Financing reproductive health in Ebonyi State, Nigeria: An investment case for equity and economic growth.

This article presents the findings from the Ebonyi State Reproductive Health Investment Case. Drawing on situation analysis, budget analysis, costing, cost-benefit analysis, and fiscal space analysis, the study estimates the resources required to achieve universal access to reproductive health services across the state. The results show that health sector allocations averaged less than 8% of the total state budget, with only 1.4% directed specifically to reproductive health. Achieving full-scale provision of services would require ₦20 billion (USD 13.3 million) by 2030. This investment is projected to avert 130,000 unintended pregnancies and prevent 1,300 maternal deaths, translating into ₦1,624 billion (USD 1.1 billion) in social and economic benefits-a benefit-cost ratio of 19:1. Equity analyses reveal particularly strong gains for rural and low-income households. Overall, increasing investment in reproductive health is a highly cost-effective and equitable strategy for improving health outcomes and advancing sustainable development in Ebonyi State.