Although the allocation to FP in 2024 is better than the last four years, the low budgetary allocation raises concerns about Nigeria's ability to meet the FP2030 targets.
Once again, the Nigerian government appears to have fallen short in prioritising Family Planning (FP) programmes in its proposed 2024 budget, potentially causing a setback to the country's aspirations to achieve a 27 per cent Modern Contraceptive Prevalence Rate (MCPR) by 2030.
Despite the commitment to allocate at least one per cent of the national annual health budget to family planning, an analysis of the 2024 health budget shows that only N2.2 billion has been earmarked for FP programmes, representing 0.16 per cent of the overall health budget.
Although the allocation to FP in 2024 is better than the last four years, the low budgetary allocation raises concerns about Nigeria's ability to meet the FP2030 targets.
FP 2030 target
The FP2030 is a global partnership supporting women's and girls' reproductive rights. It aims to empower women and girls to lead healthy lives and make informed choices about contraceptive use.
It also aims to hasten the process of addressing obstacles that delay the advancement of commitments made by governments towards family planning, by strengthening result-oriented partnerships with stakeholders and experts
Nigeria, Africa's most populous nation had missed the initial FP target set for 2020, partly due to the government's failure to fund the programme, thereby hindering progress. FP 2020 goal was to enable 120 million additional women and girls of reproductive age, globally, to have access to contraceptives by the year 2020.
At the dawn of the deadline, the FP 2020 target indicators show that Nigeria has only 12 per cent MCPR for women.
Growing population, a major concern
As of 2020, Nigeria's population reached an estimated 206 million, a figure projected to elevate the nation to the third most populous globally by 2050, trailing only behind China and India. The 2014 World Urbanisation Prospects also predicts that by 2050, 77 per cent of the country's population will be urban.
However, this population surge is not met with corresponding economic growth, particularly in essential areas like infrastructure and job creation. The repercussions of this mismatch are evident in the escalating challenges of security, poverty, and various crises plaguing Nigeria.
Despite the looming threat posed by unchecked population growth, the Nigerian government appears to downplay the urgency of implementing family planning measures.
The budget proposal
The total proposed budget estimate for Nigeria in 2024 is N27.5 trillion.
Out of the three key development sectors, including security and education, health has the lowest allocation in the 2024 proposal. Of the total budget, the health sector which is already grappling with various challenges got N1.38 trillion (5.03 per cent).
This includes healthcare funding under the service vote amounting to N155.65 billion, health capital budget at N434.79 billion, health recurrent at N667.38 billion, and statutory transfer to the basic healthcare fund at N125.74 billion.
While the total health budget increased by 18.49 per cent compared to N1.17 trillion in 2023, it constitutes only 5.03 per cent of the budget size.
Poor funding trend
A review of the budget for FP in the past four years reveals a low allocation to this important aspect of health.
In 2020, under President Muhammadu Buhari's administration, the FP programme received only 0.2 per cent of the health budget and in 2021, the allocation dwindled further to 0.01 per cent of the health budget. In subsequent years, 2022 and 2023, the budget line for FP was non-existent.
The government's failure to include FP funding in the 2022 and 2023 budgets occurred, despite the country launching a new Family Planning Blueprint (2020-2024) on 12 October 2020. The blueprint is Nigeria's roadmap for safe motherhood through the healthy timing offered by modern FP commodities.
The blueprint is said to be a clear and operational document with targets, performance indicators, and an accountability mechanism for CSOs to track and assess implementation performance.
But to effectively implement the blueprint, health experts said substantial cash backing is needed.
Analysing the 2024 proposed budget, the Development Research and Projects Centre (dRPC) said the lack of investment poses a significant challenge to achieving population-related goals and preventing maternal mortality, which are both identified as critical national development agenda in the National Development Plan 2021-2025 and National Population Policy 2021.
The dRPC said this pattern of underfunding FP programmes has consistently failed to meet the mark and address the increasing demands for FP services.
It said without adequate funding, access to essential contraceptive services, educational programmes, and reproductive healthcare may be impeded.
Implications of low allocation
In an interview with PREMIUM TIMES, the Director of Programmes, dRPC, Stanley Ukpai, said if the 2024 budget allocates less than one per cent of the health budget to FP, it could have several implications for meeting the FP 2030 target.
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Mr Ukpai said a smaller budget could mean less funding for the provision and distribution of contraceptives, which could limit access, particularly in rural and under-resourced areas. This, he said could further lead to an increase in unwanted pregnancies and sustain the population explosion.
He also said without adequate funding, the quality of FP services could suffer, leading to a lower uptake of these services, even where they are available.
"FP is linked to a range of other health and development goals, including reducing maternal and child mortality, improving women's empowerment, and reducing poverty. So, limited funding for FP could negatively impact these other areas as well," he said.
"To meet the FP 2030 target, it would be important for this budget allocation to be increased to at least one per cent, to ensure that more women and girls have access to the contraceptives they need to be able to make choices about their reproductive health."
Similarly, the Director, Family Health, Yobe State Ministry of Health, Babagana Abba said the low budgetary allocation can directly or indirectly affect the 2030 target.
Mr Abba said, "It can distort our planning at the state and national level, of course even at the lower level, collectively."
