The Partnership for Advocacy in Child and Family Health (PACFaH) Project is a social accountability investment implemented through the strategy of coalition building to achieve the goal of catalyzing government’s responsiveness on policies, budgets and administration on the most daunting challenges to Child and Family Health (CFH) at national and state levels in Nigeria. The project is implemented by a coalition of eight indigenous Civil Society Organizations (CSOs) working in Child and Family Health.
CS-SUNN under the PACFaH project is the nutrition issue lead with the mandate to advocate for the adoption and increased implementation of the National Strategic Plan of Action for Nutrition (NSPAN) with a focus on Maternal and Child Nutrition (in Kaduna, Niger and Nasarawa state) and for increase in the 2017 health sector budget (in Niger and Kaduna state). The NSPAN was approved by the National Council on Health in 2014, and targets to reduce stunting by 20%, low birth weight among newborns by 15 percent and increase exclusive breastfeeding rate to 5o percent among other targets.
CS-SUNN under the PACFaH project advocated for the Federal and State governments to:
Table 1: Summative comparison of expected versus actual outcomes and outputs achieved
Increased implementation of the National Strategic Plan of Action for Nutrition at National and 3 states
Increased 2017 health sector budget allocation and ensure timely releases in Nigeria at National and 7 States
% Health to State allocation in 2017 increased to 11.40% from 7.37% in 2014, capital releases increased to 57% from 29%
Domesticated State Specific Strategic Plan of Action for Nutrition and budget document
Capacity building achievements
This section will examine the key capacity building indicators achievements expected for the NGO in the area of:
Number of TOT workshops held for nutrition CSOs on advocacy.
2 Participants from state coalitions where part of the TOT that was conducted at the Federal level
Number of trainings held based on needs assessment findings;
Four trainings held in period one, 2 in period 2 and 2 in period 3
Total Number of Participants at the Advocacy Trainings
Total Number of Budget Tracking Trainings held
Total Number of Participants at the Budget Tracking Trainings
Number of CSOs Trained
Number of FBOs Trained
STATE GOVERNMENTS BREAK NEW GROUND; CREATE NUTRITION BUDGET LINES!!!
Over 2- year old Fatima suffering severe acute malnutrition (SAM) in Kaduna state is one among the approximately 1.7 million Nigerian children affected by SAM. UNICEF (2015) says this alarming figure constitutes one tenth of all severely acutely malnourished children in the world. The NDHS (2013) states that 37% of Nigerian children are stunted, 29% are underweight in addition to the 18% who are wasted.
Children suffering malnutrition and others hit by SAM like Fatima in Nigeria before age five go through irreparable intellectual and cognitive impairment and stunted physical growth. At school, they make poor grades, become prone to school drop-outs thereby adding to an unproductive labour force; slowing Nigeria’s economic growth/development and perpetuating poverty.
Though the Federal government has put a number of programmes and policies in place to address child malnutrition (National Policy on Food and Nutrition (2016), the National Strategic Plan of Action on Food and Nutrition in Nigeria (2014-2019), the Micronutrient Control Programme, etc) inadequate funding and low political has hampered the implementation of these policies. For instance the NSPAN will cost 912 million USD (over N327 Billion) to implement; with N377.4Billion allocated to the health sector of the 2017 national budget, how feasible is its implementation?
Nonetheless, the birth of The Partnership for Advocacy in Child and Family Health (PACFaH) Project with Civil Society Scaling up Nutrition in Nigeria as the Nutrition lead is a perfect demonstration that relief can reach children like Fatima and that the burden of malnutrition and other health challenges in Nigeria can be cut-down. CS-SUNN under the PACFaH project advocated for the Federal and State governments to:
Increase the 2017 health sector budget allocation and ensure timely releases at National and 3 States
Increase implementation of the National Strategic Plan of Action at National and 3 states
In the bid to garner political will for increased funding, CS-SUNN conducted 23 advocacies at the Federal and 3 states (Kaduna, Nasarawa and Niger) targeting government Personnel in line Ministries, Legislators in the State Houses of Assembly and spouses of state governors. It further created strong nutrition/health sector budget coalitions who through their activities in collaboration with those at the national are still engaging with the state government on PACFaH issues. In addition, CS-SUNN’s innovative engagement with the media increased visibility of nutrition issues and the PACFaH project.
Today, Fatima can access better SAM care as results from our activities has led to the creation of budget lines for nutrition in Kaduna and Nasarawa states and increased funding allocation to the lines in the 2017 budget. Kaduna state health allocation increased to 11.40% from 7.37% in 2014, capital releases increased to 57% from 29% and from 8.9% in 2016 to 11.6% in 2017.
Moreso, Kaduna state has the highest percentage allocation to nutrition with 980 million naira (3.7%) of the total health budget (26.5 billion naira). Niger state allocated 60 million naira for nutrition which accounts for just 0.44% of the health budget (13.6 billion naira) while Nasarawa state allocated 21.5 million naira which is 0.31% of the health sector budget.
Nasarawa, Kaduna and Niger state residents can now look forward to improved nutrition interventions as CS-SUNN (National and its state chapters) becoming members of the National and State Committees of Food and Nutrition as well as CS-SUNN in Kaduna and national incorporated into the Kaduna State Emergency Nutrition Action Program (KADENAP) will contribute to coordination of nutrition activities and the fight against malnutrition.
At some point though, CS-SUNN encountered hitches ranging from the lack of awareness/understanding of nutrition issues which contributed to the low media coverage of nutrition in Nigeria, Poor coordination on nutrition advocacy, dissimilar nutrition messages from relevant stakeholders and bureaucracy on the part of concerned public office holders.
But, the PACFaH project gave us insight into the fact that strengthening the competencies of nutrition stakeholders, providing support to in-government champions, supporting teamwork across relevant line ministries and speaking with one voice, one message was essential to the success of project.
From the foregoing, CS-SUNN in the last three years has contributed to the attainment of the PACFaH project’s overall goal of strengthening for CSOs and government champions to build partnerships to advance child and family health through advocacy.
We therefore look forward to providing continued support to those trained on the PACFaH project especially; the State CSO Coalitions to continue advocacy for increased funding for nutrition and track and monitor budgets. Best practices will be made available to enable these nutrition actors to continue the PACFaH initiative.
“It’s been a privilege working with CS-SUNN under the PACFaH project. You have helped bring our attention to the challenge of nutrition by bringing statistics to us regarding what nutrition is in the state. You alert us on the nutrition needs of our children. We had a stakeholders meeting sometime this year where this information was given to us and the wife of the governor was there and as a result I want to tell you that the state government has made a commitment to nutrition for the state through the World Bank” (Quote from Nasarawa State Commissioner for Health, Dr. Daniel Iya during an interview session after the National Health Dialogue on the 24th-25th September, 2017 in Abuja)
“We have learnt a lot, benefited a lot, in fact a very fruitful engagement with CS-SUNN. They were able to help us initiate the process and create a budget line for nutrition, the first time ever in Kaduna State” (Quote from Dr. Nuhu Butawa, Kaduna State Ministry of Health during an interview session after the National Health Dialogue on the 24th-25th September, 2017 in Abuja)
In their own words above, state actors reveal the level of impact of the CS-SUNN/PACFaH advocacy campaign and resultant actions taken by them to improve the challenging situation confronting the CFH sector. This for us was a successful campaign for CS-SUNN and our partners on the Project.