Health Policy Advocacy Win: How Nigeria Doubled Government Funding in 2 Years

You're staring at data showing hundreds dying from preventable diseases in your community. You know what needs to change. The policy solution is right there—so obvious, so necessary.

But six months later, nothing has moved.

What if strategic advocacy could actually move the needle on government health spending in low-income countries?

In Nigeria, for example, civil society organizations achieved exactly that. Between 2019 and 2021, they helped double domestic funding for the Nigeria Centre for Disease Control to a record 2.9 billion naira ($7.7 million). More remarkably, they did it during a period of economic uncertainty when most countries were cutting health budgets.

The Challenge: When Good Intentions Meet Political Reality

Health policy advocacy in low-income countries faces unique obstacles that advocates in wealthier nations rarely encounter. The policy-making process is often chaotic, with varied stakeholder capacities and heavy dependence on donor funding creating additional complexity.

Nigerian advocates faced all these challenges plus more:

• Competing priorities: Health budgets compete with infrastructure, education, and debt servicing
• Donor dependence: External aid historically covered 30% of health budgets, creating resistance to domestic investment
• Complex stakeholder dynamics: Multiple actors with different interests and varying levels of influence
• Limited advocacy experience: Many civil society organizations lacked formal training in policy advocacy

Yet despite these barriers, Nigerian advocates found a way through—and their success offers a blueprint for health advocates worldwide.

The Six Strategies That Moved Mountains (and Budgets)

Academic research analyzing 65 studies across multiple countries reveals that successful health advocacy relies on six key strategies. Nigeria's experience demonstrates how these work in practice:

1. Tailored messaging: Nigerian advocates presented epidemic preparedness as both a health security and economic development priority, helping different stakeholders understand broader implications.
2. Strategic coalitions: Rather than working alone, civil society organizations partnered with government officials, technical experts, and international partners to amplify their voice.
3. Simple framing: They avoided jargon, presenting epidemic preparedness as protecting Nigeria's families and economy—a message that resonated with policymakers.
4. Leveraged external events: Advocates used global health security concerns and regional disease outbreaks to demonstrate the urgency of domestic investment.
5. Provided concrete solutions: Beyond advocacy, they offered draft legislation and technical expertise that made it easier for government officials to act.
6. Forum flexibility: When progress stalled in one department, advocates strategically moved discussions to other forums—from health ministries to finance departments to legislative committees.

Learning from Nigeria's Success

Organizations like the Global Health Advocacy Incubator have been documenting these successes to help advocates worldwide. With a 10-year track record of supporting health policy advances across 32 countries, GHAI has seen firsthand how strategic advocacy can drive measurable policy change.

"The Nigeria experience demonstrates that civil society advocacy can drive tangible policy change when organizations have access to evidence-based tools and technical support," notes a GHAI representative. The organization has supported the passage or strengthening of over 143 health policies across 32 countries, impacting more than 4 billion people.

The Nigeria case study is particularly valuable because it shows how advocacy can work even in challenging contexts. The success wasn't just about the funding increase—Kano State also established a dedicated budget line for epidemic preparedness and adopted a comprehensive Action Plan for Health Security, providing a model for other Nigerian states.

The Broader Context: Why This Matters Now

Nigeria's advocacy success comes at a crucial time. As traditional donor governments reduce foreign assistance, countries face growing pressure to finance their own health systems through domestic resources. External aid has historically accounted for approximately 30% of low-income countries' health budgets, making this shift both urgent and necessary.

The Nigerian model demonstrates that strategic advocacy can help countries make this transition successfully. By building government commitment to domestic health financing, advocates can help create more sustainable, resilient health systems that don't depend on external funding cycles.

What This Means for Health Advocates

Whether you're working in health policy, civil society advocacy, or government relations, Nigeria's experience offers practical lessons:

• Start with evidence, but don't stop there: Technical data is important, but it must be translated and strategically communicated
• Build coalitions early: Broad-based support amplifies your voice and provides diverse expertise
• Develop multiple pathways: If one approach stalls, having alternative forums and strategies keeps momentum going
• Invest in skills development: Advocacy requires specific competencies that can be learned and improved
• Think long-term: Sustainable policy change takes time, but strategic persistence pays off

Final Thoughts

The Nigerian model proves that civil society doesn't need to wait for perfect conditions or unlimited resources to drive change. When equipped with strategic advocacy skills and evidence-based approaches, civil society organizations can effectively influence government budgets and policy priorities—even in challenging contexts.

To learn more about strategic health advocacy approaches, visit: https://www.advocacyincubator.org/news/2025-03-14-opinion-civil-society-has-a-crucial-role-in-shaping-global-public-health