Family Planning (FP) has long been recognised as one of the cornerstones of public health, offering benefits for maternal health, gender equality, and the overall well-being of the population. In 2021, Nigeria and 35 other countries committed to allocating 1% annual state and national health budget to family planning services in line with the FP2030 partnership. The financial commitment aimed to address domestics funding gaps and support the expansion of family planning services.
FP2030 is an international effort to ensure that citizens are provided with the necessary resources and support to make informed decisions about their sexual and reproductive health. The Family Planning (FP) 2020 initiative, launched in 2012, aimed to expand access to family planning services in developing countries, including Nigeria, to reach 120 million additional women and girls globally by 2020. Nigeria, as part of its FP2020 commitment, set specific targets such as increasing the modern contraceptive prevalence rate (mCPR) among women of reproductive age and reducing unmet needs for contraception. By 2020, Nigeria made some progress, but challenges remained, including a low mCPR of 12% for married women (falling short of the 27% target) and high unmet needs, particularly in rural areas, due to cultural barriers, limited access, and healthcare provider shortages.
Building on FP2020, FP2030 adopts a more inclusive, rights-based approach and is focused on sustainable and equitable family planning services, with an emphasis on quality of care, gender equality, and youth empowerment. The new framework encourages countries like Nigeria to take ownership of their commitments, deepen engagement with local communities, and drive innovative solutions to overcome previous barriers. FP2030 emphasises collaborative partnerships and adaptive, data-driven strategies to ensure long-term, impactful results.
The FP2030 strategy is anchored on seven priorities. These include advancing the recognition of family planning by expanding partnerships and leveraging the 2030 agenda; promoting increased, diversified, and efficient use of sexual and reproductive health financing to ensure sustainability; and prioritising the rights of youths, including marginalised and stigmatised groups, to improve their sexual and reproductive health outcomes.
It also includes supporting the scale-up of evidence-based practices to accelerate impact, working with local actors to solve in-country issues, using and expanding data for evidence-informed decision-making, and improving the performance of people, systems, and processes to drive results.
Financing family planning since the commitment
Despite the bold pledge made in 2021, Nigeria has not met the financing expectations for family planning commodities and services. According to a Development Research and Project Centre (dRPC) report titled 'Funding for Family Planning at National and State Level the Federal Government of Nigeria did not allocate any funds for contraceptive commodities between 2021 and 2023.
In 2024, the federal government allocated two billion naira for family planning commodities. However, this falls short of what is required to achieve the National Family Planning Blueprint (2020-2024) targets and Nigeria's FP2030 commitments. The funding deficit has grown steadily, increasing from $12.1 million in 2021 to $25 million in 2022. In response, national guidelines on state-funded procurement of FP commodities were introduced to encourage state-funded procurement of family planning commodities, urging to states to allocate their domestic resources to family planning as there was a $32 million funding gap that remains a critical challenge."
The state governments need to prioritise family planning services. In 2024, only two states, Kebbi and Lagos, allocated 1% of their health budgets to family planning, with Kebbi dedicating 1.18% and Lagos committing 1.69%. Although these states are leading in family planning financing, with Lagos allocating N2.73 billion in 2024, there is still a long way to go. The significant funding gap between Lagos and other states also highlights the need for more states to contribute financially to comprehensive family planning services.
Borno State has allocated N1.12 billion for various healthcare interventions in 2024. This includes funding for nutrition, family planning, reproductive health programs, financial support, and management of infectious disease outbreaks. Additionally, there is a counterpart fund for the Primary Healthcare Memorandum of Understanding and BHCPF throughout the state.
Impact of family planning financing shortfall
Nigeria's economic development is intricately linked to its population growth. Rapid population growth, driven by a high fertility rate and limited access to family planning, can hinder the country's progress. According to the United Nations Population Fund (UNFPA), Nigeria's fertility rate remains one of the highest in the world, at 5 children per woman. This has significant implications for the country's economic development, as rapid population growth outpaces the government's ability to provide adequate social services such as education, healthcare, and employment opportunities.
With a population of over 220 million people, Nigeria's healthcare infrastructure is often stretched thin. The inability to provide adequate family planning services leads to higher birth rates, which in turn increases the demand for maternal and child healthcare services. This strain makes it difficult for healthcare facilities to manage resources, offer quality care, and address other critical health issues.
The rise in unintended pregnancies also leads to higher cases of unsafe abortions, which place additional strain on healthcare providers, further reducing the efficiency of the healthcare system. Unmet family planning needs have far-reaching economic implications, straining national and state finances. Overburdened health systems divert resources from critical sectors like education and infrastructure, hindering Nigeria's economic growth and global competitiveness.
Next Steps
Addressing family planning financing constraints in Nigeria requires a shift towards increased domestic resource mobilisation for family planning.
Over the past decades, donor involvement has played a critical role in advancing family planning services in Nigeria. Through significant funding, international organisations, foundations, and bilateral donors have helped bridge the gap in access to reproductive health services, especially for underserved populations. These contributions have been instrumental in expanding contraceptive access, promoting family planning education, and strengthening healthcare systems across the country. Organisations like the Bill & Melinda Gates Foundation, the United Nations Population Fund (UNFPA), and USAID have led efforts to increase the availability of modern contraceptives, reduce maternal mortality, and empower women to make informed decisions about their reproductive health. Donor-funded initiatives such as the "Nigerian Urban Reproductive Health Initiative" (NURHI) have transformed the landscape, driving progress towards meeting national and global reproductive health goals.
Despite these efforts, challenges remain in ensuring sustainability and scaling up access to family planning services. . Governments at both national and subnational levels need to allocate more resources to family planning programmes, ensuring a steady supply of contraceptives and the strengthening of healthcare systems.
Improving access to family planning in underserved regions -- especially in rural parts of Nigeria -- can significantly boost uptake. FP is an integral component of Primary Health Care (PHC) services, offering essential reproductive health services to communities across Nigeria. Expanding the availability and coverage of FP commodities at PHC centres, alongside training and re-training healthcare providers, are critical steps towards improving maternal and child health outcomes. Strengthening these services will help address the significant unmet need for contraception and empower women with greater autonomy over their reproductive choices.
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According to Nigeria's Primary Health Care Minimum Service Package, ensuring a consistent supply of FP commodities and building the capacity of healthcare workers through continuous training are key strategies to enhance the delivery of family planning services at the grassroots level. These efforts are crucial for improving access to quality care, especially in rural and underserved areas. With robust government support and collaboration from stakeholders, Nigeria can achieve greater success in family planning coverage through its PHC system.
While continuous community engagement and awareness campaigns are required to overcome the cultural and religious barriers that deter the uptake of FP services, the government needs to ramp up investment, address commodity availability, and stock out gaps. Advocacy efforts should focus on educating communities about the benefits of family planning for maternal and child health and economic development.
The upcoming 8th Nigeria National Family Planning Conference themed "Sustaining Commitments for Family Planning within the Nigeria Health Sector Renewal Investment Programme and advancing progress towards achieving FP2030 goals" is scheduled to take place 2nd -- 6th December 2024 will seek to address among others issues, the funding gaps in FP services and the use of technology and innovation to improve family planning services.
