How poor fiscal attention to primary healthcare in Kebbi deprives residents access to healthcare
By Aminu Abubakar
The dire water and sanitation situation in Kebbi State suggests the critical need for a sound and viable Primary Healthcare system.
Budget Allocation and Spending on PHC
According to data from the Kebbi State government, there are over 3.2 million people in the state. In 2024, the total budget allocated to the Primary Healthcare Development Board was N2.927 billion. However, only N955 million was spent throughout the year, which represents just 32.7% of the total approved budget. Notably, N937.7 million of this amount went toward capital expenditure.
The planned capital expenditure for PHC was N2.903 billion, meaning only 32.3% of the capital expenditure budget was executed.
This low execution rate highlights a significant gap between the budgeted and actual funding allocated to improving healthcare in the state.
Inadequate Primary Healthcare Facilities
For context, of the 148 medical facilities listed by the Kogi State Contributory Healthcare Management Agency, only 25 were general hospitals, while the remaining 123 were PHC Centres. This underscores the pivotal role of Primary Healthcare in providing essential health services to Kebbi’s residents. Yet, the funding allocated to these facilities falls far short of what is needed to ensure their effectiveness.
Historical Budget Performance and Fiscal Trends
The inadequate funding for Primary Healthcare in Kebbi is not a new issue. In 2023, the state government allocated N2.1 billion for PHC expenditure, but only N961.7 million (44.7% of the budget) was spent by year-end. Similar to the previous year, a large portion (N937.7 million) of this spending went toward capital expenditure, while the overall performance still remained significantly below the planned budget.
Water, Sanitation, and Health Impacts
The funding gap for PHC becomes even more concerning when considered alongside the state’s serious water and sanitation issues. According to the National Bureau of Statistics, 79% of households in Kebbi lack access to clean drinking water, and 68% lack sanitary facilities. These conditions exacerbate health challenges, making access to a robust healthcare system even more critical for residents.
Reports from communities like Mugadi Koko illustrate the dire need for potable water. Residents risk contracting waterborne diseases from the contaminated water sources they rely on, further highlighting the interlinked challenges of sanitation and healthcare.
Challenges in Healthcare Availability
Additionally, the availability of drugs and basic medical equipment at Primary Healthcare Centres in Kebbi remains alarmingly low. A report indicated that the state was at the bottom among Nigerian states in terms of drug availability, with only 13.7% of drugs available at Primary Health Centres. Basic medical equipment, such as stethoscopes, thermometers, and weighing scales, is also scarce.
Disease Outbreaks and Public Health Risks
This lack of adequate healthcare infrastructure and resources is evident in the frequent outbreaks of diseases like cholera. In November 2024, at least 24 people died in a cholera outbreak affecting 10 local government areas in Kebbi. The Director of Public Health in the State Ministry of Health, Abubakar Bagudu Muhammad, reported 875 cases of cholera, with the highest number of deaths (13) occurring in Suru Local Government Area.
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The cholera outbreak serves as a stark reminder of the importance of effective PHC systems in preventing and managing public health emergencies. The limited fiscal attention to PHC raises serious concerns about the state’s ability to adequately respond to such crises.
The persistent underfunding of Primary Healthcare in Kebbi State, coupled with the dire conditions in water and sanitation, deprives residents of access to essential healthcare services.
If the state is to improve health outcomes for its citizens, it must prioritize proper allocation and execution of funds for Primary Healthcare, along with addressing broader infrastructural and sanitation challenges.
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