REPORT OF 2015 NATIONAL FAMILY PLANNING BUDGET TRACKING

Transcription

1 ASSOCIATION FOR THE ADVANCEMENT OF FAMILY PLANNING PARTNERHIP FOR ADVOCACY IN CHILD AND FAMILY HEALTH REPORT OF 2015 NATIONAL FAMILY PLANNING BUDGET TRACKING JUNE 30, 2016

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3 ACRONYMS BIR: Budget Implementation Report BOF: Budget Office of the Federation CIP: Costed Implementation Plan CPR: Contraceptive Prevalence Rate CRF: Consolidated Revenue Funding CSOs: Civil Society Organization DFID: Department for International Development ESCA: Eastern, Central and Southern African Region FP: Family Planning GDP: Gross Domestic Product NDHS: National Strategic Health Development Plan NPHCDA: National Primary Health Care Development Agency NHAct: National Health Act UNFPA: United Nation Funds for Population Activities USAID: United State Agency International Department WHO: World Health Organization WRA: Women of Reproductive Health

4 I. EXECUTIVE SUMMARY Nigeria is responsible for one in 9 maternal deaths in the world with a maternal mortality ratio (MMR) of 1 576/100, 000 live births. Some of the factors responsible for non-realization of government target on the reduction of maternal and infant death is due to poor funding. This includes the allocation and implementation of budgets. Programs derived from the National health policies and the National Financing Policies are not strictly implemented. The study examined the federal government policies in line with the global commitments to family planning specifically focusing on the 2015 national family planning budget. The Federal Government policies on family planning, its commitments and side by side approved line items for FP commodities in the budget form the major tool for tracking FP. The study scanned the various commitments to FP made by the federal government tracked them to determine government's performance in the fulfillment of these promises; it also reviewed the 2015 budget and reported on the level of government performance in the 2015 budget for family planning. Analysis of the 2015 FP allocation, release and use for FP applying the following budget tracking techniques, percentage share of the budget, nominal growth rate, real growth rate, per capita budget and comparing budget to cost; revealed that although there was increase in the nominal rate of FP budget from that of 2014, both 2014 (18.73%) and 2015 (50.72%) are still less than 1% of the total health budget; Analysis of the per capita budget for 2014 is N compared to 2015 which is N Despite the increase the per capital budget provision for FP still falls below the recommended per capital 2 budget of (N65.525). The average annual cost per user of family planning is $4.10 (N750.30) Comparing budgets to costs show that there is a provision of 2.379% provision of the amount required revealing a shortfall of N25, 635,760,269 representing a 97.6% shortage in FP provision for 2015 compared to 2014, which had 98.4% shortage in FP allocation. Cost per unit which determines how much it will cost to deliver comprehensive service to a user in a year. These calculations were based on allocated funds only. Review of the release and use of the 2015 enacted budget did not revealed information from the FMOH and the Budget Office of the Federation on the implementation of the 2015 budgetary allocation to FP. Infarct allocations were made to the FMoH only twice in 2015 September and October but the FP funds were not known to be part of it. The progress report on federal government FP captioned, Federal Government FP Financial Update: Donor Versus Government Expenditure in FP itemized in the table below, shows that the disbursements for FP were made by only donor agencies Association for the advancement of family planning 2014tracking report REPORT OF 2015 NATIONAL FAMILY PLANNING BUDGET TRACKING i

5 Table 1: FG Family Planning Financial Update; Donor versus Government Expenditure in FP Source: FP2020, UNFPA, USAID From the table it can be observed that no commitment was made by the FG (MDG funds) and the SURE-P in 2015 on family planning, this is as a result of the expiration of these programs. Donor funding also dropped in the same year. Just of recent, the donor community announced its plan to withdraw its funding support to countries that have crossed the low income category. Nigeria is a country in this category that will be disqualified from donor funding. With the dispassionate commitments shown by government at all levels in shouldering its own responsibility, the withdrawal of donor support to Nigeria will spell doom for implementation of FP programs, especially if government continues to fail in keeping up with its own financial commitments. In another report released in September 2015, the FG shared an update on progress in achieving its policy, financial and program and service delivery commitments to FP2020. According to ESCA & Family Planning: lessons for Nigeria- Nigeria official Report on family planning; The one and only disbursement made by government towards the US$8.35 million additional London commitment for procurement of reproductive health commodities was US $1.8 million to UNFPA for only one year out of the four years pledged ( ). With the transition to a new administration, there is doubt if the FG will be committed to the existing commitments so far on FP or also whether it will perform better than the previous government in implementing the FP programs. Apart from the London 2012 FP summit which has not been implemented. Other commitments like the dedication of 15% national budget to health, declared during the African world leader's summit is yet to be effected in Nigeria. Whereas other African countries have since implemented this agreement. Nigeria has never dedicated up to 6% of its budget to health. The implementation of the 1% of the consolidated revenue fund (CRF) to the provisions in National Health Act 2014 has also failed to make the budget since the enactment of the Act. The federal government has cited some of the challenge to its implementation of FP commitment to the decentralized political system and policy change and also the decline in crude oil price. It is highly recommended that CSOs should track It is imperative that, the federal government and indeed all stakeholders improve efforts in the allocation of funds towards sustaining ongoing effort to sensitize the populace on family planning and make the various family planning services freely available. Tracking templates have been developed to track the various components of family planning as elucidated in this study. REPORT OF 2015 NATIONAL FAMILY PLANNING BUDGET TRACKING ii

6 TABLE OF CONTENTS Executive Summary Background Rationale Specific Objectives Methodology and Challenges Brief Overview of Family Planning Funding Situation in Nigeria FG Commitments to Family Planning Budget Tracking - Analysis of FP Budgetary Allocation & Comparing with Analysis of Nominal Growth - Analysis of 2014 and 2015 Budgetary Allocation on Family Planning - Utilization & Progress Report of 2015 Budgetary Allocation on FP Recommendations Conclusion Appendix i. Appendix Template for Monitoring Supplies and Commitments in FP ii. Appendix Template for FP Capital Budget Project Monitoring iii. Appendix Template for Monitoring FP Financing iv. Appendix Template for Tracking FP Policies & Regulation v. Template For Tracking Fp Policies & Regulation i REPORT OF 2015 NATIONAL FAMILY PLANNING BUDGET TRACKING iii

7 II. BACKGROUND Countries which find itself in a situation where its available resources is not enough to meet up with its growing population are bound to suffer from poor human development index and including high mortality rates especially in maternal and infant mortality. Hyper-demographic countries are burdened with the search for resources to improving its human development Index and per capital income. Education, Health and provision of social services come in high demands in such countries. In line with this, cases of mix match between available resources of a nation and its population, leads to high incidences of poverty, disease and insecurity. UNFPA posits that FP helps lift nations out of poverty. A recent study predicted that Nigeria's economy would grow by at least $30 billion if the fertility rate in the 3 country fell by just one child per woman in the next 20 years. In 2050 the world population is expected to hit 9.25bn, out of this figure, the 10 most populated country in the world including Nigeria, will contribute about half of the population which is 4.9bn from its present 4.2bn the rest of the world currently runs with a population of 3.0bn and this is expected to grow at 4.3bn by This statistics leaves highly populated countries with competing demands for increased resource generation to both cater for its population growth and also ensure that the lives of 4 newborns and their mothers are safeguarded at birth and after delivery. Where this is not met, the Human Development Index of the country continues to depreciate. Measures have been put in place by countries to control rapid population growth and one of such measures includes family planning. Essentially family planning implies family by choice and not by chance. By applying preventive measures, people can regulate birth rate and the success of this method depends on the consistent availability of efficient and effective FP/child spacing. Chander Sheker puts it this way, Hurry for the first child, Delay 5 the Second Child and avoid the third. Leaders facing high population problems have come together at some points to deliberate on ways of tackling the menace. In some of these forums commitments have been made by leaders of countries. One of such is the 2012 London Summit on Family Planning. These Commitments led to the adoption of policies for improved funding to enhance reproductive health, empowerment and to foster productivity. Countries like India devised several methods to reduce population one of such is regulation on marriageable age amongst citizens. In India marriage below 18 years for women and 21 years for men are forbidden. In China a birth control policy existed since 1978 known as the one child policy, but recently allowance is given for the application for birth permit to have a second child. 6 The Nigerian National population policy 2004 has a target to; 1. Achieve a reduction of the national population growth rate to 2 per cent or lower by the year Achieve a reduction in total fertility rate of at least 0.6 children every five years. 3. Increase the modern contraceptive prevalence rate by at least 2 percentage point per year. 4. Reduce the infant mortality rate to 35 per 1000 live births by Reduce the child mortality rate to 45 per 1000 live births by Reduce maternal mortality ratio to 125 per 100, 000 live births by 2010 and to 75 by 2015 Currently, the national population growth rate stands at 3.18% negatively impacting on the high fertility rate of approx. 5.5 per woman, the contraceptive prevalence rate (CPR) has stagnated for over ten 3 The challenges of effective implementation of family planning (reproductive health) with a view to improving women and children's health in the developing worldhttps://novoed.com/mhealth/reports/ Other measures to control population. 6 Population Policy. REPORT OF 2015 NATIONAL FAMILY PLANNING BUDGET TRACKING 4

8 years, unmet need for FP is 16% while the maternal mortality ratio (MMR) is among the highest in the world. (NDHS 2013) It was in realization that FP is one of the key pillars and most cost effective means of achieving the goals the commitments were made by the federal government to promote the use of modern and natural planning methods by couples. II. RATIONALE The budgeting, allocation release and use of funds earmarked for programme is way that a government expresses its commitment to the program. Therefore a critical ingredient to determining government priority within the emerging policy environment and dialogues is to track fund availability and expenditures on the various the programme by the different levels of government. This is why the Association for the Advancement of Family Planning (AAFP) with support from the Partnership for Advocacy in Child and Family Health (PACFaH) commissioned this budget tracking to determine what is happening in the FP funding space at the national level. The outcome of this would be used to assess public sector fiscal spending on family planning and consequently generate evidence development of media briefs for advocacy for improved funding for FP at all levels III. SPECIFIC OBJECTIVES 1. To track the 2015 family planning budget at national level. Within this we look at how the budget is created as well as how it is then distributed/differences between budget allocations and actual expenditures, growth rates and the challenges within the process. 2. To make recommendations that will enhance increase and release of budgeted funds for family planning. IV. BUDGET TRACKING Budget tracking seeks to examine how public resources flow from one level of government to the next, and eventually to the intended beneficiaries. There are two aspects in budget tracking, they include, the revenue tracking and the expenditure tracking. REPORT OF 2015 NATIONAL FAMILY PLANNING BUDGET TRACKING 5

9 Revenue tracking involves tracking the allocated funds in the budget of a given financial year, the amount released and used. In Nigeria, it has been found that most times allocations are not always cash backed. So budget tracking, must seek to track how much was appropriated, released and cash backed for program implementation. The expenditure tracking involves tracking the amount utilized from the releases and also reporting on the exact items spent on. Sometimes released funds could be diverted towards other projects that were not originally budgeted for. Therefore, while tracking expenditure, it is expected that the monitor determines if the items spent on were originally budgeted for. Also in tracking expenditure, the value of what was spent on must be determined to see if it meets with the original quality, specifications and quantity. VI. METHODOLOGY AND CHALLENGES The methodology adopted for this study includes desk review of existing literatures on family planning as related to the terms of reference for the project as well as reports from the federal ministry of health and international agencies working on health such as USAID. The Federal government 2015 appropriation Act was also used as a basis to review its allocations on FP and the eventual analysis. The basic challenges encountered in the course of carrying out this study is the unwillingness of the federal government MDAs, especially the department in charge of Family Health in the Ministry of Health to disclose information regarding financial commitments by the FG and releases and use to FP. There does not seem to exist in Ministry of health a comprehensive statistics that backs family planning implementation. Specifically, most times FP programs are lumped into other primary health care services and are reported as such. Nevertheless, the understanding of the specific FP items made it easy to segregate the information on family planning and report on them. VII. FINDINGS i. OVERVIEW OF FAMILY PLANNING FUNDING SITUATION IN NIGERIA Historically in Nigeria, family planning program has been driven and funded totally by donors. Donor agencies like the UNFPA, USAID, Bill & Melinda Gates Foundation, CIDA and DfID have fully funded FP programming and procurements in Nigeria. The government of Nigeria first committed funds ($3million) to FP in 2011, this was given based on the background that the total estimated cost of procuring commodities from was over $50 million. At the London Summit of July 2012, the government publicly committed to the following: Achieving the goal of a contraceptive prevalence rate of 36% by 2018 Increase the current annual commitment of US $3 million for the procurement of reproductive health commodities, to an additional US $8.35 million annually over the next four years Work with the state and local governments to secure complementary budgets for family planning and reproductive health service delivery Training of frontline health workers to deliver a range of contraceptives and action to improve equity and access to family planning for the poorest Partnering with the private sector, civil society, traditional and religious institutions and development partners. See full text of the speech REPORT OF 2015 NATIONAL FAMILY PLANNING BUDGET TRACKING 6

10 There is a strong link between the population of a country and its national development, Nigeria currently has an unacceptable high maternal and mortality rate, therefore there is need for basic and essential live saving intervention, which also include the need for family planning, this has to be done within the integrated framework of a primary health care approach, the structure of the Nigeria population the favorable ratio to working age to non working age has remain stable, it enhances human capital investment as well as household savings potentials. In order for Nigeria to reap its demographic dividends, and fulfil its aspiration to become one of the world largest economy by 2020 there is need for purposeful government effort to meet the currently unmet need for family planning commodities, enhance the education of both boys and girls and empower our women. This is why human capital development is a key pillar of the transformation agenda of his excellence president Good Luck Ebele Jonathan's administration. Within the context of our desire to enhance maternal and Child Survival, as well as accelerate our demographic transition, Nigeria is committed to achieving the goal of contraceptive prevalence rate of 38% by 2018 by making available to those women who choose freely the family planning commodities. Achieving this goal will mean averting 31,000 maternal deaths and over 700 mothers will be prevented from injuries from long time complications due to child birth. This is consistent with our result focus initiative of saving one million lives by 2015; we will achieve our goals by working in close collaboration with our diverse and complimentary partners. From the side of government we have already created enabling policy environment and taken concrete actions that support our vision and aspiration for improving maternal and child health. We will work with the private sector, civil society, traditional and religious institutions as well as development partners. In addition to our annual commitment of USD3m for procurement of reproductive health commodities, we are now committing to provide an additional USD8.35m annually over the next four years making it a total of USD33.4m over the next four years. Zambia increased its commitments by 100%, Senegal by 200%, Nigeria is going 300%. This additional commitment will be programmed within the existing projection for the subsidy reinvestment and empowerment fund for Maternal and Child Health; we will use the funds to procure the commodities through UNFPA, on the platform of an already existing agreement. Within the context of our fiscally decentralized federal system of government we would work with the state and local government to ensure complimentary budget for family planning and reproductive health service delivery. We would train our frontline health workers to deliver a range of contraceptives and most especially to improve, the utilization of long acting methods like the Uterine devices and the injectable contraceptives. We would work to unleash the potential of our private sector in making life saving commodities available for our people. We would encourage the private sector to engage in domestic manufacturing of essential health care commodities including contraceptives. We would also pursue to make the commodities more available especially through regulation and improving in-country logistics systems. We recognize that in Nigeria the total average fertility for uneducated women is more than twice that of women who have had above REPORT OF 2015 NATIONAL FAMILY PLANNING BUDGET TRACKING 7

11 secondary education. Thus girl child education remains an important area of focus to improve reproductive health and reduce maternal and child mortality. Girl child education focusing on completion of primary, secondary and post secondary education for our future mothers, is critical, but girls and women alone do not make babies. We would continue to increase effort to improve our overall quality of education for all children. These efforts will take time and perhaps more time because of the already large birth cohort that are constantly coming into the educational system. So access to reproductive health services and commodities remains the first priority in this context. We are aware of the challenge to address the inequities in access, utilization and distribution in health outcomes.in the case of family planning in Nigeria, women in the richest wealth Quinter are more than ten times likely to get access to family planning services, regardless of geography ethnicity, or religion compared to the women in the lowest 20th wealth quintil of 35% vs 3.2% as of We are committed to increasing the demand and the awareness for family planning and reproductive health care services by women regardless of their social economic status and without cohesion. In our quest to save one million lives in Nigeria by 2015, we consider all lives to have equal value. In conclusion I wish to affirm that the Federal Government of Nigeria, remains fully committed to meeting the unmet needs for reproductive health services and family planning commodities. This will be done in an integrated, collaborative manner and without cohesion. We are focused to saving the lives of mothers and children from preventable causes and consider family planning a life saving intervention. This effort is important for our country to reap its demographic dividends in the year to come. Analysis of a budget tracking of 2014 FP budget at the national level conducted by the AAFP in 2015 to determine the level of FP funding revealed the absence of a sustained budget line to implement it as in table 1 below Table2: Percentage of 2013 and 2014 health and FP budgets to the total national budget. The figures presented in the table above simply means that government contributed only percent of the amount required for FP services in Nigeria in Individuals' out of pocket expenses and development partners paid for the remaining 98.5 percent. This clearly indicates that government is not meeting its commitments. REPORT OF 2015 NATIONAL FAMILY PLANNING BUDGET TRACKING 8

12 This 2015 budget tracking therefore seeks to ascertain its performance within the fiscal year of 2015 in relation to these commitments. ii. Analysis of Federal Government Family Planning Budget The 2015 Budgetary Allocations on Family Planning The provisions for family planning programme in 2015 budget spans thus: Procurement and distribution of contraceptives Capacity building for service providers Information management, If the projects cited in the 2015 Federal budget are to be compared with the line items recommendation contained in the Nigerian Urban and Reproductive Health Initiative (NURHI), which includes; Contraceptives, Procurement, Ware housing and Distribution, FP training and Re-Training, FP Management and Information System, (MIS), IEC and BCC Media based Interventions, FP Clinics, Infrastructure and Construction, Family Planning Equipment Procurement, FP, Policy Development and Advocacy, Rents/Electricity/Water for Clinics, Contraceptives Commodities and Water for Clinics, FP Review Meetings, National Capacity Building Programs, Program Evaluation/Assessments, External Partners/International Resources; iii. Line Items in the 2015 Family Planning Budget Table 3: Line items contained in the 2015 Budget on FP REPORT OF 2015 NATIONAL FAMILY PLANNING BUDGET TRACKING 9

13 Budget Office of the Federation Appropriation Act of FMOH 2015 Appropriation iv. Analysis of 2015 FP Budgetary Allocation & Comparing with 2014 In budget tracking, it is necessary to conduct analysis of government allocations and utilization for the purpose of investigating if the government is meeting up with its set goals and demands. In the process of this study, the 2014 budgetary allocation on family planning will be used as a baseline to track the allocations of Budget analysis uses certain techniques to generate data that will reveal how well the enacted budget was implemented This analysis employed the following techniques: Percentage share of the budget Nominal growth rate Real growth rate Per capita budget Comparing budget to cost Percentage share of the budget: This was done to ascertain the priority placed by government on a programme by its budget. The formula used to determine this is calculating the percentage (%) share of total budget. Table 3: Representation of the Family Planning Health Budget for 2014 and 2015 Source: Budget Office of the Federation: FMOH 2014/2015 Appropriation From the table above, health budget in 2014 is 4.4% of the national budget while 2015 health is 5.2% of the National Budget. A further analysis of the Family Planning budget to the health budget shows that although there was increase in the FP budget from that of 2014, both 2014 and 2015 are still less than 1% of the total health budget. Using the above percentage share to total budget, the nominal growth rate and the real growth rate can be determined. Analysis of the Nominal Growth Rate Nominal growth rate is always presented as a percentage; determines increase or decrease of the amount from one year to another at face value; and inflation is not factored into the calculation. Using the formula; Amount allocated in Year 2 minus Allocated in Year 1 x100 Amount Allocated in Year 1 It is important to note that the nominal growth rate for family planning in 2014 is 18.73% while that of 2015 is 50.72% which is equivalent to an increase of 31.99% from the 2014 value. REPORT OF 2015 NATIONAL FAMILY PLANNING BUDGET TRACKING 10

14 Analysis of the Per Capita Budget This determines how much is allocated per-person over the population. Using the Nigeria's Family Blueprint 2014 estimate on the population of Women of Child Bearing Age (WRA), 35million women in Nigeria needs to be catered for, in the provision of FP services. Therefore the formula to use in adjudging the per capital budget for FP shall be: amount allocated population (WRA) Using this formula it shows that the per capital budget for 2014 is N compared to 2015 which is N Despite the increase the per capital budget provision for FP still falls below the recommended per capital budget of (N65.525). 7 The average annual cost per user of family planning is $4.10 (N750.30) Analysis of Cost per budget for 2015 The comparing budgets to costs determines to what extent the amount provided is sufficient to meet the expected output. Specifically, it examines the adequacy of the budget in relation to costs and performance targets efficiency and effectiveness. Cost per unit refers to how much it will cost to deliver comprehensive service to a user in a year; it can also mean unit cost of an item from place to place added over a period of years or a number of places and divided by the total number to get 8 the average cost per unit/service. To calculate cost per budget the following formulas are adopted; % of required amount provided for: Amount allocated x 100 Amount required According to the FP Blueprint, Nigeria requires N26, 260, 500, per year to provide services for WRA. Using the above formula to calculate cost per budget for 2015, it shows that there is a provision of 2.379% of the amount required. To determine the shortfall the amount required is subtracted from the amount allocated. This revealed that there is a shortfall of N25, 635,760,269 representing a 97.6% shortage in FP provision for Using the same variables to calculate that for 2014, a 98.4% shortage in FP allocation was recorded. v. Utilization and Progress Report of 2015 Budgetary Allocation for FP There is no information from the FMOH and the Budget Office of the Federation on the implementation of the 2015 budgetary allocation to FP. However, the progress report on FG Family Planning captioned, FG Family Planning Financial Update: Donor Versus Government Expenditure in FP itemized in the table below, shows that the disbursements to family planning were made by donor agencies. Table 4: FG Family Planning Financial Update; Donor Versus Government Expenditure in FP JUNE 30, 2016 Source: FP2020, UNFPA, USAID 7 Association for the advancement of family planning 2014tracking report 8 Report of the Budget Tracking of the 2014 National Family Planning Budget REPORT OF 2015 NATIONAL FAMILY PLANNING BUDGET TRACKING 11

15 From the table it can be observed that no commitment was made by the FG (MDG funds) and the SURE-P in 2015 on family planning, this is as a result of the expiration of these programs. Donor funding also dropped in the same year. Just of recent, the donor community announced its plan to withdraw its funding support to countries that have crossed the low income category. Nigeria is a country in this category that will be disqualified from donor funding. With the dispassionate commitments shown by government at all levels in shouldering its own responsibility, the withdrawal of donor support to Nigeria will spell doom for implementation of FP programs, especially if government continues to fail in keeping up with its own financial commitments. In another report released in September 2015, the FG shared an update on progress in achieving its policy, financial and program and service delivery commitments to FP2020. According to ESCA & Family Planning: lessons for Nigeria- Nigeria official Report on family planning; The government made a payment of US $1.8 million based on the US$8.35 million commitment to UNFPA for one year (2013) out of the four years pledged ( ). The federal Government of Nigeria is making efforts to ensure payment of the outstanding balance on this commitment. The payment is being delayed by the drop in oil price and the reduction in funding stream to the Subsidy Reinvestment and Empowerment Program (SURE-P). Following the development of the Nigeria's Family Planning Blue Print Scale-Up Plan and its launch by the Hon. Minister of Health in November 2014, the federal Ministry of Health in collaboration with implementing partners is working with states to develop costed implementation plan (CIPs) that will provide realistic data on the financial requirement needed to support family planning activities. This will provided necessary impetus to engage with states for adequate fiscal space for the family planning services. In addition, the federal government has secured $500 million for Saving One Million Lives Performance for Result, a result-based financing program, to strengthen the health system and the three tiers of health care delivery. With the transition to a new administration, there is doubt if the FG will be committed to the existing commitments so far on FP or also whether it will perform better than the previous government in implementing the FP programs. Stakeholders have decried the act of breaching agreement willfully entered into by government itself. It is a trajectory that is hampering on the growth and development of the health sector. Apart from the London 2012 FP summit which has not been implemented. Commitments like the dedication of 15% national budget to health, declared during the African world leader's summit did not see the light of the day in Nigeria, whereas other African countries have since implemented this agreement. Nigeria has never dedicated more than 5% of its budget to health. The implementation of the 1% of the CRF to the provisions in National Health Act 2014 has also failed since the enactment of the Act. The federal government has cited some of the challenge to its implementation of FP commitment to the decentralized political system and policy change and also the decline in crude oil price. VIII. RECOMMENDATIONS The Nigeria 2015 FP budget is contained only in the budget of the Ministry of Health. Line items that relates to family planning services and commodities were captured in the various agencies under the ministry of Health such as National Primary Health Care Development Agency, National Health Insurance Scheme, University Teaching Hospitals, and Obstetrics Centers. The FP issues are supposed REPORT OF 2015 NATIONAL FAMILY PLANNING BUDGET TRACKING 12

16 to cut across different government ministries, departments and agencies, e.g. women affairs, National Population Commission and education. These ministries have some vital role they could play in FP, hence they should have made some provisions for family planning programs in their budget but this was not the case. Adequate funding is critical for ensuring that people are able to choose, obtain and use high-quality contraceptives as needed. It will be discovered that most of the items provided for in 2015 budget concentrates mainly on training, procurement of contraceptives sponsored by the MDG.s while others in the 2015 budget are projects that supports FP goals. The question that would be asked is; is the appropriation in line with the FP2020 goals, are the amount allocated for these projects enough to meet with the demand? It is in line with this that the following recommendations are made: The federal government should: implement its various commitments including the basic provision funds of the National Health Act (NHAct) (2014), the FP2012 London commitments. strictly implement the various policies and National goals on Family planning including the FP2020 goals and abide by the recommendation of 2.2% annual increment of funding to family planning as recommended by the SDG's 3030 ensure the development of adequate data for effective planning and allocation of resources of family planning programs The budgetary allocations to FP should be fully implemented and MDAs such as National Population Commission, National Planning etc. should be able to mainstream family planning programs in their annual budgetary implementation To the Legislators should: strengthen its oversight on the various agencies on the implementation of FP programs mainstream sensitization, and public awareness as well as procurement and distribution of contraceptives to their constituents as part of their constituency projects work with the executive in devices innovative funding for family planning and including health funding interventions that would seek to reduce high incidences of Maternal Mortality ensure that the NHA (2014) is appropriated for in the budget To the Civil Society Organizations should: build the capacity of smaller CSOs to be able to join in the budget tracking CSOs should engage in monitoring and tracking of the various components of FP and engage with the various stakeholders on the outcome of their reports REPORT OF 2015 NATIONAL FAMILY PLANNING BUDGET TRACKING 13

17 CONCLUSION The study has been able to establish the fact that there are lapses in keeping up to the funding commitment made by the FG, in the London 2012 summit, including the lack of implementation of the various policies on FP. It is regrettable that despite the increased awareness of family planning in most part of the country the demand for contraceptives is still very low. The lack of funding and provision of contraceptive commodities by government at all levels have contributed to the high margin of unmet demands. The study exposes the over reliance on donor funding for family planning activities and programs in Nigeria this is evidenced on the poor allocation and release of the FG to FP programme in the 2015 budget. The withdrawal of the MDG's in 2015 affected the implementation of the 2015 budget on family planning. The indicators for monitoring each of the various components are contained in the templates. However, the monitoring exercise is a means to an end in the tracking of progress and achievement in family planning but it is not an end to itself. It requires efficient use and proper engagement with the stakeholders on the findings generated from the reports. The study exposes the over reliance on donor funding for family planning activities and programs in Nigeria this is evidenced on the poor allocation and release of the FG to FP programme in the 2015 budget. The withdrawal of the MDG's in 2015 affected the implementation of the 2015 budget on family planning. REPORT OF 2015 NATIONAL FAMILY PLANNING BUDGET TRACKING 14

18 IX. APPENDICES Appendixes I: TEMPLATE FOR MONITORING SUPPLIES AND COMMITMENTS IN FP REPORT OF 2015 NATIONAL FAMILY PLANNING BUDGET TRACKING 15

19 Appendix II TEMPLATE FOR FP CAPITAL BUDGET PROJECT MONITORING REPORT OF 2015 NATIONAL FAMILY PLANNING BUDGET TRACKING 16

20 Appendix III TEMPLATE FOR MONITORING FP TRAINING REPORT OF 2015 NATIONAL FAMILY PLANNING BUDGET TRACKING 17

21 Appendix IV TEMPLATE FOR MONITORING FAMILY PLANNING FINANCE Source USAID Deliver Project REPORT OF 2015 NATIONAL FAMILY PLANNING BUDGET TRACKING 18

22 Appendix v TEMPLATE FOR TRACKING FP POLICIES & REGULATION REPORT OF 2015 NATIONAL FAMILY PLANNING BUDGET TRACKING 19

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