Costing comprehensive sexual and reproductive health and rights services in Nigeria: a financial model for costing and funding gap analysis

Sexual and Reproductive Health and Rights (SRHR) are critical for achieving Universal Health Coverage (UHC) and improving health outcomes, particularly in low-resource settings. In Nigeria, inadequate funding and inequitable access to SRHR services persist, especially in states like Kano and Kaduna, where maternal mortality and unmet family planning needs remain high. This study aimed to estimate the financial requirements for scaling up SRHR services in Kano and Kaduna States and identify potential funding sources to bridge existing gaps. Using a mixed costing approach, the study estimated the costs of delivering comprehensive SRHR services under four coverage scenarios (25% to 100%) from 2023 to 2028. Data were obtained from state health budgets, national surveys, and facility visits. The OneHealth Tool (OHT) was used for cost projection, incorporating costs for human resources, infrastructure, and programmatic activities. Funding gaps were analyzed using an Excel-based tool, and potential revenue sources were identified using Peter Heller’s fiscal space framework. The study found that achieving universal SRHR coverage by 2028 would require an annual average of ₦39 billion ($49.3 million) in Kaduna and ₦63.9 billion ($80.8 million) in Kano. HIV/AIDS and STI interventions accounted for over 50% of the total costs in both states. Current funding levels fall short of these requirements, with an estimated funding gap of ₦16.88 billion ($21.34 million) and ₦41.91 billion ($52.98 million) in Kaduna and Kano, respectively, under the 50% SRHR coverage scenario. Potential revenue sources include increased domestic financing, reprioritization of health budgets, earmarked funds, and enhanced private sector engagement. Scaling up SRHR services in Kano and Kaduna States requires significant financial investments and strategic resource mobilization. Addressing funding gaps through improved budget allocations, innovative financing mechanisms, and stakeholder collaboration is essential to achieve UHC and improve health outcomes. These findings offer evidence to inform budgeting choices of policymakers to prioritize SRHR and ensure equitable access to essential services.