Talk to the Emir to save new-born chilrden

If you want to protect new-born babies from dying of preventable cause, who do you talk to? The Ministry of Health, right? Because it is their mandate. And their expertise. And they get the funding to do it. Well, do they?

Nigeria has the highest number of maternal and newborn deaths of all African countries, with 33,000 women dying during pregnancy and childbirth every year and 251,000 babies dying in their first month of life – often due to preventable and treatable causes. Katsina State in the North is one of the states where the situation is especially dire, because on average people are poorer and because the state is mainly rural, so hospitals and health centers are few and far between.

My colleagues at Save the Children wondered: Is it really enough to speak to the Ministry of Health? In the past they had observed that making a good plan, submitting a solid budget is one thing, whether or not the funding actually gets released to the agencies is a completely different story. So they asked me to map out: “Who influences the budgeting and the release of funds for newborn survival activities in Katsina state?” I am lucky to have well trained Net-Mappers on the ground, Amina Yauri Mustapha and Haj. Amina Lawan interviewed a whole range of people in Katsina, and this is what we found out:

 

Links: Black - Hierarchy, Red - Funding, Actors: Yellow - Government, Red - Donors, NGOs, Projects, Grey - Others, size of actor - influence

Two completely different sets of actors influence making the plan on the one hand and disbursing the money on the other. The size of the dots indicates the influence of actors on the specific issue (on planning/budgeting in map 1 and on disbursing in map 2). As you can see on the second map, the governor, executive council and political associates of the governor have a stronger influence than the Ministry of Health. And the Ministrie’s influence is on par with that of the governor’s wife. And even the Emir (here called “religious leaders”) has far more influence on the disbursement of funds than the front line health providers – the people who do the job (State Primary Health Care Development Agency – SPHealthDevA and Health Services Management Board – HealthSMBoard).

What does this mean for a successful advocacy strategy aimed at getting the money to implementing agencies? Read the full case study here (1845 KB).