FG seeks stronger domestic financing to bridge N720bn health funding gap

The Federal Government has called for stronger domestic resource mobilisation to bridge the ₦720 billion funding gap in Nigeria’s 2025 health sector Annual Operational Plan (AOP), saying increased investment in maternal healthcare is essential to reducing the country’s high maternal mortality burden and achieving national health targets.

The call was made on Saturday during a performance dialogue on maternal health financing, where the National Lead of the Maternal Mortality Reduction Innovation Initiative (MAMII), Dr Dayo Adeyanju, presented an investment case for maternal health delivery, while the Strengthening Health Systems Lead at BudgIT Foundation, Dr Biobele Davidson, highlighted financing and accountability challenges affecting maternal health outcomes.

Presenting the AOP performance review, Adeyanju said Nigeria continues to record one of the world’s highest maternal and neonatal mortality burdens, with a maternal mortality ratio of more than 572 deaths per 100,000 live births and a neonatal mortality rate of 41 deaths per 1,000 live births.

He said the MAMII, launched during the 2024 Joint Annual Review, aims to reduce maternal mortality by 30 per cent and neonatal mortality by 20 per cent by 2027, while increasing health facility utilisation by 60 per cent by 2030.

According to him, the initiative has identified 172 priority Local Government Areas (LGAs), which account for about 50 per cent of Nigeria’s maternal mortality burden.

“The initiative is addressing the key factors responsible for maternal and neonatal deaths, including delays in seeking healthcare, reaching health facilities, receiving quality care, taking timely action, and strengthening coordination among stakeholders,” Adeyanju said.

ALSO READ: Umahi orders autopsy over death of Ebonyi physiotherapist

He explained that the MAMII strategic framework focuses on strengthening data intelligence and surveillance, improving coordination through the Sector-Wide Approach (SWAp), expanding health financing and digital solutions, enhancing facility readiness, improving physical and financial access to services, and promoting community engagement.

Reviewing the 2025 National Annual Operational Plan, Adeyanju disclosed that the health sector requires an estimated ₦3.68 trillion to implement planned interventions.

He said government funding accounts for ₦1.70 trillion (46.3 per cent), development partners are expected to contribute ₦1.25 trillion (34 per cent), while the remaining ₦720 billion, representing 19.5 per cent, remains unfunded.

“The largest allocation in the AOP, amounting to ₦3.09 trillion or 87.9 per cent, is dedicated to building efficient, equitable and quality health systems, underscoring the government’s priority of strengthening healthcare delivery,” he said.

In his presentation on Nigeria’s maternal health financing landscape, Davidson said inadequate domestic financing and weak budget implementation continue to undermine efforts to reduce maternal deaths.

He noted that Nigeria records an estimated 993 maternal deaths per 100,000 live births, accounting for about 19 to 20 per cent of global maternal deaths, despite representing only about two per cent of the world’s population.

“Approximately 82,000 Nigerian women die annually from pregnancy-related complications, most of which are preventable with adequate financing and a functional primary healthcare system,” Davidson said.

He observed that although Nigeria committed under the Abuja Declaration to allocating 15 per cent of its national budget to health, public spending has consistently remained between 3.5 and 6 per cent.

“The 2026 Federal Government health budget stands at ₦2.51 trillion, representing just 3.67 per cent of the national budget. Meanwhile, between 69 and 77 per cent of healthcare financing comes directly from patients through out-of-pocket payments, creating significant barriers to maternal healthcare,” he said.

Davidson said MAMII has made notable progress since its launch, including interventions in 172 priority LGAs across 33 states, the registration and tracking of more than 500,000 pregnant women, the upgrading of more than 3,000 primary healthcare facilities, the deployment of digital platforms to monitor high-risk pregnancies, and the establishment of state-level MAMII task forces.

However, he warned that poor budget execution continues to limit the impact of health spending.

“Across many states, actual health expenditure falls between 30 and 50 per cent below approved budgets. This means resources intended for emergency obstetric care, skilled birth attendance, antenatal medicines and referral transport often do not reach frontline health facilities,” Davidson said.

He added that BudgIT’s assessment of 5,099 primary healthcare centres found that only 13.89 per cent have ambulances, 49.6 per cent lack nurses or midwives, 40 per cent have no laboratory facilities, while 55.09 per cent are not physically secure enough to provide round-the-clock emergency services.

Davidson identified poor transparency in budget implementation, the diversion of local government health funds, inconsistent enforcement of the Basic Health Care Provision Fund accountability framework, and weak use of digital budget-tracking tools as major obstacles to improving maternal health outcomes.

He called on governments to increase health budget allocations towards the Abuja Declaration target, strengthen the implementation of the Basic Health Care Provision Fund, expand health insurance coverage for women in the informal sector, increase domestic financing for essential maternal health commodities and emergency transport, and publish regular budget implementation reports.

“Financing decisions must translate into better maternal survival outcomes for the approximately 82,000 Nigerian women who die every year from pregnancy-related complications,” he said.