Case Study of an Emerging Domestic Resource Mobilization Strategy for Primary Healthcare in Nigeria

In Nigeria, the primary healthcare (PHC) system is critically underfunded, and the gaps in areas of infrastructure, commodity availability and human resource are increasingly exacerbated as foreign aid shrink globally. This challenge has prompted advocates and researchers in Nigeria to revisit the extant conversation on innovative domestic resource mobilization strategies. The "Adopt A PHC" (AAP) initiative is one of different piloted models long before the recent aid crisis. The approach is characterized by a systematic mobilization of local philanthropy investment to revitalize PHC facility infrastructure. However, a lack of documented evidence on its implementation has hindered its adoption and scale. This retrospective case study investigates the pilot of the AAP initiative in the Federal Capital Territory, Abuja, drawing on key informant interviews with relevant stakeholders. Insights were synthesized from civil society actors who led the implementation, government program managers at the state and district levels, health workers as well as community members. Relevant quotes were analyzed thematically to profile the processes, enablers, barriers and opinions of the mapped stakeholder groups. Findings reveal that AAP is positively perceived to support existing efforts to address PHC infrastructure gaps, leveraging Nigeria's strong culture of giving. It was enabled primarily through relationship-building competencies of civil society actors and the charitable culture among the Nigerian populace. However, barriers such as weak monitoring and coordination among stakeholders limited the potential for expansion and sustainability of the initiative after a successful pilot. Thus, a conceptual framework is extracted to map the ideal roles of involved stakeholder groups.