This study focuses on budget credibility in primary health services in the Nigerian states of Oyo and Anambra, and the federal government. Oyo state is in South West Nigeria, with an estimated population of 9.29 million1, and 913 Primary Health Care Centres. Anambra state is in South East Nigeria, with an estimated population of 6.36 million people and 740 Primary Health Care Centres.
Though the drivers of budget credibility on the revenue end of public finance are well documented, this report will focus on budget credibility as it affects revenue and expenditure. They include unrealistic revenue projections in the budget, weak revenue collection mechanisms, revenue leakages, and weak accountability mechanisms.
Summary of key findings:
- To address budget credibility in sectors like primary health and immunization in Nigeria, understanding specific deviations in expenditure is crucial. Different tactics are needed to address deviations between released and budgeted cash, as compared to addressing differences between utilized and released cash.
- Primary health services face significant budget credibility risks related to the Basic Health Care Provision Fund (BHCPF) in all 36 states, but these issues are hard to track. An issue in Anambra is the absence of explicit BHCPF funding in the state’s budget, making it challenging to measure deviations accurately. Policymakers must anticipate and address risks such as inaccessibility to federal BHCPF funds due to eligibility criteria noncompliance, which may involve baseline assessments and capacity building for Primary Health Care Centres.
- In the health sector, weak budget credibility is driven by procedural, regulatory, and political obstacles in Oyo and Anambra states, as well as at the federal level. These bottlenecks result in deviations in procurement for Primary Health Centers (PHCs) and must be addressed individually, as suggested in the report.