Identifying Innovative Approaches to Increase Domestic Resource Mobilization and Financing Contributions for Family Planning in Nigeria

Identifying Innovative Approaches to Increase Domestic Resource Mobilization and Financing Contributions for Family Planning in Nigeria
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Abstract: Background: Improving domestic resource mobilization (DRM) for family planning (FP) can contribute to improving and sustaining maternal health outcomes, especially in such places as Ebonyi State, Nigeria, which has one of the highest unmet needs for FP in the country. This study explored the prospects for increasing government spending on FP in the short-to-medium term in view of the well-defined needs for improved FP service delivery and stocks of contraceptive commodities.

Methods: A fiscal space assessment was conducted in Ebonyi State. We applied the Roadmap for Assessing Fiscal Space for Health (Tandon & Cashin, 2010) to identify the need for additional funding for FP services in Ebonyi State and assessed the potential and feasibility of increasing funding for FP through DRM. Data collection entailed a document review and two key informant interviews. We performed descriptive trend analysis of financial data to determine change over time and to make assumptions (of increases or declines in the fiscal space) for the short-to-medium term (2016–2020). For the qualitative data, we performed a manual thematic analysis then triangulated the narratives with the quantitative data.

Findings: Statutory allocation constituted a considerably high proportion of the total revenue in Ebonyi State but there has been a downward trend since 2018. With the exclusion of the 2020 budget, the budgetary allocation to health in the past five years has been very poor, ranging from 2.7 percent to 3.2 percent, which is far less than the Abuja Declaration recommendation of 15 percent. The main sources of funding for FP in the past five years were the federal government’s earmarked funds under the Saving One Million Lives Program for Results and donor contributions, specifically from the United Nations Fund for Population Activities. Although budgetary allocations for FP were made in the state government’s budget in the past five years (2016–2020), releases were only made in 2016 and 2017, albeit very paltry sums. Therefore, in the past three years, FP services have been funded from external sources.

Conclusion: The fiscal space for FP services and contraceptives is very poor in Ebonyi State. It could be improved if the state government honors its commitment to allocate 15 percent of its budget to the health sector and if a proportion of the Basic Health Care Provision Fund is earmarked for FP services.
Shortname: wp-22-253-d4i
Author(s): Chinyere Mbachu, Ifunanya Agu, Chinazom Ekwueme, Irene Eze, Chinonso Obayi, Obinna Onwujekwe
Year: 2022
Language: English
Region(s): NIGERIA