Nigeria Toolkit: Advocacy
What is it?
In order to finance a State’s family planning program, it relies on a combination of funding sources, mainly public funds and donor funds. TCI supports the State to develop an integrated State FP workplan in order to more fully see what resources are required for funding the various approaches as well as to bring more accountability to bear. This integrated State FP workplan denotes Ministry of Health funding, Saving One Million Lives funding, as well as funding that the implementing partners / donors bring to the table. The interventions outlined on this page are intended to increase the public funding support of TCI proven interventions.
Why is it important?
- Increases local buy-in, ownership and financial sustainability of proven family planning interventions
- Enhances accountability for family planning monies by ensuring that resources committed for family planning (for example, those committed during the London Summits on Family Planning in 2012 and 2017) are used appropriately
- Enhance funds/resource efficiency and minimize duplication of effort and implementation partners/donors funds
What are the main interventions for implementing this approach?
Two main interventions used for this purpose are:
Budget Line & Monitoring Training
Adapting the materials developed under NURHI, TCI facilitates a training of 2 ACG members and a representative from the State Ministry of Health and Budget and Economic Planning per State on the strategic importance of securing a dedicated funding line item for family planning. The State Ministry of Health and Budget and Economic Planning representatives serve as change agents within the State structure and provide insiders knowledge about the particularities about the State’s budgeting process in terms of start time and levels of review/approval which may differ from State to State.
During the training, participants calculate what has been budgeted per health per head per State – which would be difficult to do without having State Ministry of Health and Budget and Economic Planning officials present for the training. They then look at the budget by women of reproductive age per total population (per capita/head) per year and compare this amount to the total budgeted for health expenditure as well as compared to infrastructure and education expenditures. This helps the ACG members make its case for a dedicated line item for FP and increase of funding for FP. The participants are then trained on budget monitoring, using the Budget Tracking Tool developed by NURHI to monitor how family planning budgets are being released and used.
Each quarter, ACG compiles a report that compares family planning expenditures against the approved budget. These reports are then used to debrief policymakers about how the budgets are really being used. This approach has contributed to the achievement of high-level support from policymakers to improve expenditures on family planning programs.
As a result of this effort, 8 out of 10 TCI-supported States now have dedicated FP budget line items. Niger State has line activities for FP but under a RH budget line and Rivers’ advocacy efforts for this are in process but activities for FP are under RH and MNCH.
Intervention in Action
For the very first time in the history of Anambra, Abia, Taraba and Delta States, dedicated budget line was created for family planning. Prior to the commencement of TCI support in the States, the State Ministry of Health has always had a composite budget line for Reproductive Health. In 2018, Anambra state allocated N30M ($83,000) in the budget for all the six priority areas of reproductive health. But, once the Initiative began activities, the need for a dedicated budget line was brought to the fore and reiterated at every opportunity. All of these efforts yielded great results. The Commissioner for Health of Anambra State directed the Department of Planning, Research and Statistics to create a separate budget line with about $140,000 (N50million) allocated to family planning, Taraba State budgeted N50 million and Delta N8Million.
For more about the Anambra story, see Dedicated Budget Line for Family Planning Created in Anambra.
Grants Management Orientation
TCI organized a Grant Management Orientation for stakeholders in the TCI geographies with the aim of introducing the performance-based tracker and dashboard as a way to transparently share how TCI will reward local governments once they meet and exceed their commitments and are performing. States can see what resources are available to them (that is, those guaranteed and what they can potentially unlock). In YR2, we guaranteed a certain amount available for funding. If a state wants more, then they need to meet the state counterpart contribution of 30%. By building capacity through advocacy efforts, the phase 1 states have already exceeded (188.08%) their state counterpart contributions. This is an advocacy tool that you can use with states. If they use up the guaranteed amount and haven’t met their own counterpart contribution, we will not give them any more money. State leads should look at the color lines to see how their state is faring and discuss with state. If exceeding may want to discuss, plans to scale-up to more facilities for example. Our job is to push states and then build their capacity.
In addition, through the integrated State FP workplan, States are effectively able to leverage multiple funding sources in order to achieve maximum impact of its activities. This has helped the State to better leverage Nigerian State Health Investment Program (NSHIP) and Saving One Million Lives (SOML), which also includes a budget report that incorporates performance-based disbursement.
The Grants Management Orientation event was highly interactive, and all parties agreed that TCI is about adaptation, learning and sharing. This culminated in the Ogun State Commissioner of Health, Dr. Babatunde Ipaye, likening the TCI model and catalytic fund mechanism to an “Antigenic stimulation to enable the States produce antibodies in form of continuous domestic funding to ensure sustainability.”