Bridging the Gap: Using a CLA Approach to Improve Health Financing in Nigeria

As governments strive to provide affordable, quality healthcare and adhere to the Abuja Declaration of 15 percent budgetary allocation to health, there is a growing need for multi-sector stakeholder collaboration. To stimulate increased domestic financing for the HIV and AIDS response in Nigeria, the United States Agency for International Development (USAID’s) Health Finance and Governance (HFG) project is supporting Rivers, Cross River, Lagos, Akwa Ibom, Sokoto and Bauchi states to initiate and implement Domestic Resource Mobilization Technical Working Groups (DRM TWGs). The DRM TWGs enable cross-stakeholder engagement, bringing together representatives from Nigeria’s health and non-health sectors and central budget agencies to identify and address state-level obstacles to the promotion healthcare financing work in HFG priority states.

Beginning in 2016, the DRM TWGs provided a platform to apply a collaborating, learning, and adapting (CLA) approach to strategically engage multi-sector stakeholders to enhance DRM at the subnational level. The TWGs foster collaboration across sectors with an end-goal of increased domestic financing for healthcare across Nigeria. To date, the state DRM TWGs have positively impacted program and project-level results including:
• Stakeholders successfully advocating for an increase of  USD $1 million in the budgetary allocation for HIV programs in Cross River State;
• A public-private contract of USD $48,000 between Rivers State and Cool/Wazobia FM/Nigeria Info Radio Station to provide HIV-related radio programming in Rivers State;
• Creation of a DRM platform that led to the passing of the State Health Insurance Scheme Bill in Cross River State.