In a bid to raise the accountability bar for health financing including the implementation of the Basic Health Care Provision Fund (BHCPF) in Nigeria, the BHCPF Ministerial Oversight Committee (MOC) secretariat with support of the USAID Local Health System Sustainability (LHSS) Project organized a one-day stakeholder’s workshop to validate the harmonized BHCPF accountability framework after more than two years of rigorous design efforts.

In 2022, the Health Sector Reform Coalition (HSRC) led the development of the BHCPF accountability framework in collaboration with diverse health sector stakeholders through series of engagement and consultations. These stakeholders include but are not limited to DGI Consult, Health Reform Foundation of Nigeria (HERFON), the World Health Organization (WHO), Legislative Initiative for Sustainable Development (LISDEL), Africa Health Budget Network (AHBN) in consultation with the BHCPF gateways – the National Primary Health Care Development Agency (NPHCDA) and National Health Insurance Authority (NHIA).

The processes of developing the accountability framework also involved piloting in selected states to ensure its suitability for wider adoption. The multi-level accountability framework aims to improve accountability for the BHCPF at the national, state, LGA, facility, and community levels across the thematic areas of governance, programme management, finance, service delivery and client satisfaction. The framework is also digitized for ease of data collection, transmission, analysis and data visualization.

The validation workshop which held on Friday 13^th September, 2024 was attended by health sector stakeholders from government MDAs, donors, the Nigeria UHC Forum, Forum of Health Commissioners, donors, implementing partners and civil society organizations (CSOs). Dr Mukhtar Muhammad, the Director of the BHCPF and Secretary of the MOC in his welcome address reiterated the importance of ensuring accountability for financing in the health sector, particularly for the BHCPF and how accountability aligns generally with the vision of the Honourable Coordinating Minister of Health and Social Welfare. He urged the stakeholders to support the implementation of the framework to hold implementers accountable for efficient utilization of BHCPF at all levels for improved health outcome through the primary healthcare. The workshop was heralded with an overview of the BHCPF accountability framework presented by Dr Gafar Alawode, Managing Partner, DGI Consult. Dr Gafar Alawode led the design effort of the BHCPF accountability framework as the erstwhile Chair of the Health Financing Committee of the HSRC. His presentation was followed by a presentation of the result of the piloting of the BHCPF accountability framework by Dr Opeyemi Anuoluwapo of HERFON. Thereafter, Dr Kamal Getso of the MOC led the presentation of the harmonized BHCPF accountability framework for the Federal, State and LGA level across the thematic areas of governance, programme, management, finance, service delivery and client satisfaction.

Stakeholders at the workshop provided invaluable contributions for improving the framework and thereafter validated as amended. The session also witnessed discussions on the strategies for effective deployment and implementation of the BHCPF Accountability Framework. Some of the key inputs from stakeholders include ensuring adequate capacity building for actors for effective use of the framework; funding support from stakeholders to support the deployment and implementation of the framework; the need to ensure tracking outcome is used for decision making at all levels; ensuring citizens have access to the monitoring dashboard to enhance transparency; and aligning indicators of the framework with the SWAp with clear mechanisms to track improvement at all levels. 

The inputs and contributions of stakeholders will be incorporated into the framework and integrated into the operationalization of the BHCPF to enhance its overall accountability and transparency across the country at different levels.