The Federal Government has launched the Nigeria Health Financing Observatory to improve accountability in health spending by tracking how funds are allocated, released, and spent, while linking financing to health outcomes.
The Director-General of the National Health Insurance Authority (NHIA), Dr Kelechi Ohiri, disclosed this on Tuesday in Abuja at the second day of the inaugural Nigeria Health Finance Research and Learning Forum, themed, “Evidence and Learning for Nigeria’s Health Financing Future: Building a Locally Led Research and Learning Ecosystem.”
Ohiri said the observatory was developed to address persistent challenges of fragmented health financing data and provide reliable evidence for policy and decision-making at both national and subnational levels.
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He said the country could no longer afford to continue relying on the status quo in health financing decisions, noting that poor data should not remain an excuse for inaction.
“Can we really afford the status quo? I think it’s way too expensive,” Ohiri said.
Reflecting on previous efforts to use evidence to measure health outcomes, he recalled the challenges encountered during the implementation of the Saving One Million Lives Initiative, when government struggled to obtain timely and reliable data.
He said that while Nigeria’s data environment had improved significantly through better technology and increased availability of information, the challenge of translating data into useful evidence remained.
“A common theme, really, about today and yesterday is about narratives and telling stories. And how can we use the data we have and translate that into evidence? How can we translate that evidence into insight, and how can all the insight we pull together create a credible and accurate narrative about who we are and where we are as a country?” he asked.
Ohiri said Nigeria had increased healthcare financing over the years but still spent less than comparable countries in terms of health expenditure per capita and as a percentage of GDP.
He stressed that beyond increasing resources, government must be able to determine whether available funds were being spent appropriately.
“Even tracking to know are we spending it right? Is it channelled to the right things? And we have different data sources. There’s a health account. There are public expenditure tracking surveys. There are multiple data sources, extremely fragmented, and so it’s almost starvation of evidence in the midst of plenty data,” he said.
According to him, the observatory would bring together fragmented information and transform it into evidence that could generate insights for policymakers, researchers and other stakeholders.
He said the platform would provide dashboards, comparative analytics and an evidence repository to document research findings and lessons on health financing.
Ohiri said the observatory would also address the challenge of insufficient subnational data, which had limited the ability of policymakers to understand health financing across Nigeria’s federal structure.
“The notion of the observatory is to again do something about the bad quality of data we have, do something about the fragmentation of data, do something about the fact that the data is always very high level in global observatories,” he said.
He explained that health financing in Nigeria involved several layers of government and development partners, making it difficult to determine the exact flow of resources to individual facilities and programmes.
“The average primary healthcare centre in Nigeria is partly funded by a development partner, the local government, the state government, and the federal government at the same time,” he said.
Ohiri added that the observatory would provide greater visibility into intergovernmental fiscal transfers and the contributions of different levels of government to healthcare financing.
He described the observatory as a public good that would make information available to researchers, policymakers and other stakeholders.
“This observatory is a public good, meaning that the TWG intends to make this data available to people, to researchers, to anyone who wants it,” he said.
He also invited civil society organisations to use the information on the platform to promote accountability.
“I would always welcome civil society that holds us accountable based on evidence rather than based on perceptions,” Ohiri said.
He said federal and state institutions would be expected to contribute reliable and current financial, budget and expenditure information, while researchers and academics would contribute their findings and analytical expertise.
Ohiri said the ultimate measure of the observatory’s success would not be the sophistication of its dashboards but its impact on policy decisions and healthcare delivery.
“The success of this observatory will be measured not just by how beautiful the dashboards will be. They are nice, by the way, but will be measured by the policy decisions it enhances and improves its utilisation,” he said.
He added that the platform should contribute to “better care, better financial protection, better budgeting, better planning in the health sector.”
Speaking on the rationale behind the platform, Dr Yewande Ogundeji of the Alliance for Health Policy and Systems Research said the observatory would strengthen Nigerian ownership of health financing information and enable policymakers to make decisions using locally generated evidence.
She said the platform would bring together data from Nigerian and international sources and make it accessible to researchers and policymakers.
“No ownership without control for health financing. This means being able to set our own priorities, understand the resources that are available to us, and use our own evidence to guide our decisions,” Ogundeji said.
She said the observatory would support Nigeria’s financing transition by tracking domestic and external financing, budgets and releases at national and subnational levels.
Ogundeji said the platform would also help researchers overcome difficulties associated with accessing health financing data.
She disclosed that almost 200 indicators had been identified for the observatory, with the platform being rolled out in phases.
“For this particular observatory, we have almost 200 indicators that have been identified as important and necessary for the observatory to be functional,” she said.
According to her, the first phase has about 50 validated indicators, while subsequent phases would introduce additional indicators and test artificial intelligence-assisted search and predictive analysis.
“We don’t want it to be a static observatory. We want to be able to somewhat test as we go along, receive feedback, evolve it if necessary,” she said.
Ogundeji said the platform would ultimately provide health financing and health outcome data in one place, enabling users to examine how financing decisions affect health outcomes.
“It’s about being able to have that harmonised on one platform,” she said.
Presenting the technical features of the observatory, Samuel Atanda, who led the team that developed the platform, said it was designed to provide unrestricted public access to verified health financing information while supporting research and accountability.
He said the platform would allow users to compare indicators across states and regions, track trends and identify gaps in health financing.
Atanda said one of the key features was the ability of researchers to submit research and data to the platform, which could then be reviewed and used to generate further research questions.
“What that does is that it raises some questions. We begin to create relationships between health outcomes, health financing data, establish new questions that may have not been asked before, give birth to further research subject or topic areas that needs to be deeply looked into,” he said.
He said the observatory would also provide an indicator catalogue explaining how each indicator was defined and, for derived indicators, the formula used to calculate it.
Atanda said the platform would draw data from about 10 sources, including the NHIA, Federal Ministry of Health and Social Welfare, National Population Commission, Budget Office, Central Bank of Nigeria and WHO, among others.
He said the system had been designed to provide transparency on the sources and methodology behind the data.
“So that by the time you go into the platform, you see exactly where we got the data from. If it is a derived indicator, how we derived it, and how you can either use that in your research to arrive at the same figure,” he said.
Atanda said the observatory could also be used by state governments to assess their performance against the Abuja health financing target, while legislators and civil society organisations could use it to scrutinise budget allocations and expenditure.
He said the platform would also enable users to compare health budgets, execution, insurance enrolment and health outcomes.
According to him, the observatory currently contains indicators covering budgets and allocations, health spending, government health expenditure, household financial burden, health coverage and outcomes.
He said data would pass through validation processes before publication, including automated checks for anomalies and review by the technical working group.
Responding to concerns about cybersecurity, data protection and reliability, Atanda said the platform had been developed in compliance with Nigeria’s data protection requirements.
“We are NDPA certified,” he said.
He added that the platform’s architecture was selected after considering data sovereignty, reliability, sustainability and future integration.
Also speaking, the Executive Director of the WHO Alliance for Health Policy and Systems Research, Dr Kumanan Rasamathan, said the observatory could strengthen Nigeria’s health sovereignty by enabling the country to clearly track where health resources came from, where they went, and what they achieved.
He said countries could not make effective health financing decisions without knowing how money was flowing through their health systems.
“How do you make decisions about your policies if you don’t know where the money is flowing? You don’t know what you’re getting for the money,” he said.
Rasamathan compared the observatory to an astronomical observatory, saying it would help policymakers bring together fragmented data points and identify patterns that might otherwise remain hidden.
He cautioned, however, that the value of the platform would depend on the quality of the data feeding into it.
“You could, however fancy your dashboards are, there are a lot of dashboards in the world, but their value is only in the quality of the data informing those dashboards,” he said.
Rasamathan said the initiative was consistent with a World Health Assembly resolution urging countries to improve tracking of health financing data to inform policy.
He stressed that the observatory should remain Nigerian-led, with international partners supporting the country’s priorities rather than determining them.
“This is not a WHO initiative. This is not a World Bank initiative. This is an initiative from Nigeria. That is sovereignty,” he said.
He said the platform could eventually support broader health-system performance monitoring, analysis, knowledge brokering and advocacy.
Rasamathan urged stakeholders to ensure that the observatory produced timely data that could support current policy decisions, rather than relying on information several years old.
He said the ability to provide timely and accessible financial data would be important for advancing universal health coverage and strengthening Nigeria’s health system.
“It’s a necessary condition for progress, for universal health coverage, and for health sovereignty,” he said.
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