Financing Sdg 3 (Good Health and Well-Being): Partnerships, Investment, and Accountability in Nigeria

Abstract

This study examines the financing architecture of Sustainable Development Goal 3 (Good Health and Well-Being) through the interconnected pillars of Partnerships, Investment, and Accountability, with specific attention to West Africa, using Nigeria as a case study and comparable developing economies. Despite global commitment to the 2030 Agenda, the financing gap for Universal Health Coverage (UHC) in Sub-Saharan Africa remains substantial, worsened by macroeconomic instability, currency depreciation, post–COVID-19 fiscal pressures, and, in some cases, a lack of accountability.
Using a qualitative descriptive design grounded in interpretivism, the study analyses secondary data from the World Health Organisation (WHO), the World Bank, and Nigerian fiscal policy frameworks. The theoretical foundation integrates the Human Capital Framework (World Bank, 2018), the Fiscal Space for Health Framework (Barasa et al., 2018), the Health Governance Model (Brinkerhoff & Bossert, 2020), and the Health Systems Resilience Framework (Thomas et al., 2020) to examine structural constraints in health financing.
Research shows that Nigeria’s reliance on Out-of-Pocket (OOP) payments—exceeding 70% of total health expenditure—continues to expose households to catastrophic costs and undermines equity objectives (World Bank, 2024; Adewole et al., 2021). While Public-Private Partnerships (PPPs) and Foreign Direct Investment (FDI) offer potential pathways for infrastructure expansion, they remain constrained by exchange rate volatility, regulatory uncertainty, and political risk. The study also identifies weaknesses in domestic accountability systems, particularly in the administration of the Basic Health Care Provision Fund (BHCPF) at sub-national levels (Eboreime et al., 2020).
The study concludes that sustainable progress toward SDG 3 requires a shift from donor dependence to strengthened domestic resource mobilisation, mandatory social health insurance under the NHIA Act (2022), and institutionalised procurement transparency. Policy recommendations emphasise blended finance mechanisms, ring-fenced health taxes, Direct Facility Financing, and the adoption of Open Contracting Data Standards in health procurement.