Following the Supreme Court’s judgement that granted Local Government Authorities (LGAs) financial autonomy, DGI Consult commissioned research to explore the potential implications of the autonomy on primary health care delivery, funded by the International Rescue Committee (IRC). The policy analysis assessed the potential implications of the LGA financial autonomy for PHC management, the implementation of specific health sector policy thrusts, such as PHCUOR and BHCPF, and other sectors contributing to health outcomes, such as education, WASH and agriculture.

The study was conducted in 12 states (2 states per Geopolitical Zone) and 36 Local Government Areas (3 LGAs per state) using mixed research methods, including desk review of relevant documents and key informant interviews with national, state and LGA-level stakeholders. It provided insights on the (a) understanding of the supreme court ruling; (b) capacity development on administration, planning, and financial management; (c) coordination between LGA and state agencies; (d) accountability for financial management; (e) political economy to understand influence and interests of actors and institutions and how they can determine the outcomes of financial autonomy; (f) institutional responsibilities; (g) service delivery; (h) unintended consequences of financial autonomy; and (i) policy alignment.  

The findings and recommendations from the policy analysis will guide the effective implementation of the LGA financial autonomy towards harnessing its potential benefits for improving PHC financing and service delivery and other key sectors that contribute to health outcomes. DGI Consult will work with all relevant stakeholders to translate the key recommendations from the policy analysis into implementable policy thrusts.