Inadequate financing has been identified as a major factor that affects the implementation of strategies geared towards improving reproductive and maternal health (RMH) in Nigeria. To transform the financing landscape for reproductive and maternal health in Nigeria, the Clinton Health Access Initiative (CHAI) engaged DGI Consult at the National (Federal Ministry of Health) and subnational levels (Kano and Kaduna States), to develop a financial modelling tool, which will help in the accurate costing and financial forecast of RMH programs.

The RMH financial modelling tool, leveraged the One Health Tool (OHT) developed by the UN International Technical Working Group on Costing and programmed by Avenir health. The tool will help with the generation of evidence for estimating RMH resource gaps, which could be used for evidence-based advocacy and planning. As part of the processes of implementation in Kano and Kaduna states, primary and secondary facilities were visited to obtain relevant cost and protocol data for essential RMH services identified by the Guttmacher-Lancet Commission. The data collected were used to develop an excel-based modelling tool that presents the financial requirement to achieve 25%, 50%, 75%, and 100% service coverages for the essential RMH interventions in the two states from 2023 to 2028. In addition, the tool also featured a simple calculator that could be used to estimate RMH funding gaps in the two states. To tackle the funding gaps, a Fiscal Space Analysis (FSA) was conducted to identify potential source of additional revenues for RMH in the two states.

A slightly different approach was employed at the Federal level; rather than an excel-based tool, the OHT was customized for the national RMH program. The essential RMH programs of National priority were identified through an inception meeting with relevant RMH stakeholders at the federal level which was followed by a comprehensive desk review and stakeholder’s consultation. Information obtained from the desk review and engagements were used to design the draft RMH financial modelling tool. To review the draft tool and seek stakeholder’s input, a 2-day national-level stakeholders’ meeting was organized after which the modelling tool was appropriately updated.

Further, DGI Consult in collaboration with CHAI organized a 3-day capacity building workshop for relevant officers from the Federal Ministry of Health (FMoH) and National Primary Health Care Development Agency (NPHCDA) on how to navigate the tool to improve budgeting, resource utilization and efficiency for RMH. A Standard Operating Procedure (SOP) which contains the guideline, procedures was developed to guide the usage of the tool towards achieving equitable and accessible RMH services.

In conclusion, DGI Consult and CHAI developed a Financial Strategy to address the resource shortfall for RMH in the country and will further support FMoH to utilize the tool to inform budgetary processes and ensure efficiency in the use of available RMH resources.