Public health financing, environmental quality, and the quality of life in Nigeria

• Author: Solomon Nathaniel,Syed Khan
• DOI: http://doi.org/10.1002/pa.2103
• Published date: 01 August 2020
• Date: 01 August 2020

ACADEMIC PAPER

Public health financing, environmental quality, and the quality

of life in Nigeria

Solomon Nathaniel

1

|Syed Khan

2

1

Department of Economics, University of

Lagos, Akoka, Nigeria

2

School of Economics and Management,

Tsinghua University, Beijing, China

Correspondence

Solomon Nathaniel, University of Lagos,

Akoka, Nigeria.

Email: nathaniel_solomon21@yahoo.com

This study explores the relationship between health financing, environmental quality,

and the quality of life in Nigeria. The Bayer and Hanck cointegration test affirms

cointegration. Findings further reveal that CO

2

emissions have no meaningful impact

on life expectancy in the short run. In the long run, urbanization significantly deterio-

rates the quality of life. Also, public health expenditure has not contributed meaning-

fully to the quality of life. The study discovers no evidence of a feedback causality,

but a one-way causality flowing from urbanization to CO

2

emissions. Policies that

can enhance a sustainable environment and improve the quality of life are discussed.

1|INTRODUCTION

Health is far beyond the mere absence of sickness (WHO, 2015).

Health is an important end in itself. Poor health reduces an individual's

capacity to perform and deliver effectively and efficiently in both the

social and productive sectors of the economy. An improvement in

health status enhances human capital development (Bloom, Canning, &

Sevilla, 2005; Lichtenberg, 2011). Improving health service delivery is

required for efficient human capital development. More investment in

health services could enhance life expectancy and reduce infant mor-

tality. For these to be achieved, individuals must have access to health

facilities, there must be an improvement in environmental quality and

a tangible increase in public health expenditure (PHE, hereafter).

Health has a tendency to promote economic growth. Studies like

(Akran, 2009; Bakare & Olubokun, 2011; Baldacci, 2004; Bedir, 2016;

Dauda, 2011; David, David, & Jaypee, 2004; Kurt, 2015; Mehrara &

Musai, 2011; Odior, 2011; Odubunmi, Saka, & Oke, 2012; Ogundipe &

Lawal, 2011; Onisanwa, 2014; Rivera & Currais, 2003; Scheffler,

2004) discovered that an investment in health, in terms of PHE,

improves economic growth. These studies affirmed that, for growth

to persist, the government needs to increase its expenditure on

health.

The Nigerian government allocation to health expenditure over

theyearshaswitnessedafluctuatingtrend.ItwasN7.3 million

in 1970, but reduced to N4.88million in 1972. In 1982, it was

N79.2 million but decline to N17.2million in 1987. It significantly

increasedto N297.96 millionin1988.Thiscolossalincreasecould

be attributed to the outbreak of endemic diseases like the HIV virus.

The value dwindled to N137.3million in 1991. By 1992, it has

reducedby75%toN33.72 million.ItwasN586.2 millionin1993,

N17, 717.42 millionin 2003,N33,396.97 million in2005, andN34,

647.9 million, N64, 922.9 million, and N79, 321.09 million in 2007,

2008, and 2011, respectively (CBN, 2018). Figure 1 shows the trends

of PHE and CO

2

emissions in Nigeria.

In 2015, Nigeria allocated 5.7% of its total budget to health

expenditure. But in 2016, PHE accounted for 4.1% of its total budget.

This represents a far cry from what other African countries allocated

to health expenditure in 2016. Rwanda allocated 18% of its total bud-

get to health expenditure in 2016, while Botswana, Malawi, Zambia,

and Burkina Faso allocated 17.8, 17.1, 16.4, and 15.85%, respectively.

The value slightly increased by 0.7–4.17% in 2017. In 2018,

N340.456 billion which represents 3.9% ofthe total budget was allo-

cated to health expenditure. The WHO during the Bamako initiative

instructed countries of the world that their health care expenditure to

GDP should be up to 15%. Income inequality, low life expectancy, and

high level of poverty are as a result of poor budgetary allocation to

the health sector. The WHO (2005), attributed about 50% of growth

differentials between developing and developed nations to low life

expectancy and ill-health.

The Nigerian government is still unable to proffer lasting solu-

tions to some health challenges, like malnutrition, high maternal

mortality rate, polio, yellow fever, malaria, and poor health emer-

gency responses, among others. The country health records are

among the worst in the world. According to the World Fact Book in

2017, the number of deaths of infants before their first birthday in

Nigeria is still veryhigh compared to its counterparts in Africa. In

Received: 14 October 2019Revised: 22 December 2019Accepted: 24 February 2020

DOI: 10.1002/pa.2103

J Public Affairs. 2020;20:e2103.wileyonlinelibrary.com/journal/pa© 2020 John Wiley & Sons, Ltd1of9

https://doi.org/10.1002/pa.2103