Inadequate funding and a shortage of healthcare workers are crippling the healthcare systems in Kaduna and Sokoto States, leaving rural communities in challenging situations, a BudgIT report reveals.
In the State of States Report 2024, BudgIT noted that Kaduna State’s under-five mortality rates exceed the national average.
In Sokoto State, the major challenges in the sector include insufficient health infrastructure and an alarming disparity in healthcare accessibility.
BudgIT, a civic organisation that promotes good governance through accountability, reported that the two northwestern states share in common a myriad of challenges in delivering quality healthcare to their populations in 2023.
WikkiTimes earlier reported that inadequate funding and a dearth of staff in healthcare facilities across Kano and Katsina states are affecting the states’ healthcare systems.
Hitherto, another report showed that five northeastern states, including Adamawa, Borno, Gombe, Taraba, and Yobe, have fallen short of the 15% budget recommendation for healthcare at the subnational levels in their 2023 expenditures.
The performance of healthcare systems, especially primary healthcare, is a critical indicator of state-level governance and development.
Kaduna State
The report shows that the State has an average of 7,170 people per healthcare facility. It noted that 77.39% of its 1,420 health facilities are publicly owned, comprising 1,276 primary healthcare centres (PHCs).
However, the report revealed that under-five mortality remains alarmingly high, at 127 deaths per 1,000 live births, above the national average of 102.
The state allocated N25.84 billion to health in 2023, representing 10.41% of its total expenditure below the suggested Abuja declaration of 15%. Key capital investments included N15.23 billion for a new 300-bed specialist hospital, N4 billion for a nuclear medicine centre, and N2.52 billion for upgrading 255 PHCs.
However, shortage of professional persists undermining quality health service delivery.
The report argued that recruitment and training of healthcare professionals, alongside budgetary increases for maternal and child health, remain critical for improving outcomes.
WikkiTimes review of the state budget performance indicated that Kaduna has not yet improved on its spendings on critical sectors that need more attention.
The state performance on capital expenses remains comparatively low relative to the recurrent spendings.
For instance, the state’s total Recurrent Expenditure within the first six months of 2024 was N71.4, representing 50.8% of the N140,5 billion allocated.
On the other hand, the state spent N110.2 billion on Capital Expenditures within the period, representing just a 34.7% performance against the budgeted N317.7 billion.
In the first two quarters, the personnel expenditure of the state’s Secretary to the State Government (SSG) office was N362.3 million out of the N575.8 million budgeted for the 2024 fiscal year, representing 62.9% implementation.
Sokoto State
Sokoto State faces more acute challenges in primary healthcare than Kaduna State. The state has 837 health facilities, 96% of which are publicly owned. This includes 797 PHCs, with each facility serving an average of 7,367 people – slightly worse than Kaduna’s ratio.
Sokoto allocated N12.32 billion to health in 2023, representing 7.93% of its total expenditure, which is significantly lower than Kaduna State’s allocation.
The report, however, noted that the State had initiated some healthcare projects, including N2 billion for the completion of the Sokoto State University Teaching Hospital and N650.65 million for rehabilitating existing facilities.
However, critical indicators reveal gaps with only 0.4% of men and 0% of women having health insurance coverage, according to the MICS 2021 report, compared to national averages of 2.7% and 2.8%, respectively.
This lack of coverage leaves residents vulnerable to catastrophic health expenses, further expanding health inequities.
The State Q3 2023 budget performance report shows that the Recurrent Expenditure had a 74% implementation while the Capital Expenditure had just a 19% performance.
As of that period, the office of the Sokoto State Secretary to the State Government (SSG) gulped over N1.5 billion representing 45.1%.
Comparative Analysis
While both states grapple with insufficient human resources and inadequate infrastructure, Kaduna appears to have a more robust approach.
Its higher budgetary allocation (10.41% versus 7.93% of total expenditure) and investments in PHCs, hospitals, and specialised facilities show Kaduna has some commitment to improving healthcare outcomes.
Sokoto, on the other hand, lags in several areas, with its capital expenditure on health infrastructure being lower, and its lack of progress on health insurance coverage leaves a significant portion of the population without access to affordable care.
Furthermore, the higher average population per facility in Sokoto indicates more severe accessibility issues compared to Kaduna.
The report also noted that tuberculosis cases surged in both states, but Kaduna’s response, including achieving 78% TB service coverage and a 98.4% treatment success rate, highlights its proactive stance.
Sokoto’s efforts, though notable, remain insufficient to close the gap in accessibility and service delivery.
Babaji Usman Babaji is an investigative journalist with over four years of experience, renowned for his impactful reporting on corruption, human rights violations, and holding those in power accountable in Nigeria.
His career is distinguished by participation in numerous media training programs and conferences, which have honed his investigative and reporting skills. Babaji’s data-driven stories have made a significant impact, particularly in Northern Nigeria, shedding light on critical issues and driving meaningful change.
As a reporter under WikkiTimes’ Collaborative Media (CMEDIA) Project, Babaji has led several groundbreaking investigations. He was a 2022 fellow of the Centre for Journalism Innovation and Development (CJID) and a 2024 Media Foundation for West Africa DPI/DPG fellow. His contributions to accountability journalism earned him a Certificate of Recognition from Xchange Hama Media for impactful community work.
