OPM (Clara Picanyol)

Tracking of Resources

Planning, Costing and FinancingCommunity of Practice

CIFF

CSN

Donor Network

REACH

Questions

Spending to Save

Challenges and opportunities for financing Nigeria’s Saving One Million Lives initiative

Kelechi Ohiri, Banji Filani, Robert Hecht, Helen Saxenian, Paul Wilson, Marty Makinen, Milan Thomas, Adeel Ishitiaq, Sasha Frankel and Mark Roland

Saving One Million Lives

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An initiative launched in October 2012 to rapidly improve outcomes in Nigeria through evidence-based, cost-effective investments in six pillars: 1. Essential medicines for neonatal, child, and maternal

health 2. Immunization 3. Malaria prevention and treatment4. Maternal-child health (MCH)5. Nutrition 6. Prevention of mother-to-child transmission of HIV (PMTCT)

The goal is to save one million additional lives between 2010-15

Given the importance of achieving national targets in health, the PDU asked R4D, with support from CIFF, to perform a fiscal space analysis for SOML pillars

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Key questions this work addresses:

How much will it cost to achieve national targets for the six pillars? How much funding has been secured to pay for pillar activities? How large are the remaining gaps, and what might be done to fill these

gaps partially, if not fully?

Answers to these questions will help government policy makers and donors to make resource mobilization and allocation decisions. Relevant to the actions of key ministries, partners, and bodies such as the Global Fund Country Coordinating Committee.

Methodology

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1. Revision of 2012 resource needs estimates

2. Updating of probable financing estimates

3. Development of alternative projections

4. Aggregation and estimation of overall funding

5. Analysis of scope for increasing domestic financing

Using 2012 Model,

National and Donor

Plans

Limitations and caveats: State and LGA-level health expenditure are not captured in pillar

analyses, because of unavailability of data Baseline spending estimates for some pillars are uncertain because

of weak expenditure reporting and tracking Resource needs and financing estimates continue to evolve as

implementation progresses and donor priorities and budgets change

Variable quality of plans – many coverage assumptions overly optimistic

Illustrative scenarios for generating additional domestic funds for SOML-supported activities*

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• Health share of GGE increases by 0.2 percentage points/year, 15% allocated to SOML-supported activities

• US$158 m additional resourcesScenario 1: Expanded

Commitment to Health

• Health share of GGE increases by 0.2 percentage points/year, 25% of the increase allocated to SOML-supported activities.

• US$263 m in additional resources

Scenario 2: Expanded Commitment to Health and

to SOML-supported activities

• Same as Scenario Two• In addition, 5% of FMOH allocation to tertiary hospitals

redirected to more cost-effective SOML-supported activities

• US$398 m in additional resources – enough to avert 140,000 child deaths through the Nutrition pillar

Scenario 3: Expanded Commitment to Health and

SOML, and modest reallocation from tertiary

hospitals:

*Other levers for increasing fiscal space are explored in the recommendations section of the report