Blog

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 the 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 an 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 per cent and increase the exclusive breastfeeding rate to 5o per cent among other targets.

CS-SUNN under the PACFaH project advocated for the Federal and State governments to:

1. Increase 2017 health sector budget allocation and ensure timely releases at National and 3 states (Kaduna, Niger and Nasarawa)
2. Increase implementation of the National Strategic Plan of Action at National and 3 states

Through the following approaches:

• Increased capacity of key stakeholder groups to advocate for and to track and monitor nutrition funding: CS-SUNN conducted training

• Increased awareness of the Plan and commitment to adopt
• Increased political support by key national and state policymakers and program managers for the adoption and implementation of the NSPAN
• Evidence-based advocacy engagement with policymakers, legislators and key influencers for increased budgetary allocation to the nutrition and health sector at the national and focal states in 2017.

• To support existing policy, legal and budgetary frameworks to be more accountable to meet the national needs of Nigerians ·
• To enhance experience sharing and learning between and within organizations.

Technical Achievements

Table 1: Summative comparison of expected versus actual outcomes and outputs achieved

Outcomes	Fully Achieved
Increased implementation of the National Strategic Plan of Action for Nutrition at National and 3 states	Increased awareness, support and implementation of the policy. Policy document adopted in the state with work plans produced; Increased inter-sectoral coordination among Ministries Departments and Agencies (MDAs), Nutrition budget lines created in the state in 2015, budget lines were funded in 2017
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%
Outputs	Fully Achieved
Increased awareness, support and implementation of the policy. Policy document adopted in the state with work plans produced;Increased inter-sectoral coordination among Ministries Departments and Agencies (MDAs), Nutrition budget lines created in the state in 2015, budget lines were funded in 2017	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:

• M&E; b) Financial management; c) research and data analysis; d) professionalizing the NGO; e) fund-raising and proposal writing; f) human resource management; g) project management

S/N	Indicators	Federal	Kaduna	Nasarawa	Niger	Total	Notes
1	2 Participants from state coalitions were part of the TOT that was conducted at the Federal level	1	0	0	0	1	Four trainings were held in period one, 2 in period 2 and 2 in period 3
2	Total Number of Participants at the Advocacy Training	2	2	2	2	8	Number of training held based on needs assessment findings;
3	Total Number of Participants at the Budget Tracking Training	77	93	88	86	344
4	Total Number of Budget Tracking Trainings held	2	2	2	2	8
5	Total Number of Participants at the Budget Tracking Trainings	37	39	40	37	153
6	Number of CSOs Trained	26	26	22	27	101
7	Number of FBOs Trained	0	22	12	17	51

Lessons learned

1. Building the capacity of Identified nutrition stakeholders on nutrition advocacy, coalition building and partnerships were fundamental to the success of the project.
2. Identification, improving the understanding of issues in CFH and providing adequate support to In-Government Champions were also critical to the success of the project.
3. Supporting inter-sectoral collaborations and partnerships contributed to increased investment in nutrition and promoted the kind of synergy required for an improved multi-sectoral approach to nutrition programme design and implementation.
4. Achieving an increase in budget allocation to the health sector in 2017 was made possible by the one strong voice raised by all the PACFaH partners working together.  
5. CS-SUNN measured the success of its advocacy in terms of the level of scoring the states on the implementation of the Policy, availability of budget lines and funding and increased awareness and interests of Policymakers and CSOs in nutrition.
6. Despite the successes of the PACFaH project, there is a need to strengthen existing coalitions and provide continuous support to state actors to ensure the sustainability of the gains from the PACFaH project.
7.  

Sustainability Plans

1. CS-SUNN will support 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 and will enable these nutrition actors to continue the PACFaH initiative.
2. The Coalition will build on the successes of the PACFaH Project by incorporating key components that will sustain gains from the project in future programming.

our success story

STATE GOVERNMENTS BREAK NEW GROUND; CREATE NUTRITION BUDGET LINES!!!

Over 2 years old Fatima suffering from 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 18% are wasted.

Children suffering from 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, and 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 N377.4 billion 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 with 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 the visibility of nutrition issues and the PACFaH project. 

Today, Fatima can access better SAM care as results from our activities have 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) becomes 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 the 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, and one message was essential to the success of the 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 to the nutrition needs of our children. We had a stakeholder meeting sometime this year where this information was given to us and the wife of the governor was there 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 the 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.