Nigeria is currently the 7th most populous nation in the world with a fertility rate of 5.4 and an annual growth rate of 2.2%. By 2050, the country is projected to become the 3rd most populous nation.

With a much lower annual GDP growth rate than many Western countries, the country’s resources cannot meet the needs of this rapidly growing population. Nigeria has roughly 45 million women who are of reproductive age, and of that number, 15 million want to avoid an unwanted pregnancy. Sadly, 9.5 million have an unmet need for modern contraceptives or family planning services.

This results in an increasing rate of unintended pregnancies which can lead to unsafe abortions which account for 5-13% of all maternal deaths and unplanned births.

Although the Nigeria Family Planning Blueprint, 2020-2024, outlines the country’s plans for achieving a revised target modern contraceptive prevalence rate of 27% by 2024, funding remains inadequate to cover the unmet need for family planning services.

In addition to the reduction of allocation to family planning in the 2021 budget, there was the recent announcement of an 85% cut in funding to the United Nations Population Fund by the UK government, further putting pressure on family planning initiatives.

To press home the need for improved funding to ensure access to family planning services, Nigeria Health Watch on June 24 hosted a family planning policy dialogue with a number of health policy experts.

The need for a strategic objective to improve domestic funding to adequately cover family planning costs countrywide through mobilization of resources from public and private sector funding sources formed the major crux of the discussion.

The dialogue brought together speakers and participants from federal and state governments, development partners, civil society organizations, youth groups, and the public who discussed the current landscape for family planning services in Nigeria.

Participants also identified and discussed the consequences of the reduction in funding for family planning.

Seeking domestic sources to fund family planning services

While delivering the keynote address, Emmanuel Adedolapo Lufadeju, with the Rotarian Action Group for Reproductive Maternal and Child Health, said there was a compelling need to shift the emphasis on reliance on foreign donors and leverage local resources for funds to tackle family planning needs in Nigeria.

Lufadeju noted that the best way to achieve this would be for critical stakeholders to come together and prepare documents that will convince sources, both private and public, that every penny injected into family planning services will be well spent.

“We shall embark on a massive advocacy campaign to ensure that we get the proportion we need to inject into [family planning] and sectors such as banking, oil and gas and communications, will be helpful in providing the required funds,” he said.

Earlier in her address, Vivianne Ihekweazu, the Managing Director of Nigeria Health Watch, said it was worrying that the Nigerian population is increasing more than the economy, resulting in low investment in critical sectors, such as healthcare which is just 0.6% of GDP.

Impact of reduced funding on family planning services

The impact of lack of adequate funding for family planning services is far-reaching. Among these impacts, according to Toyin Chukwudozie, the Head of Programs with Education as a Vaccine, was the reduction in the availability of commodities for family planning services.

Chukwudozie said this has resulted in an increasing rate of unintended pregnancies which can disrupt education for young girls and lack of access to economic opportunities.

Chukwudozie maintains that there is a need to understand that behind the statistics of women with unmet needs for contraceptives, are real and young people who form a greater percentage of Nigeria’s population.

Lending his voice, Effiom Effiom, the Country Director of Marie Stopes International, said that the reduction in funding for family planning services is partly a result of the impact of COVID-19 on both foreign donors and the Nigerian government.

Effiom, however, regretted that state governments have failed to reflect funding for family planning services in their budgets, noting that family planning was the cheapest means of reducing maternal death.

Recommendations to improve domestic resource mobilization

Part of the reason why several sectors continue to lag behind in Nigeria is the lack of favorable and well-thought-out policies by the government.

For family planning services to improve in Nigeria, Ulla Elisabeth Mueller, the Country Representative of the United Nations Population Fund, said the right kind of policies and an enabling environment must be in place.

“We must think about our revenue and ensure that funds for [family planning] services are not only captured in the budget but also allocated and prioritized,” she said.

Mueller further noted that one of the major impediments to accessing family planning services was the proven dimension between men and women because only 46% of Nigerian women aged 15 to 49 years make their own decisions regarding healthcare, contraception, and sex with their husbands or partners.

Similarly, Ejike Oji, with the Association for Advancement of Family Planning, said it was necessary to begin with a policy-driven investment such as making sure that it is made a legislative agenda so it can get the kind of attention it deserves.

“We must educate our leaders so they can understand the importance of [family planning] and where to invest funds. It is not just about asking them to provide funds. They need to know how important it is for the country,” Oji said.

In his address, Olumide Okunola, a senior health specialist with World Bank Nigeria, said that to achieve a reduction in the total fertility rate there is the need for a 24.53% increase in the modern contraceptive prevalence rate.

If unmet needs for modern contraception in Nigeria are satisfied, by some estimates, unintended pregnancies would drop by 77%, from 2.5 million to 555,000 per year while the number of unplanned births will drop from 885,000 to 200,000 and the number of abortions would drop from 1.3 million to 287,000.