E4A Mamaye – Health Financing case-study in 3 states in NigeriaNigeria
Dates: March – April 2021
Project Description: Since starting in 2012, the Evidence for Action (E4A) programme has used a combination of evidence to drive accountability for maternal and new-born health outcomes. In 2021, across the three states supported by E4A, reports indicated that funding for healthcare interventions and programmes, including Reproductive, Maternal, Newborn, and Child Health (RMNCH), were affected by the COVID-19 pandemic. However, the extent to which funding was affected, and whether funds remained within the health sector or had been diverted to other sectors, was not clear. Structured information-gathering on what facilitated or hindered funding for RMNCH during the pandemic was therefore required to better inform decision-making by government, civil society and other relevant stakeholders.
Our Role: E4A commissioned LAMP to conduct a case study to identify how allocation and release of funding for RMNCH changed between 2019 to 2021 in Bauchi, Niger, and Lagos States. It aimed to identify how allocation and release of funding for RMNCH changed in the year preceding the COVID-19 pandemic and during the pandemic and to assess the extent to which the COVID-19 pandemic contributed to these changes. Specifically, it aimed to pinpoint the decision-making process that informed funding choices, including how they were influenced by advocacy/accountability efforts of the State-Led Accountability Mechanisms (SLAMs), and to understand the impact these adjustments had on the delivery and take-up of RMNSHC services.
LAMP utilised a mixed methods approach. Both quantitative and qualitative data collection tools were developed, and data collection was carried out using cost templates and key informant interview guides. The data was cleaned and analysed, and key findings were summarised in a report which was reviewed with the E4A team before the final case study report was produced.
- LAMP’s case-study enabled E4A and relevant stakeholders to understand how the COVID-19 pandemic affected RMNCH funding. E4A is now using this to inform programming for the coming year and will be implementing LAMP’s recommendations with their partners and government stakeholders.
- LAMP’s team used its in-depth experience of health financing in Nigeria to overcome challenges such as tight deadlines and having to undertake data collection with limited access to stakeholders. LAMP adapted its approach during implementation to ensure sufficient high-quality data was collected and used regular feedback to E4A to ensure the development of relevant and informative analysis.