US$20 million grant from the Global Financing Facility will lay the groundwork for the government to improve and expand primary health care services throughout the country
WASHINGTON, DC – The Government of Nigeria and the Global Financing Facility (GFF) announced today that the GFF, a multi-stakeholder partnership, was investing US$20 million to improve and strengthen primary health care starting in three states, with the aim of reaching the poorest and most underserved throughout the country. The Government of Nigeria is linking this investment financing to about US$150 million equivalent per year from its budget, implemented as part of the Basic Healthcare Provision Fund (BHCPF) of the National Health Act. The quantum of resources and prioritization of services will contribute to sustainably financing the health and nutrition needs of women, children and adolescents.
“The Government of Nigeria is committed to ensuring that all Nigerians—particularly the women, children and adolescents facing some of the most challenging circumstances, in the most challenging places—have access to the basic health and nutrition services that they need, without becoming poorer by paying for them,” said Professor Isaac F. Adewole, Minister of Health of Nigeria. “The Global Financing Facility has created a new sense of awareness that we must put our money on the table for these essential investments in our people, and use them in even smarter ways—and that is something that hasn’t been done before.”
Nigeria, the most populous country in Africa, faces big challenges: Nigeria is the single largest contributor to the global annual number of maternal deaths; infant and child mortality rates are high and unchanging; total fertility rates have remained stubbornly high; nutrition outcomes in children have worsened; and child immunization rates are low, especially among the poorest children.
These challenges have hugely outpaced government spending on health and nutrition, with government spending in recent years unable to reach those who needed it most, and doing little to reduce high—and impoverishing—out-of-pocket spending on health by poor Nigerians. Recently, with the advocacy and support of the GFF, the World Bank, the Bill & Melinda Gates Foundation, Global Affairs Canada, Norwegian Ministry of Foreign Affairs, the U.S. Agency for International Development, the UK Department for International Development and other partners, the Government of Nigeria has begun implementing the National Health Act, which was enacted in 2014 and established the BHCPF for the first time in 2018. Through the BHCPF the Nigerian Government is expanding its fiscal space for health to the tune of US$150million or NGN 55.1 billion for primary health care strengthening and service delivery.
The grant from the GFF will co-finance early implementation of the BHCPF with funds mobilized from the government and other contributors, starting in three states: Abia, Niger, and Osun. Following this start-up phase, the government will provide most of the financing for the scale-up to the remaining 33 states and the Federal Capital Territory.
“The Government of Nigeria will make an enormous difference in the lives of millions of Nigerians by making a lasting investment in the health and nutrition of women, children and adolescents, the foundation of society and the economy,” said Mariam Claeson, Director of the Global Financing Facility. “Nigeria’s commitment to sustainably financing health and nutrition is a beacon for other countries, as they work closely with the Global Financing Facility to make sure that the investments they make today last for years to come.”
The GFF US$20 million, together with US$2 million in start-up support from the Bill & Melinda Gates Foundation, will complement the Nigerian Government’s funding for the BHCPF and help move implementation forward as quickly and effectively as possible. The BHCPF has four priorities: 1) to finance "best buy" reproductive, maternal, newborn, child and adolescent health and nutrition interventions, as well as screening for high blood pressure and diabetes; 2) to innovate systems of delivery in primary health care that reach those with the greatest needs first—with a focus on rural areas, and a commitment to keeping services free for those who need them; 3) to improve primary health care facilities’ ability to operate effectively and with autonomy, by providing direct funding for operational expenses; and 4) to track implementation and promote continuous learning and course corrections for better results and accountability.
With today’s announcement, the GFF is investing a total of US$47 million in Nigeria, linked to US$350 million in funding from the International Development Association, the World Bank’s fund for the poorest countries, which has focused on scaling up health services in North East Nigeria and accelerating nutrition results for women, children and adolescents in Nigeria.
“Together, the Government of Nigeria, with the support of the Global Financing Facility, the World Bank, and other partners, are catalyzing real change for the people of Nigeria,” said Rachid Benmessaoud, World Bank Country Manager for Nigeria. “This investment in human capital will pay dividends in lives saved and improved, and help build a stronger, more prosperous economy.”
In the long run, the BHCPF’s success will be underpinned by the use of the Government of Nigeria’s own resources to purchase services instead of inputs; the buying of services from both public and private providers; the establishment of a system of accreditation to improve quality of care; the financing of a rigorous system of verification that helps ensure value for money; the creation of robust payment systems; and the demonstration of long-term government commitment to using public funds to subsidize the cost of services for the poor. Success will also activate the potential for the BHCPF to function as a credible and effective channel for support from Nigeria’s multilateral and bilateral donor partners.