The Lagos Family Planning Budget Line

  • Nigeria family planning scorecards
In Nigeria, the process of government creating a new budget line can be long and hard. Lagos State Commissioner for Health, Dr Jide Idris knows this too well, and he explains some of the reasons why this could happen.

In an environment where there is keen competition for resources that are never enough, getting a new budget line requires one’s best efforts. “When you’re in Council, every MDA (Ministries, Agencies, Departments) has need for the limited funds,” Dr Idris says.

At that point, nobody wants to know whether it is a health or education issue; everybody is fighting for as much of the budget as possible. 

A new line means more resources for the institution for which it is created, and probably less for others. All kinds of documentary justification and hard evidence are needed to support the request.

In 2016, the Lagos State Ministry of Health (LSMoH) needed to create a budget line for family planning (FP), which is one of the means to prevent maternal deaths. One expert put it very succinctly: “If you are not pregnant, you can’t die of pregnancy,” he said. Moreover, the Lagos State Government needs to reduce the population growth rate, which is fuelled by unplanned pregnancies.

To justify the new FP line, LSMoH deployed an array of scorecards on the performance of the state in maternal and newborn health and health financing. These ‘technologies’ and other documents that LSMoH deployed did the trick. Among them were scorecards that measured performance around health finance and maternal and newborn health, all of which showed the need to step up.

These scorecards are the initiative of MamaYe-Evidence for Action (E4A), a Bill and Melinda Gates Foundation grantee working to use evidence, advocacy, and pursuit of accountability to cause life-saving changes for mothers and newborn children. The MamaYe supported-scorecards are the Maternal and Newborn Health Scorecard, Maternal and Perinatal Death Surveillance and Response Scorecard, Magnesium Sulphate (MgSO4) Scorecard, and the annual Lagos State Health Budget Scorecard. The scorecards are produced and used for advocacy purposes by three sub-committees of the Lagos Accountability Mechanism for Maternal and Newborn Health (LASAM), another MamaYe-E4A initiative supported with funding from the Gates Foundation.

Of the entire MamaYe support, Dr Idris says,

It has complemented our activities, particularly with respect to reducing maternal and child mortality and morbidity.

And of the scorecards, he pays glowing tribute:

I’ve used them, and will continue to use them. It’s a nice way of getting feedback; it’s something relatively new, and from an independent party, rather than from within the system itself. And it’s another way of creating a benchmark and assessing performance in different areas, different LGAs, and different groups…

He adds: “We can easily see where we’re having problems, and the way to address those things specifically. It’s also another way of keeping track of our indicators, and directly spend resources to improve those areas where we’re not performing. The printing and dissemination of the scorecards is something that had never been done before in the state. And this accountability mechanism for MNH is something worth commending…”

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