Sustaining Funding for Public Health Institutes in Kano State
By Mustapha Salisu Yakubu
Kano State is one of the 36 states of the federation with a projected population of approximately 15,462,200 in 2022. The state comprises of 44 local government areas (LGAs), 484 political wards and 26,732 settlements.
Kano State has over the years grown its health budget in line with an increased prioritization and the need to invest significantly to improve its poor health metrics. After 2017 advocacy by several CSO groups, the state’s health budget rose from single-digit figures and in 2019 and 2020, has exceeded the 15% mark to which several nations (Nigeria) included committed to the Abuja declaration of 2010. Though the target is for the national level, Kano state has taken examples and guidance from this. In fact, the sum of N39.1 billion was allocated to the health sector in the recent 2023 budget of the state.
Also as part of the state’s efforts to effectively prevent, detect and respond to public health threats like Lassa, Covid-19, monkey pox, Diphtheria and frequent outbreaks like measles, cholera etc, it developed the ‘Kano State Action Plan For Health Security (KSAPHS) as a form insurance for the well-being of citizens of Kano state.
However, funding inadequacies in the health sector often hampers disease control and prevention in Nigeria. In the 2023 budget, the Nigerian Government allocated only 5.75% (1.17 trillion) of the national budget to health. This falls short of meeting the African Union’s Commitment of 15% allocation of the total budget allocation to the health sector. In line with this allocation, Nigeria is yet to meet the Abuja Declaration agreement despite being the host country of the pact.
Notably, Public health institutes play a crucial role in maintaining the health and well-being of individuals in Nigeria. These institutes are responsible for monitoring and controlling infectious diseases, preventing and treating chronic diseases, conducting health education and awareness campaigns, and implementing various health programs and interventions. Therefore, these institutions need to be adequately prepared against an epidemic outbreak.
Although there is more to epidemic preparedness and response than money, yet, funding and sustainability remain a root part of the process. As Health financing is a core function of every health system. According to World Health Organization (WHO)
It is on this background, that Kano State Government has consistently continued to implement some significant initiatives that have boosted the state’s primary health care such as the State Health Trust Fund (KHETFUND), the Kano State Contributory Health Care Management Agency (KSCHMA) as well as Drugs and Medical Consumable Supply Agency (DMCSA).
According to the Director of Budget, Kano State Ministry of Planning and Budget, Yakubu Sabiu Garindanga, the initiatives are serving as basket funds to the Ministry of Health for Epidemic preparedness and response. And has contributed greatly to the availability of readily stockpiled commodities for emergency response.
Garidanga disclosed, the Commissioner of Health is the Executive Secretary of the Agencies who authorizes the release of funds in the case of an outbreak/emergency without any matching protocol of seeing the Governor for authorization so as to save lives urgently.
“The Kano State Action Plan For Health Security (KSAPHS) document covers 14 technical areas with detailed plans for each technical area were developed by multi-sectoral working groups in the state to cover the period between 2022/2026. With a total estimated cost of 1.232 billion to implement all planned activities.
The major cost driver in the plan is the Emergency Response Operations with a total cost of 283 million, mainly to develop Public Health Emergency Operation Centre (PHEOC) in all the 44 LGAs of the state, followed by Surveillance and reporting with a total cost of 253 million” he revealed.
While on an assessment visit to some Primary Health Cares in Kano state to measure the extent to which they access and utilize funds for effective preparedness against the epidemic outbreak, this writer arrived at Kabuga PHC, located at Gwale LGA on a Tuesday morning at exactly 9:00 am.
The hospital environment was well stocked with patients and health workers all engaged in the day’s activity. During, an interactive session with the Ward Technical Officer/In-Charge of Kabuga PHC, Yusuf Adamu Muhammad, he disclosed that the KSCHMA and Basic Health Care Provision Funds (a Federal Government Intervention) have contributed to the improvement of facilities settings, supply of drugs, rendering free medical services to the vulnerable etc
He explained that the intervention has collapsed all administrative bottlenecks of accessing funds to prepare and rapidly respond to an outbreak. Additionally that the KSCHMA funds have granted them a license to increase human resources in terms of recruitment as well as establishing and setting up the KSCHMA unit in Kabuga PHC.
According to the IOC, “We design quarterly plans by inviting stakeholders and highlighting to them seasonal diseases that are likely to attack the community and then we map out emergency preparedness strategies and funds needed in case of the outbreak”
Similarly, another stop by this writer was at a PHC in Ja’en, where patients were seen in their numbers trooping into the premises for health care despite the limited space of the PHC.
The IOC Ja’en PHC, Ahmed Adamu Diso, described the KSCHMA funds as a sustainable intervention to most PHCs in Kano state but unfortunately, Ja’en PHC is not in the system. “but all official preparations have been put in place for accreditation to kick start the program.” He also disclosed that they have registered fully for the Basic Health Care Provision Funds but the funds are yet to be disbursed holding to some administrative protocols.
Key takeaways
The research was rich and knowledgeable as recommendations shared by the data sources paved way for the following key takeaways.
- KSCHMA and Basic Health Care Provision Funds have contributed to the improvement of facilities settings, supply of drugs, rendering free medical services to the vulnerable etc. As well as collapsed all administrative bottlenecks of accessing funds to prepare and rapidly respond to an outbreak.
- The Basic Health Care Provision Funds, although, a Federal Government intervention needs to simplify its registration processes for PHCs as well as make its accreditation exercise a speedy one in order to capture all the PHCs in Kano state.
- There is a need to establish and set up an epidemiology unit/department in every PHC in the state for immediate action to control an infectious disease outbreak.
- There is also the need to decongest and expand Ja’en PHC as it attends to about 6000 patients in a month. The IC, Ahmed Adamu Diso, demonstrated a building opposite the PHC which has been offered and reserved for sale to the PHC. Thereby soliciting intervention from the government and relevant stakeholders towards securing the building.
