- All > Medicine Access and Rational Use > Financing
- All > Medicine Access and Rational Use > Supply Management
- Keywords > financial plans - funding and expenditure projections
- Keywords > funding gap analysis
- Keywords > funding requirements
- Keywords > maternal and child health - MCH
- Keywords > maternal, newborn, and child health commodities
- Keywords > medicines for maternal and child health
- Keywords > morbidity-based forecast
- Keywords > qualifications - requirements
- Keywords > quantification
- Keywords > quantification - forecasting of medicines and supplies
(2013; 72 pages)
The Federal Ministry of Health (FMOH) of Nigeria and partners have made considerable efforts to combat maternal, newborn, and child health illnesses. Despite this, the burden of these conditions in Nigeria remains high. Results from the latest Demographic and Health Survey (Measure DHS 2008) of 2008 showed that Nigeria is still a long way from meeting the Millennium Development Goal (MDG) goals 4 and 5, which relate to reducing the burden in child and maternal deaths by 2015, respectively. In this survey, the infant mortality rate (per 1,000 live births) was estimated at 75 and the percentage of births attended by skilled health personnel was 38.9 percent. Immunization rates remain low, especially among rural populations.
To accelerate progress toward meeting the MDG goals, the FMOH and partners have developed a number of strategic interventions, especially at primary health care level. These interventions aim at increasing basic antenatal, newborn, and child care for the most vulnerable populations, with the goal of saving approximately one million lives by 2015. The key to these interventions is to provide medicines and health commodities. In July and August 2012, the office of the honorable Federal Minister of State for Health, with technical assistance from the USAID | DELIVER PROJECT, Task Order 4, conducted a forecast and funding gap analysis of commodities for maternal, newborn, and child health (MNCH) in Nigeria for one year.
Using morbidity information from various sources, the USAID | DELIVER PROJECT carried out a morbidity-based forecast. This report includes the findings from the forecast, as well as the funding gap analysis that can be used for advocacy with key stakeholders to increase the level of funding and eventual availability of commodities for MNCH conditions in Nigeria. The project quantified the main commodities needed for a comprehensive MNCH program in Nigeria, by commodity groups. These groups were nutrition, antimalarials, essential medicines, HIV and AIDS medicines and supplies, vaccines, family planning commodities, and general health consumables (e.g., syringes, giving sets, mama kits, etc.). In total, the project estimated the funding requirements for 135 medicines and 67 general health supplies. The quantification team used purchase prices that states and program representatives reported. If local prices were not available, we used the International Drug Price Indicator Guide (MSH and WHO 2011) median prices.
The USAID | DELIVER PROJECT estimated an annual funding requirement of approximately U.S.$859,496,126. Using information from the state-level ministry of health (MOH) officials, the FMOH, and partners, we estimated that $361,719,211, of this is currently funded, leaving a funding gap of approximately $497,776,915. In Nigeria, this is an annual expenditure of approximately $5.00 per person. Using the Lives Saved tool in the Spectrum set of models, we estimated that providing these medicines and commodities to a level of coverage sufficient to reach the 2015 MDG targets would result in a significant reduction in maternal, newborn, and child deaths by 2015. For example, the team estimated the potential reduction for child deaths only if the MDG targets were met by 2015 could be up to 750,000 lives. Ensuring that the necessary commodities are available in public health facilities for the trained service providers will definitely contribute to saving the lives of mothers, newborns, and children, and to meeting the Government of Nigeria’s ambitious, “Saving One Million Lives Initiative.”
Going forward, the USAID | DELIVER PROJECT recommends that the results of this forecast and funding gap analysis should be used by the FMOH and partners to source for funding. Concurrently, a supply plan that takes into account existing stock levels, as well as commodities that may already be on order needs to be developed in order to inform the procurement of these commodities. Finally, a national forum for all stakeholders (including state-level representatives) needs to be created to meet regularly and chart a way forward toward creating MNCH commodity security for Nigeria.