Human Capital Public Expenditure and Institutional Review - An analysis of financing and governace constraints for the delievry of basic education and primary health care in Nigeria - 2024

Jul 19, 2026

Human Capital Public Expenditure and Institutional Review examines how financing and governance constraints affect delivery of basic education and primary health care in Nigeria. The review focuses on human-capital performance, including under-5 mortality and out-of-school children, and evaluates the state of health and education services covering access, quality, and equity. It analyzes public spending levels, adequacy, efficiency, equity, and predictability, timeliness, transparency, and accountability, then studies intergovernmental transfers and related fund flows and accountability mechanisms. Recommendations synthesize policy actions across sectors.

LanguageEnglish

CategoryResearch & Report

FormatPDF

Pages106

Reading Time4 h 27 min

Introduction: Human Capital, Its Importance and Constraints to Improvement

Why a focus on under-5 mortality rates and out-of-school children?

The State of Human Capital in Nigeria: Primary Health Care and Basic Education

The state of basic health care services

Access to health care

Quality of care

Equity in access to health care

The Solutions are not simply technical

The state of basic education services

Equity

Shortage of classrooms and teachers

Out-of-school children: Magnitude and trends

What are the main drivers of school attendance?

Public Spending in Primary Health and Basic Education: Inadequate and of Poor Quality

Institutions

Financing

Adequacy of spending: Overall public spending in health and education

Efficiency of spending

Equity of spending

Predictability, timeliness, transparency, and accountability

Understanding Intergovernmental Transfers for Human Capital

The Basic Health Care Provision Fund and the Universal Basic Education Fund

Teachers: Too Few in Number, Poorly Recruited and Trained, and Unevenly Distributed

Challenges in teacher recruitment, distribution, and deployment

Low quality of teachers

Teacher absenteeism

Teacher well-being

Summary: Key messages and potential reform areas

Strengthening Data Systems for Human Capital

Data quality and digitizing HMIS

Data use for decision making and harmonization of surveys

Challenges of the education information systems in Nigeria

Recommendations: Matrix of Policy Actions

Matrix of Policy Actions to Address Financing and Governance Constraints in Primary Health care and Basic Education

Disclosure Authorized Public Disclosure Authorized Human Capital Public Expenditure and Institutional Review An analysis of financing and governace constraints for the delievry of basic education and primary health care in Nigeria Tekabe Belay • Martin Elias De Simone • Dilip Parajuli • Olumide Olaolu Okunola • Mahesh Dahal Ayodeji Gafar • Elina Pradhan • Dmitry Chugunov • Deborah Isser • Ikechukwu John Nweje 2024 Pub lic Disclosure Authorized Pub lic Disclosure Authorized Public Human Capital Public Expenditure and Institutional Review © 2024 International Bank for Reconstruction and Development / The World Bank 1818 H Street NW Washington DC 20433 Telephone: 202-473-1000 [Internet: www.worldbank.org](Internet: www.worldbank.org) This work is a product of the staff of The World Bank with external contributions. The findings, interpretations, and conclusions expressed in this work do not necessarily reflect the views of The World Bank, its Board of Executive Directors, or the governments they represent. The World Bank does not guarantee the accuracy, completeness, or currency of the data included in this work and does not assume responsibility for any errors, omissions, or discrepancies in the information, or liability with respect to the use of or failure to use the information, methods, processes, or conclusions set forth. The boundaries, colors, denominations, and other information shown on any map in this work do not imply any judgment on the part of The World Bank concerning the legal status of any territory or the endorsement or acceptance of such boundaries. Nothing herein shall constitute or be construed or considered to be a limitation upon or waiver of the privileges and immunities of The World Bank, all of which are specifically reserved. Rights and Permissions The material in this work is subject to copyright. Because The World Bank encourages dissemination of its knowledge, this work may be reproduced, in whole or in part, for noncommercial purposes as long as full attribution to this work is given. Any queries on rights and licenses, including subsidiary rights, should be addressed to World Bank Publications, The World Bank, 1818 H Street NW, Washington, DC 20433, USA; fax: 202-522-2625; e-mail: [pubrights@worldbank.org](pubrights@worldbank.org). Cover photo: © 2010 Arne Hoel/World Bank Contents ix List of Acronyms xi Acknowledgments 1 CHAPTER 1. Introduction: Human Capital, Its Importance and Constraints to Improvement 3 Why a focus on under-5 mortality rates and out-of-school children? CHAPTER 2. 5 The State of Human Capital in Nigeria: Primary Health Care and Basic Education 6 The state of basic health care services 8 Access to health care 9 Quality of care 11 Equity in access to health care 12 The Solutions are not simply technical 13 The state of basic education services 14 Equity 14 Shortage of classrooms and teachers 16 Out-of-school children: Magnitude and trends 17 What are the main drivers of school attendance? CHAPTER 3. 21 Public Spending in Primary Health and Basic Education: Inadequate and of Poor Quality 22 Institutions 23 Financing 24 Adequacy of spending: Overall public spending in health and education 33 Efficiency of spending 39 Equity of spending 43 Predictability, timeliness, transparency, and accountability 44 Summary: Key messages 45 Annex 3A. Overview of key MDAs/institutions Contents iii Human Capital Public Expenditure and Institutional Review 46 CHAPTER 4. Understanding Intergovernmental Transfers for Human Capital: The Basic Health Care Provision Fund and the Universal Basic Education Fund 47 Intergovernmental interaction and its challenges 48 The Basic Health Care Provision Fund 50 BPHCF as a complement to state-level efforts to expand UHC 51 Fund flow to frontline service providers 53 Accountability for results 55 The Universal Basic Education Intervention

FAQs

Why does the review focus on under-5 mortality rates and out-of-school children in Nigeria?

It links human-capital outcomes to measurable gaps in health and education delivery. These indicators help identify constraints that hinder improvement in basic services.

What dimensions of public spending are assessed for primary health care and basic education?

The review evaluates institutions, financing, adequacy of overall spending, efficiency, equity, and cross-cutting governance aspects such as predictability, timeliness, transparency, and accountability.

How are intergovernmental transfers analyzed for the Basic Health Care Provision Fund and the Universal Basic Education Fund?

It examines intergovernmental interaction, fund arrangements, flexibility to respond to state needs, allocation equity across states, disbursements, utilization, accountability for results, and fund flow to frontline service providers.

Jul 19, 2026

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