WASHINGTON — The Global Financing Facility’s first annual report, released Tuesday, shows promising results from its early front-runner countries, including Tanzania, the Democratic Republic of the Congo, and Cameroon.
Those three countries are profiled in depth in the report with key results and learning, while core indicator profiles are published for 13 other partner countries in which GFF has been operating but doesn’t yet have enough data.
According to the report, Tanzania has increased its number of high-performing health facilities to 22 percent from 1 percent, and outpatient care has risen from 2.5 percent to 14 percent in 18 months. In DRC, assisted deliveries are up 14 percent and vaccination rates for children are up 25 percent. Cameroon has more than doubled its budget for women and child health and nutrition, and saw a doubling of family planning visits and antenatal care visits in facilities using performance-based financing in just one year.
The facility launched in 2015 to mobilize public and private capital to support women's, children's, and adolescents' health. Since then, it has been experimenting with a number of financing models and helping countries develop investment cases for investing in health. Here's what you need to know about GFF.
“In this report, you will see us focus on a few case studies to better understand what happens in countries. What does it take for a DRC, a Cameroon and a Tanzania to show results in just a year?” GFF Director Mariam Claeson told Devex. “You will see a combination there: Highly prioritized, strong focus on results; aligning financing with programs; being honest with data.”
GFF is currently operating in 27 countries, but 10 of those joined last November and Mali joined last month, so progress data is not yet available for those 11. GFF aims to eventually increase its partnerships to 50 countries.
The early results report’s country profiles include each country’s progress on GFF core indicators: Maternal mortality ratio; neonatal mortality ratio; under-5 mortality ratio; adolescent birth rate; percent of births less than 24 months after the preceding birth; stunting among children under 5; and moderate to severe wasting among children under 5.
Claeson said one of the key takeaways from GFF’s first three years is that fragile situations do not prevent countries from making advancements on maternal and child health.
“What’s surprising to us, I think, is that we are seeing results already in difficult areas, in fragile areas,” Claeson said. “The world always says, ‘you can’t achieve things in fragile communities,’ therefore it’s so important that countries like DRC, Cameroon, Tanzania are actually showing results at scale in areas that are challenging.”
GFF began in 2015 following insufficient progress on maternal and child health in the Millennium Development Goals. Sitting under the World Bank and launched in conjunction with partners including the United Nations, the governments of Canada and Norway, it aims to mobilize domestic investment in maternal and child health and nutrition in up to 50 countries.
“It was very important among the global health community to ensure that we address this unfinished agenda going into the SDG [Sustainable Development Goal] era. Those who articulated the SDG goals have very specific targets for how we could further reduce and frankly eliminate preventable maternal and child deaths,” Claeson said.
“At the same time, everybody recognized that ODA, official development assistance, had increased over the years, but stagnated. And it’s very unlikely, as you well know, going into [the] future to increase further. So we needed a new way of doing financing for development that enabled small amounts of money to be really catalytic.”
Its housing under the World Bank allows GFF to be particularly effective, Claeson added.
“The reason why the GFF is well positioned to work with countries on domestic resources is because we are linked to the World Bank, so we have access to ministers of finance,” Claeson said. “Being linked to the World Bank doesn’t just mean more money, but it means that you can enter into the policy dialogue between sectoral ministers and ministers of finance.”
GFF trust fund financing is linked to the International Development Association and International Bank for Reconstruction and Development at a ratio of more than $1 to $7, according to Claeson. As of the end of last month, $452 million GFF financing was linked to $3.3 billion in IDA and IBRD financing.
Cheriff Moumina Sy, the high representative of the president of Burkina Faso, said GFF has been key to mobilizing additional resources in his country to improve maternal and child health and nutrition.
“We believe that coordinated action is essential and the GFF model is an ideal model which allows us to work together in order to solve some of our problems,” Sy said at the report’s launch in Washington, D.C., on Tuesday.
“One of the first steps taken in 2016 by President [Marc] Kabore was to adopt a measure giving free care to children who are less than 5 years old, pregnant women for childbirth and C-sections, and screening of breast and uterine cancer. This was not easy, but it shows that the government of Burkina Faso wants to take measures fairly quickly to reach universal health coverage.”
His country, along with the government of Norway, the World Bank group, and the Bill & Melinda Gates Foundation, will host a GFF replenishment event in Oslo, Norway, in 2018. According to GFF, it needs to raise $2 billion for 2018-2023 in order for it to expand its activities to 50 countries and make key progress on maternal and child health indicators to reach the SDGs.
Claeson said that this first report on early results is encouraging, but noted that it takes time to measure impact. She said GFF sees room for improvement in maximizing resources with its partners, and plans to develop implementation guidelines on which everyone involved is consulted, appoint a designated liaison within partner governments, and take better advantage of human capital.
“When we look across the board, we see progress in all countries but where we think we could really maximize our results and impact is the more feedback we get from countries to be sure that we engage all partners in this,” Claeson said.
“That’s what we in the GFF feel like going forward that we need to put emphasis on, which is strengthening partnership, collaboration, and coordination.”
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