Recently-elected Nigerian President Umaru Musa Yar' Adua has suspended the construction of 774 healthcare centres throughout his country, drawing questions on how his administration plans to tackle the increasingly dire health care situation in Africa’s most populous nation.

"Whatever the rights or wrongs of the suspension of the contract… the fact remains that Nigeria has in recent years spent less of its budget per capita on healthcare than any other African government,” Ben Foot, programme director for Save the Children in Nigeria said.

According to the Nigerian Ministry of Health, the contracts for the building of one health centre in each of the 774 local council districts, which was drawn up during former President Olusegun Obasanjo’s tenure, was to be funded by direct monthly deductions from local council accounts.

Councils protested the deductions, arguing they were being taken without permission and were therefore unconstitutional. In response, on 6 August Yar'Adua issued a presidential directive to stop the withdrawal of money and simultaneously created a task force to review the completed work that were being carried out by private firms.

The task force, led by representatives from the ministries of health and finance, is to report back to the president by 6 September and a decision will be made as to whether construction of the centres will continue. About 18 billion naira (about US$142.6 million) had been deducted from the monthly allocations of local councils up to 6 August.

Unconstitutional

“The new government believes the policy of taking money from local councils without their approval is unconstitutional, even if it is on seemingly altruistic grounds,” Theodore Ogazieci, chief press secretary for the Ministry of Health in Nigeria told IRIN. “The money belongs to the councils and they should decide what to do with it.”

“On the grassroots level, people were happy about the centres because they would allow improved access to health care. But without due process, the contract lacked the transparency the new government is working towards,” he said. “The task force will work to come up with a solution that is both transparent and gets the health centres built,” he said.

Deteriorating healthcare system

Even so non-governmental organisations remain concerned. Nigeria’s healthcare system has continued to deteriorate in the face of corruption, bad economic policy and political turmoil. Despite great wealth in natural resources, total government expenditure on health in 2004 amounted to only 3.5 percent of the oil rich nation’s federal budget, according to the World Health Organization.

One in five children does not live to the age of five, and life expectancy at birth is just 44. An estimated four million Nigerians are living with HIV/AIDS.

As of 2003, there were only 34,923 doctors for the country’s some 140 million citizens, and large sections of the country still lack even the most basic healthcare facilities. In northern Nigeria, mothers with malnourished children have been crossing the border to look for help in Niger, the poorest country in the world. (See IRIN report)

In 2001, African Union (AU) members met in Abuja, Nigeria, promising to set aside 15 percent of their respective budgets for healthcare costs. To date, only four nations have met this goal, despite the AU having renewed their commitment in May of 2006 at a Special Summit on HIV/AIDS, Tuberculosis and Malaria.

“Save the Children hopes that President Yar' Adua will soon disclose his plan for tackling the appalling state of health services in Nigeria and in particular in the north," said Foot.