Advocacy in Nigeria’s Delta State Leads to the Release of 20 Million Naira for Family Planning Activities

Contributor: Nwanne Kalu

Dr. Christian Tetsola is a Reproductive Health Coordinator in Delta State.

Before The Challenge Initiative (TCI)  began supporting Delta State, Nigeria, in October 2017, family planning activities were partner-driven with little or no coordination by the state. The Ministry of Health had budgeted for reproductive health interventions, but the funds allocated were meager and had never been released.

To motivate Delta State to release those allocated funds, TCI helped the state establish an Advocacy Core Group (ACG) to advocate for family planning funding. TCI also worked with the state to develop a Family Planning Annual Operational Plan (AOP) to harmonize the activities of all family planning partners in Delta State. For the first time in the history of Delta State, the state identified the need to create and fund a specific budget line for family planning through the AOP instead of it being subsumed under the overall Reproductive Health budget line item.

Dr. Christian Tetsola, the Delta State Reproductive Health/Family Planning (RH/FP) coordinator, shared his firsthand experience with this situation and the changes he has observed as a result of the state’s engagement with TCI:

As the Delta State RH/FP coordinator for over six years, I have experienced a lot of frustration arising from poor to no funding for core FP interventions, which has culminated in low uptake of FP services. I can categorically say the entrance of TCI to Delta and the coaching that came through the adaption of the proven-to-work interventions helped in no small measure to the success the FP program now enjoys. The SMART advocacy training of the ACG members, which was funded by TCI, helped to identify key influencers and target them with specific advocacy messages which centered on increased voice and funding for FP.”

As a result of active engagement with high-level policymakers in both the State Ministry of Health and the State Primary Health Care Development Agency, a specific budget line for family planning was created in the Ministry’s fiscal year 2018 budget with an allocation for 8.5 million Naira (approximately $22,332). While this was a great advocacy win, the funds were not released for implementing family planning activities. The same situation occurred with the 2019 budget.

Consequently, the release of family planning funds became a major call to action for advocacy efforts in Delta State. TCI coached the ACG to identify and engage with key stakeholders who could facilitate the release of funds earmarked for family planning. These advocacy efforts led to 20 million Naira (approximately $52,546) being budgeted for family planning activities in 2020 and a call for the immediate release of the funds.

But when COVID-19 hit in March 2020, the Executive Governor of Delta State asked that all health programs focus on their activities on fighting the pandemic. Although this was discouraging, the ACG continued its active engagement with key stakeholders until the 20 million Naira budgeted for family planning was released on January 5, 2021. These funds helped procure family planning consumables and disseminate the revised Nigerian health management information system (NHMIS) tools to all health facilities in the state.

One of the major reasons for relatively low uptake of family planning services among adolescents and women of reproductive age in Delta State had been the user fees charged for services, specifically for the supply of family planning consumables. Providers in facilities said they did not have sufficient family planning consumables and reporting forms and, therefore, passed these costs along to clients. Successful advocacy efforts mean adolescents and women of reproductive age can now access family planning services for free. The released funding also boosted provider morale because some had openly expressed frustration and demotivation associated with the lack of basic supplies to perform their job. Ultimately, the RH unit believes the release of these funds will improve the overall quality of family planning services rendered at service delivery points, increase family planning uptake and ensure family planning data is accurately captured.

This significant advocacy win – which was covered in the national Nigerian press – helps ensure that Delta State is ready to overcome any obstacles in ensuring accessible, quality family planning service delivery once it graduates from TCI direct support in the coming months.