In September 2015, the Government of Nigeria shared an update on progress in achieving its policy, financial and program and service delivery commitments to FP2020.
- The policy on task shifting and task sharing of responsibilities to community health extension workers (CHEWS) has been endorsed at the last national council on health meeting. This provides the enabling environment to build CHEW capacity for delivering long-acting and reversible methods. A comprehensive national training plan for 3,700 CHEWs has been included in the strategy document to transit from Implanon classic to NXT. The training documents necessary to operationalize the policy is currently being developed by the government and partners.
- In 2014, several state level and national level workshops were held to sensitize policy makers and stakeholders on the Demographic Dividend, which includes investment in the youth population, especially young girls and family planning. The concept is well received and efforts are ongoing to support the government and state levels to implement an intervention program focused in reaping the demographic dividend in the next 25 years.
- There has been a consistent and cohesive decision by the government at national levels to support states to take ownership of the last-mile distribution of contraceptives using integrated distribution. This includes using private sector contracting as third party logistics (3PL) and specific system wide strengthening efforts, such as the formation of a State Logistics Management Coordination Unit. There are also efforts to lower the regulatory barriers for importing contraceptives with expedited processing of waivers and product registration by NAFDAC. USAID/JSI and UNFPA are supporting the federal Ministry of Health to conduct last mile distribution of contraceptives across the 36 states and the Federal Capital Territory. The two models deployed are the Review and Resupply Meeting and the Direct Delivery and Information Capture Model. Implementation of last mile distribution over the years has resulted in more than 90 percent availability on contraceptives in health facilities and improved availability of logistic data for decision making.
Financial
- The government made a payment of US $1.8 million based on the US$8.35 million commitment to UNFPA for one year (2013) out of the four years pledged (2012 – 2014). The federal Government of Nigeria is making efforts to ensure payment of the outstanding balance on this commitment. The payment is being delayed by the drop in oil price and the reduction in funding stream to the Subsidy Reinvestment and Empowerment Program (SURE-P).
- Following the development of the Nigeria’s Family Planning Blue Print Scale-Up Plan and its launch by the Hon. Minister of Health in November 2014, the federal Ministry of Health in collaboration with implementing partners is working with states to develop costed implementation plan (CIPs) that will provide realistic data on the financial requirement needed to support family planning activities. This will provided necessary impetus to engage with states for adequate fiscal space for the family planning services. In addition, the federal government has secured $500 million for Saving One Million Lives Performance for Result, a result-based financing program, to strengthen the health system and the three tiers of health care delivery. The states will be provided the funds to disburse to expand services. Contraceptive Prevalence Rate is one disbursement linked indicator being tracked.
- The SURE-P Program is winding up as indicated in the response to the Government of Nigeria’s policy commitment progress, but the National Health Act is a new opportunity to implement Primary Health Care Under One Roof (PHCUOR) to increase financing for health. The one percent of the federal Government of Nigeria consolidated resources provided for by the National Health Act will go a long way to support to both the demand and supply side of Health care.
| Donor | 2011 to 2014 | 2015 | ||
| Pledge | Disbursed | Pledge | Disbursed | |
| DfID* | 18 | 18.75 | 4.5 | 4.497 |
| DFATD* | 4.8 | 4.58 | 0 | 0 |
| UNFPA* | 12 | 11.59 | 3 | 4.588 |
| FGoN (MDG funds)* | 12 | 7.042 | 0 | 0 |
| FGoN (SURE-P) funds* | 16.7 | 1.869 | 0 | 0 |
| Total US$ millions | 63.5 | 43.837 | 7.5 | 9.086 |
*UK Department for International Development; Department of Foreign Affairs, Trade and Development; United Nations Population Fund; Federal Government of Nigeria, Millennium Development Goals funds; Federal Government of Nigeria, Subsidy Reinvestment and Empowerment Program.
Policy & Political
- The Government of Nigeria has upheld the free family planning information and services policy to date [in support of efforts to] eliminate the financial barrier to family planning uptake in the public sector. In addition, the government in two states is piloting a public-private partnership model, which provides free commodities to the private health facilities towards reducing the cost of service provision in the private health facilities. The six-month study will provide evidence for possible scale-up of the model. Engaging with organizations for social marketing and other social and behavioral change communication activities has expanded service provision and provided more options for services.
- In response to the dearth of skilled health workers in the rural and northern part of the country with the lowest contraceptive prevalence rates, the country endorsed the Task Shifting and Task Sharing policy, which allows lower cadre staff, the community health extension workers (CHEWs), to provide injectables and long-term contraceptive methods. Efforts are on track for its full implementation.
