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Health Budget Allocation and Performance; and the Budget’s Preparedness for Health Events such as COVID-19: Enugu State Perspective

This is an exploratory study of the health budget allocation and performance of a State against the background of its health indices and preparedness for any public health emergency such as COVID-19. This is aimed to guide future health programming in the state. Three research instruments (Questionnaire, data collection, and interview guides) were used to collect data, key informant interviews with health planners and managers; synthesis of relevant literature reviews to identify relevant documents; and responses gathered from the public and civil servants. The findings identified eight (8) Ministries, Departments, and Agencies (MDA) under the State Ministry of Health, which is the policy-making body that monitors and coordinates/regulates all health activities in the State. The government budget, donor partners, out-of-pocket expenditures, and contributory schemes are sources of funds for Health. The State’s budgetary allocations for health shows an annual increment from reaching 15% in 2016 to 16% in 2017 and over 17% in 2018, surpassing the Abuja Declaration target of 15% of the state budget. In nominal terms, allocation to the health sector fluctuated between 2011 and 2016 and finally went down in 2018. There is no clearly cut-out budgetary provision for emergency preparedness for health events in the State’s health budget. The government has proactively made budgetary provisions for the challenges facing the health care system to facilitate efforts towards addressing them. However, it remains to be seen whether the poor health indices will get better in the long run.