Nigeria’s healthcare system continues to struggle, and poor public finance management is a major contributor. Misallocated resources, opaque budgeting, and lack of accountability have crippled the sector, leaving millions without access to quality care, according to a new report.
The report, titled “Public Finance Management & Health,” launched recently in Lagos by the Simon Health Initiative, called on the government to prioritize transparency and accountability in budgetary processes to achieve positive healthcare outcomes.
Citing examples from the West, the report noted that effective monitoring practices enhance efficiency and ensure resources reach targeted beneficiaries.
Healthcare reforms, according to the report, should prioritize evidence-based planning and strategic resource allocation. It also emphasized boosting institutional capacity to curb corruption and drive efficiency.
This involves spending on training, technology, and systems that will increase fiscal discipline and operational efficiency, the report said.
“The presence of strong institutions is critical in having accountability and ensuring that the budgetary decisions are made based on the developmental priorities and not the political interests,” the report said.
The report recommends that all levels of government adopt participatory budgeting, engaging citizens directly in decision-making processes.
“Civic participation also promotes transparency, and it also makes sure that the budgets are based on the actual needs of communities.”
“Engagement of citizens in budgetary processes will restore confidence of citizens in government institutions and enhance democratic accountability.”
The report also called for collaboration and information sharing, stating that both play a vital role in dealing with budget failures.
Speaking at the report launch, Iyanuoluwa Bolarinwa, founder of Simon Health Initiative, said public finance management impacts health in various ways, such as the level of investment in health infrastructure, the health remuneration budget, the health workforce, and the disbursement of funds to healthcare projects across the country.
Bolarinwa stated that the report findings showed that the sector recorded low budgetary expenditure across the country, creating both fiscal and delivery gaps.
He noted that poorly funded health systems are only able to offer minimal services, which results in a rise in morbidity and mortality.
“In 2025, the government of Nigeria budgeted the sum of N218 billion; only N36 billion was disbursed. This is around N0.0008 for all Nigerian citizens,” he said, adding that the country now has the highest maternal mortality rates in the world and one of the worst life expectancies at 54.9 years.
“In Africa, rural societies frequently have to endure the consequences of a poorly funded health sector.”
