E4A Research Report: A study of the financial resources for maternal and newborn health in Kano State, Nigeria, January- April 2013

Nigeria has committed to fully fund its health programme at $31.63 per person and spend up to 15% of its budget on health.  However, figures show that in 2012, only 7% of Nigeria’s overall government expenditure was spent on health. Evidence for Action commissioned this study to investigate the allocation and use of financial resources for maternal, newborn and child health (MNCH) in Kano state. The study objective was to gather information on the following six themes:

1. Political commitments to health and MNCH
2. Health funding flows
3. Tracking funding for MNCH
4. Free MCH funding
5. The budget process
6. Audit and financial controls

Methods

• Data were collected between January and April 2013
• Data were collected through semi-structured interviews and a literature review of relevant documents obtained from the interviews
• 8 qualitative interviews were conducted with heads of key governing units/departments

Key findings

• Sources of health funding include the Federal Government, the Kano State Government, donors, development partners, user fees and taxation.
• Kano committed to the provision of free maternal health services in 2001. It was the first state to do so in Nigeria.
• Although there is a free maternal child health (MCH) services policy in Kano, the drafted bill has not yet been passed. The bill is important because it ensures that free MCH services are mandatory to maintain, irrespective of a change in government.
• The initial level of funding to free MCH services was insufficient to meet the demand. Consequently, the funding was increased by 50% from June 2013 and allocated on a monthly, rather than, quarterly basis.
• Evidence of records for tracking funding for MNCH is limited.
• Despite a vast amount of evidence generated in the state health system, there is no indication that this evidence is used to inform budget formulation.

Recommendations and conclusionStudy findings reveal a number of areas of intervention to help strengthen financial resources for MNH in Kano state.  The study notes the key role that civil society organisations can have, including:

• Advocating for an increase in monthly funding for the free MCH fund
• Advocating for financial documentation to be made publically accessible
• Holding decision makers to account for formulating budgets in accordance with state-level strategic plans
• Helping conduct budget tracking analysis and advocacy

The report also recommends strengthening capacity for the use of evidence in budget formulation, at both the ministerial and agency level of the health sector. To view a factsheet on health financing in Nigeria in 2015, click here.To download the report for free, click here.Evidence for Action. (2015). E4A Research Report: A study of the financial resources for maternal and newborn health in Kano State, Nigeria. January- April 2013. London & Abuja: Evidence for Action.