the pain and tragedy of our lives. Vote for the future; our future, next year. Thank you for listening.

John Chibuzo is a Nigerian writer, literary critic, educator and multi-instrumentalist based in Jos city. His poetry and essays have been published in The National Scholar, Lolwe, Beyond the Pages, Nestle on the Rock and the anthology: Letters to the Union We Hope to Become. He co-founded The Excellent Magazine in 2024 and served as it’s first editor-in-chief. He studied English and Literature at the University of Jos.

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OPINION

Urgent Need to Tackle Public Infrastructure Theft in Nigeria

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By Tochukwu Jimo Obi

The rate at which public infrastructure is being vandalised and stolen across Nigeria, particularly in the Federal Capital Territory, Abuja, has reached an alarming level that can no longer be ignored.

What was once regarded as isolated acts of petty criminality has gradually become a serious threat to public safety, government investment and the effective functioning of cities.
Across Abuja, the brazen removal of public infrastructure has become so widespread that urgent and coordinated action is now required.

One of the most disturbing examples is the widespread theft of manhole covers.

In several parts of Abuja, open manholes have become a common sight following the removal of their metal covers by vandals. This poses a serious danger to pedestrians, motorists and other road users, particularly at night. Beyond the immediate safety risks, the theft of these covers demonstrates the extent to which public property is being systematically stripped for the purpose of making quick money.

The problem, however, goes far beyond manhole covers. Bridge rails, railway tracks, underground cables, solar street lights, electrical installations and other public facilities have also become targets. Infrastructure installed with taxpayers’ money is being dismantled and carted away, often with little or no resistance. The consequence is that facilities designed to improve public safety, transportation, security and the quality of life of citizens are being destroyed by individuals motivated by short term financial gains.

A major destination for these stolen materials is the network of makeshift scrap markets popularly referred to as “pantaker markets” in Abuja and its environs. These markets provide an avenue through which stolen public infrastructure can allegedly be disposed of with relative ease. The existence and continued operation of such markets should therefore be treated not merely as a commercial issue, but as a security and public infrastructure concern requiring the attention of relevant authorities.

Even more troubling is the role of those who purchase these materials. It is difficult to accept that buyers of manhole covers, cables, bridge components, railway materials and other government infrastructure would always be unaware of their origins. Where such materials are offered for sale under suspicious circumstances, buyers should be expected to exercise due diligence. Anyone who knowingly purchases stolen public property is not merely engaging in commerce; such a person is helping to sustain the criminal network responsible for the theft.

It is therefore worrying that successive administrations in Abuja have not appeared to give this problem the level of attention it deserves. Government agencies responsible for infrastructure, environmental enforcement and public safety must work closely with the police, civil defence authorities and other relevant security agencies to identify and raid locations where stolen public infrastructure is being traded. Such operations should not be limited to the arrest of street level vandals. Dealers, middlemen and buyers who knowingly participate in the illegal trade must also face investigation and prosecution.

The economic cost of this criminality is enormous. Every manhole cover, street light, cable, bridge rail or railway component stolen from public infrastructure must eventually be replaced. Money that could have been used to construct new roads, improve healthcare, provide schools, expand public transportation or address other pressing social needs is instead spent repeatedly replacing facilities that have already been provided. This creates a vicious cycle in which the government invests in infrastructure, criminals destroy it, and taxpayers are forced to finance its replacement.

There is also a broader question of public responsibility. Citizens should not remain passive when they witness the destruction or suspicious sale of public property. Communities have an important role to play in reporting vandals and suspicious dealers to the appropriate authorities. Government, on its part, must create effective reporting mechanisms and ensure that information supplied by citizens is acted upon. Enforcement will be difficult if citizens look the other way while stolen public property is openly traded in their communities.

The Federal Government, states and the FCT Administration and security agencies must therefore treat public infrastructure theft as a serious national security and economic issue. There should be a sustained crackdown on vandalism, proper regulation of scrap markets, effective monitoring of critical infrastructure and swift prosecution of those found culpable. Most importantly, enforcement must be consistent rather than occasional, because criminal networks quickly return whenever they discover that government attention has waned. Nigeria cannot afford to continue losing scarce public resources to vandals while millions of citizens struggle with inadequate infrastructure. The time to act decisively is now.

Tochukwu Jimo Obi, a concerned Nigerian writes from Obosi Anambra state.

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