Exploring domestic funding fields in government and the private sector is crucial towards improving Nigeria’s domestic health financing given the dwindling donor funding by bilateral and multilateral agencies. In this interview, the Assistant Director of Grants and Contracts at the Institute of Human Virology Nigeria (IHVN), Mrs Precious Okafor, spoke on how to effectively secure finances to improve healthcare in Nigeria, and private sector involvement among others.
Nigeria is bedeviled by the challenges of poor funding for health. What do you think are the opportunities the country can harness?
Several opportunities abound for funding health care in Nigeria. I will start with the most important, which is government funding. We need to take ownership of our healthcare sector. The donors are doing a lot, too, but it is declining.
One of the key opportunities that abound for us in Nigeria is government funding. The government needs to fund our healthcare sector through budgetary allocations to the Ministry of Health, agencies and parastatals that are directly managing our healthcare sector.
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One other key opportunity for us is our private sector. Our private sector organisations should be involved in the healthcare sector, especially with funding the healthcare system as part of their corporate social responsibility. There are also the health insurance schemes; national health insurance schemes, private and community-based schemes are very key.
Another opportunity in funding the health system is the out-of-pocket system/payment where health service users pay for their health services at the point of care.
How would Nigeria fare without domestic health funding?
The future of Nigeria without domestic funding is obvious. With donor fatigue; donors are gradually reducing their funding. Some donors are saying that they will also stop funding at some point. We are not sure at what point, but it’s obvious that it is gradually declining.
Some of the things some of the donors are doing at this point is ensuring that only local organisations are given opportunities to apply for grant funding and that sustainability is integrated into programming.
A few funding opportunities came up this month from one of the key funders in the country and the first eligibility criteria is that you must be a local organization; this speaks volumes.
So, donor funding is going to decline, and we all know that a good health financing system is very crucial for the effective performance of a country’s health system. It’s going to decline and that is why every one of us, the public and the private sector, needs to sit up, and be conscious about our intentions to adequately fund the health sector.
Our future with domestic funding is very bright. When we do internally what we need to do to ensure that our healthcare system is efficient, people get quality health service when and where they need to and it becomes affordable. We can achieve this easily with domestic funding.
That is why for our programme areas, there is a lot of emphasis on sustainability. It will be a bright future for Nigeria, and it is a collective effort. For implementers within organisations, we need to ask ourselves about the things we need to do to ensure that our healthcare system is adequately funded even when the donor funds go or come to the barest minimum.
How does the appropriate utilisation of funds advance the implementation of health programmes?
If you use grant funds as outlined by the donors, they will be encouraged to give more. Beyond each of the donors giving money, they conduct assessments and investigations on things like procurement and sub-awardee engagement processes etc. For instance, at IHVN, there are service areas that we work with community-based organisations, and hospitals to implement, funders look at the processes we used to engage these CBOs.
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