Nigeria records 42% health budget performance amid partial disbursements – BudgIT
Nigeria’s health sector has recorded a 345 percent increase in budgetary allocations over the past five years, yet capital expenditure utilisation has not exceeded 40.7 percent, contributing to poor health outcomes, according to BudgIT’s 2026 report on health financing.
Nigeria’s health sector has recorded a 345 percent increase in budgetary allocations over the past five years, yet capital expenditure utilisation has not exceeded 40.7 percent, contributing to poor health outcomes, according to BudgIT’s 2026 report on health financing.
The report noted that federal health allocations rose nominally from N635.53 billion in 2021 to N2.83 trillion in 2025, a 345 percent increase , signalling the government’s intention to expand healthcare coverage through increased funding.
However, the utilisation rate for capital expenditure fell short as it stood at 40.7 percent between 2021 and 2025, underscoring persistent inefficiencies in budget implementation.
In 2021, for instance, only N90 billion was released out of the N134.59 billion budgeted for capital expenditure, while just N54.76 billion was ultimately utilised, representing 40.7 percent of the approved budget, the report stated.
In 2022, N123.77 billion (59.7 percent) of the N207.39 billion budgeted for capital projects was released, but only N74.23 billion (35.8 percent) was utilised.
The utilisation rate dropped further to 27 percent in 2023 before rising slightly to 36.38 percent in 2024 for capital expenditure, according to BudgIT.
More recently, Ali Pate, the coordinating minister of health and social welfare, sparked public concern after revealing that only N36 million was reportedly released out of the N218 billion appropriated for capital projects for the Federal Ministry of Health headquarters in 2025.
Although clarifications were later issued, the statement triggered widespread reactions, with many Nigerians questioning the transparency and credibility of health expenditure in Nigeria.“Due to delays or partial disbursement, funds earmarked for infrastructure, equipment, or workforce expansion were not fully utilized in the approved health budgets, creating a disparity between planned and actual spending,” BudgIT stated in the report.
“Budget allocations were not consistently tied to measurable performance indicators, therefore, spending did not always translate into measurable service delivery improvements despite increased funding,” the report added.
The report warned that these gaps have contributed to deteriorating healthcare infrastructure, a high disease burden, maternal mortality and under-five child mortality, brain drain, poorly equipped facilities, and rising treatment costs, as citizens continue to rely heavily on out-of-pocket spending, which exceeds 70 percent of total health expenditure.
Despite increased funding, Nigeria’s health sector continues to grapple with post-pandemic recovery challenges, currency devaluation, rising inflation, and a global shift toward reduced aid. As a result, the mechanisms for healthcare financing are now under scrutiny by analysts.
Capital utilisation bottlenecksThe lack of financial accountability, fragmented financial flows, weak linkages between financing and results, citizen exclusion, and legislative oversight gaps were some of the major hindrances to better health outcomes in Nigeria.
“Financial inefficiencies reduce the impact of scarce resources, leaving health facilities underfunded and citizens exposed to high out-of-pocket costs,” BudgIT noted.“Communities and civil society have limited opportunities to participate in budget processes or hold leaders accountable for health financing decisions,” the report stated.
While the legislature has a role in approving budgets, weak oversight and enforcement mechanisms mean that deviations from approved allocations go unchecked.A combination of all these challenges continues to lead to several health inefficiencies in Nigeria.
25 years laterIn 2001, African Union member states, including Nigeria, committed under the Abuja declaration to allocate at least 15 percent of their national budgets to strengthening healthcare systems.
In response to these challenges, the federal government introduced reforms to strengthen and stabilise health financing.Central to this is the Nigeria Health Sector Renewal Investment Initiative (NHSRII), which has mobilised over $3 billion to upgrade primary healthcare and expand insurance coverage.The initiative adopts a Sector-Wide Approach (SWAp), aligning the government and partners under “one plan, one budget, and one report.”
The Basic Health Care Provision Fund (BHCPF) remains the backbone of these efforts, supporting over 8,000 primary health centres, with plans to scale to 13,000. Meanwhile, N515.02 billion has been proposed for tertiary institutions in 2026, including cancer equipment for teaching hospitals and regional mother-and-child centres. While necessary, these investments must be balanced with increased funding for primary healthcare, which serves most Nigerians.
What’s the way forward?Improved transparency, healthcare accountability, increased funding, legislative oversight and proper utilization of funds were necessary steps to improve better healthcare outcomes in Nigeria.Budget allocations must be tied to certain performance indicators to ensure effective utilization of funds according to BudgIT.
