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As part of the Collaborative Advocacy Action Plan (CAAP) initiative, Africa Health Budget Network (AHBN) mapped 148 policy, financial and service delivery commitments made by the Government of Nigeria towards improving Maternal, Newborn and Child Health (MNCH), Sexual and, Reproductive Health and Rights (SRHR) and Adolescent well-being (AWB) outcomes. These pledges were made at different meetings including the General Assembly of the United Nations (SDGs) , the International Conference on Population and Development (ICPD25) Nairobi Summit in 2019, Family Planning 2030, the Global Forum for Adolescents and are reflected in key national policies and strategic plans such as the National Health Policy, National Gender Policy and National Youth Policy among others.
A partner-led review of the implementation status of these commitments indicated that successive governments have prioritized the health and well-being of women, children, and adolescents (WCA). Investments have been made to strengthen health systems to deliver equitable and quality health services through a primary healthcare approach. As a result of these investments, infant mortality and under-five mortality rates have reduced from 87 (1990) to 67 (2018) per 1000 live births and from 193 (1990) to 132 (2018) per 1000 live births, respectively (NDHS, 2018). Furthermore, there is alignment and coherence between the policy/financing and service delivery thrusts as well goals and targets articulated in national documents and the pledges made by the Government of Nigeria.
However, with only a few years to meet the SDG targets further progress has to be made in key areas, for example in reducing maternal mortality which as 1047 deaths for every 100,000 live births accounting for 28.5% of the global burden of maternal deaths in 2020. To address these key issues, implementation of commitments has to be accelerated through i) increased budget allocations and timely budget releases, ii) enhanced domestic resource mobilization to reduce reliance on donor funding, and iii) strengthening the adaptation and adoption of some of the key commitments at the subnational levels including States and Local Government Areas, where implementation of health polices and guidelines is carried out.
These considerations and findings have informed the development of Nigeria’s Collaborative Advocacy Action Plan , which was validated through a multistakeholder convening coordinated by AHBN, and which aims to rally partners’ advocacy efforts to advance accountability for key commitments through 4 advocacy goals, as follows:
To advocate for timely release of family planning approved federal budget by at least 50% to achieve sexual reproductive health of women and adolescents for the year 2024 and 2025;
To advocate for the creation of a dedicated budget line at the Ministry of Health to support Nigeria's adolescent well-being agenda by the year 2025 and 2026 in line with the Nigeria Government Commitment Statement of Adolescent Well-being and SDG Priorities;
To strengthen meaningful engagement and participation of CSOs, young people and other relevant constituencies in the RMNCAEH-N Technical Working Group of the health sector Renewal Plan/ Sector Wide Approach; and
To advocate using existing multi stakeholder platform to implement the resolution on MNCH adopted during the 77th World Health Assembly (WHA) and co-sponsored by Nigeria.
The CAAP process provided an opportunity for further engagement of civil society organizations and others that are underrepresented in national policy process such as young people, journalists and community members to contribute through policy dialogues held in the National Reproductive, Maternal, Newborn, Child, Adolescent and Elderly Health Plus Nutrition (RMNCAEH+N) Platform, that has placed a focus on WCAH generating increased momentum for the implementation of commitments. A key learning from the experience in developing the CAAP plan included the engagement of the Federal Ministry of Health (FMOH) early in the process to secure support for accelerated implementation of national commitments in the midst of ongoing health sector reforms.
This multi-constituency approach is essential to the actualization of the goals and multi-faceted activities outlined in the CAAP. For example, the cumulative expertise of service delivery based NGOs, health professional associations, youth led organizations, advocacy organizations, and academia will be required to develop advocacy briefs related to the adequate allocation and timely release of budget for family planning programs and services as well as national commitments made towards addressing WCA issues as aligned with the MNCH resolution passed at the 77th World Health Assembly. Furthermore, the support of journalists has been identified as being key to amplify key messages contained in these advocacy briefs, as well as give visibility ,both, to the progress made by the FMOH and areas where effort needs to continue to be expended, in an effort to crowd-in contributions and support from relevant partners. Recognizing the importance of this multi-constituency approach, one of the advocacy goals of the CAAP explicitly aims to strengthen meaningful engagement and participation of CSOs, young people and other relevant constituencies in the RMNCAEH-N Technical Working Groups (TWGs) of the health sector renewal plan/ Sector Wide Approach (SWAp).
“CAAP enables the development and implementation of holistic solutions that tackle the multifaceted nature of these health issues.
“By coordinating efforts across different sectors, CAAP can address the underlying determinants of health and provide a platform for effective advocacy, raising awareness, and mobilizing support for policy changes and resource allocation,” he added.
-Dr. Aminu Garba, CEO, Africa Health Budget Network
The implementation of the CAAP relies on partners, and we invite you to join efforts to advance the advocacy goals in Nigeria. Please share your interest to join the CAAP initiative by contacting PMNCH by emailing pmnch@who.org.
Nigeria Collaborative Advocacy Action Plan