Nigeria: #FundFPNaija – Urgent prioritization of national financing needs for family planning
Nigeria is currently the seventh most populous country in the world. With an annual growth rate of 2.6%, Nigeria is expected to become the third most populous country in the world by 2050, with a projected population of over 400 million. The country will not be able to meet the needs of its rapidly growing population, which underscores the importance of improving access to family planning services and commodities.
The Nigerian Family Planning Master Plan 2020-2024 outlines the country’s plans to achieve a target modern contraceptive prevalence rate (mCPR) of 27% by 2024 from its current rate of 12%, and includes a target strategy to improve national financing to adequately cover family planning. nationwide through the mobilization of resources from new sources of financing in the public and private sectors. Funding for the purchase of family planning commodities is usually done through a national pooled fund, with contributions from the federal government and development partners. However, this is insufficient to cover unmet needs for family planning services. With the reduction in the federal government’s family planning allowance in the 2021 budget and the recent announcement of an 85% cut in funding for the United Nations Population Fund (UNFPA) by the UK government, there is an urgent need that the Nigerian government reconsider the methods of managing national resources. mobilization and identify new or additional sources of financing for FP financing.
The political dialogue of #FundFPNaija
This was the theme of the 2021 Family Planning Policy Dialogue, convened on June 24, 2021 and hosted by Nigeria Health Watch. Key family planning stakeholders met to discuss ways to increase domestic resource mobilization for family planning services in Nigeria. In his opening remarks, Professor Lufadeju, national coordinator, Rotary’s Action Group for Reproductive, Maternal, and Child Health, spoke of the need for family planning to become a priority for many reasons, including the demographic dividend. that can be learned from Nigeria’s youthful population and the achievement of the SDGs. He also stressed the need to explore domestic resource mobilization, citing how the allocation to counterpart funding for the purchase of family planning commodities has been removed from the federal budget and the allocation to services significantly reduced by 40% in 2019. He highlighted potential ways to increase domestic resources. for family planning, including taxes allocated to health, ensuring efficient use of existing resources, allocation of a percentage of the Basic Health Care Delivery Fund (BHCPF) to family planning services and the sector private. He stressed the importance of clearly communicating the potential dividends of contributions from private sector stakeholders such as banking, telecommunications and the oil and gas sector. He stressed that it is imperative to increase access to family planning services beyond health facilities, so that they become easily accessible to women and girls outside of hospitals.
How has COVID-19 changed the landscape of Nigerian family planning services?
According to Fatima B. Muhammad, results manager, LAFIYA at the Society for Family Health, the COVID-19 pandemic has had a significant impact on the ability of women to access family planning services in health facilities, given the movement restrictions and economic realities causing families to not prioritize family planning services. Toyin Chukwudozie, Education as Vaccine (EVA) program manager, highlighted the effects of reduced funding for family planning on young people, including the increase in unwanted pregnancies, obstetric complications and maternal deaths. among adolescent girls due to the reduced availability of family planning products and services. . “Unintended pregnancies can disrupt the education of girls and young women, and delaying pregnancy and childbirth is important for girls to reach their full potential and lead healthier lives, contributing to the demographic dividend. of the country, ”she said. Effiom Nyong Effiom, Country Director, Marie Stopes International Organization Nigeria (MSION), highlighted how the COVID-19 pandemic has resulted in a redefinition of health financing priorities, with health services, including family planning, suffering significant reductions. He stressed the need to explore sources of funding, including allocations from state governments.
Increased access to family planning services is essential to achieve the demographic dividend
Dr Olumide Okunola, Senior Health Specialist at the International Finance Corporation, gave a presentation on what is needed to reap the demographic dividend in Nigeria. This includes the reduction in the total fertility rate from 5.4 to less than 4 and a mRtc of 24.5%, which translates into a total investment cost of $ 400 million. The need to increase income has been emphasized, through devices such as the sin taxes, which are taxes on products like sugar, alcohol and tobacco because of their negative effects on health. These taxes should then be allocated to health, in order to increase statutory transfers such as BHCPF and Swing Wide Votes (SWV) – which is an emergency budget used for emergencies.
Ms. Ulla Mueller, Country Representative, UNFPA, explained how mobilizing domestic resources is essential for the sustainability of family planning services, but is not an end in itself. To achieve the demographic dividend by increasing national resources for family planning, it is important to ensure an enabling environment, through policies, and to ensure that funds are allocated, prioritized and released. She said it would be pointless to ensure availability of family planning commodities if there is no demand.
She gave examples of other African countries and their strategies to increase their mCPR, notably Ethiopia (like Nigeria, is also a federation with autonomous states), Senegal, Burkina Faso and Ivory Coast. . Some of these countries had increased their TPCm by increasing domestic resource mobilization, involving the private sector, rolling out policies and programs that ensure prioritization of family planning services, and increasing demand generation. She highlighted the work of UNFPA in Kano State, where they encountered some resistance to increasing family planning services for different reasons, including religion and gender inequality, with only 11 % of women who say they feel empowered enough to make decisions about their own body. Advocating for an environment conducive to the availability of family planning services therefore required targeted strategies to address this resistance in order to increase demand generation and uptake.
Dr Ejike Oji, chairman of the technical management committee of the Association for the Advancement of Family Planning (AAFP), spoke about progress in male advocacy and improving access to family planning services, highlighting emphasis on efficiency and accountability in the use of funds available at national and sub-national levels. He advocated for including family planning services in the benefit packages of health insurance schemes and the BHCPF, and targeting the right message on the demographic dividend of family planning services and the need to secure funding. adequate.
Key recommendations for improving domestic resource mobilization for family planning services
Several recommendations were made to ensure that Nigeria improves its domestic resource mobilization for family planning services.
Increase income generation and allocation of funds to health through earmarked taxes and efficient management of resources.
Work with states to identify their priorities and ensure that advocacy for family planning services fits into them to increase resource mobilization at the state level.
Increase private sector participation in financing family planning services by making a strong business case on potential benefits, such as lower taxes and reduced maternal mortality.
Give young people the right information to increase demand, use and access to family planning services
Increase the involvement of men in advocacy for better access to family planning services
Vivianne Ihekweazu, Executive Director of Nigeria Health Watch, who moderated the dialogue, concluded by emphasizing that for the private sector, civil society organizations and development partners to work in partnership with the government to improve funding for services planning, funds must be released and not just allocated.