By Abujah Racheal
Abuja, Dec. 20, 2025 (NAN) – Health sector stakeholders and financial analysts are sounding the alarm over a massive and potentially debilitating funding shortfall for Universal Health Coverage (UHC) in Nigeria, despite a proposed N2.48 trillion allocation to the sector in the 2026 budget. Their warning underscores a persistent crisis: Nigeria continues to allocate health funds at a fraction of its continental commitment, directly jeopardizing the health of its most vulnerable citizens.
The experts, who spoke with the News Agency of Nigeria (NAN) in Abuja, were reacting to the N58.18 trillion “Budget of Consolidation, Renewed Resilience and Shared Prosperity” presented by President Bola Tinubu. While the nominal figure for health appears substantial, they highlighted that it represents a decline in priority within the overall national spending plan.
The Abuja Declaration Gap: A Promise Unfulfilled
The core of the experts’ concern is Nigeria’s consistent failure to meet the 15% benchmark for health spending agreed upon by African Union countries in the 2001 Abuja Declaration. This was not a casual target but a recognition that robust health investment is foundational for economic stability and growth.
The math is stark: 15% of the N58.18 trillion total budget would equate to approximately ₦8.73 trillion for health. The proposed N2.48 trillion allocation, therefore, leaves a yawning funding gap of roughly ₦6.25 trillion. This gap isn’t just a number on a page; it translates directly into missing infrastructure, unpaid health workers, stock-outs of essential medicines, and unattained health goals.
“When we speak of a funding gap, we are speaking of lives,” explained one analyst. “That ₦6.25 trillion could fund the construction and staffing of thousands of primary healthcare centers, provide free maternal care for millions of women, or vaccinate an entire generation of children. Its absence has a human cost.”
Beyond the Headline: A Shrinking Share in a Growing Budget
A critical nuance often missed is that while the health budget has grown in absolute Naira terms—from ₦550 billion in 2021 to ₦2.48 trillion in 2025 and proposed for 2026—its share of the total federal budget has stagnated between 4% and 5%. In an era of high inflation and population growth, this effectively represents a cut in real-term, per-capita health spending. The sector’s needs are expanding, but its slice of the national pie is not.
Systemic Reforms Hamstrung by Inadequate Funding
Nigeria has enacted visionary policies to achieve UHC, but experts warn they are being undermined by the overall funding environment.
- The Basic Health Care Provision Fund (BHCPF): Anchored in the National Health Act (2014), the BHCPF is designed to provide sustainable financing for primary healthcare, targeting women, children, and vulnerable groups. It is funded by at least 1% of the Consolidated Revenue Fund. However, Dr. Ibrahim Musa, a health policy analyst, notes, “The BHCPF cannot function optimally in isolation. When total health spending is low, releases become unpredictable, and states struggle to provide their counterpart funding. Primary healthcare facilities, where most maternal and child services are delivered, bear the brunt.” Services like antenatal care, immunisation, and emergency obstetric care suffer first.
- The National Health Insurance Authority (NHIA) Act: This law makes health insurance mandatory, a major step towards UHC. Yet, its success hinges on public funding to subsidize coverage for the poor and informal sector. Mrs. Maimuna Abdullahi, a Health Economist with the Africa Health Budget Network, stated, “Mandatory health insurance is a major step forward, but without sufficient public funding, many states will struggle to enrol vulnerable groups. UHC will remain elusive if insurance is out of reach for the poorest households.” Inadequate investment here sustains high out-of-pocket spending, pushing families into poverty when illness strikes.
The Human Impact: Maternal and Child Health in the Crosshairs
Experts unanimously agree that the implications of this underfunding will be felt most acutely in Nigeria’s troubling maternal and child health outcomes. Nigeria accounts for a disproportionate share of global maternal and under-five deaths.
“Maternal and child health indicators are highly sensitive to funding,” said public health economist Dr. Amina Lawal. “Without increased investment in primary healthcare, skilled health workers, medicines, and referral systems, progress will remain slow.”
Maternal health advocate Mrs. Grace Okonkwo put it in stark terms: “Pregnant women and children are often the first to suffer when health facilities are under-resourced. You cannot achieve UHC if the primary healthcare system, which is their first and often only point of contact, remains starved of funds. Investment in maternal and child health is not an expense; it is an investment in national productivity and development.”
The Path Forward: Beyond Budget Announcements
The 2026 budget proposal identifies health as a priority sector. The challenge now is to translate that rhetorical priority into fiscal reality. Stakeholders urge the National Assembly to critically review the allocation and consider:
- Increasing the health sector allocation towards the Abuja Declaration target.
- Ensuring timely and full release of approved funds, including the statutory 1% CRF for the BHCPF.
- Strengthening budgetary oversight to ensure funds are efficiently utilized and reach the frontline facilities where they are needed most.
The consensus is clear: closing the ₦6.25 trillion funding gap is not merely an accounting exercise but a fundamental requirement for saving lives, securing Nigeria’s human capital, and building a foundation for shared prosperity. (NAN) (www.nannews.ng)
AIR/DCO
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Edited by Deborah Coker
