Researchers at HPRG, based at University of Nigeria, Nsukka, said in a policy brief, for the funds to reach primary health services, "it is necessary that strategies are in place to ensure accountability between the stakeholders at different levels of government." "If the fund is not properly managed, the purpose for which it was established will be defeated," said Felix Obi, health economist and official of HPRG. He said it was a concern that domestic government funds are not given as much scrutiny as donor funds to plug leakages as they flow from Federal to state and local government levels.

 

The policy brief developed in the wake of research using FCT and Anambra recommends that Federal government produce "clear guidelines about who is responsible for implementing the fund across all levels and what their roles are." It also recommends use of external auditors to monitor and evaluate how the fund is implemented and said government should consider disbursing funding on condition of results of previous disbursements. States will also disburse funding to local government on condition of performance, but local governments must produce a plan for how it will give money to health facilities, according to the brief.

 

It also recommends use of finance managers for disbursing funds but adds facility committees should monitor how the fund is spent, while facility charges are paid electronically or through banks. Community members must also be involved in deciding spending, the brief added. The researchers suggests it is anticipate and work around challenges that recurrently hamper health policies, including delayed transfer of funds, poor data and financial management, corruption and preparedness for manage the fund.