GFF We Want

The GFF CSOs advocates should strongly call for increased engagement and participation of the local communities in addressing challenges in delivering RMNCAH-N. Accountability should be enhanced across the entire ecosystem identifying and holding the different stakeholders (e.g., government, CSOs, Faith-based institutions, citizens, youth, Donors) to account for the unique
roles that they play. The GFF should also push governments to stick to the GFF conditions ofadditionality” in order to unlock additional funds to improve health outcomes for women, children and adolescents. The GFF should advocate for the increased participation of CSOs and youth given that they are the linkage between the GFF and the local communities. Increased
knowledge of the existing GFF framework will also enable a better inclusion of community voices and representation by the CSOs and the youth. Encourage participation by other donor agencies and the private sector to support the RMNCAH-N initiatives. This will enable initiatives developed that are well suited to address the challenges facing the local communities.

The GFF should push for governments to share critical information across the different partners enhancing joint accountability. Increase the community engagement in addressing the challenges faced in the RMNCAH-N initiatives. The GFF should explore opportunities to increase the participation of private sector and other donor agencies in the GFF framework. This will drive the additional growth of the funds intended to invest in RMNCAH-N initiatives in countries.

The COVID-19 pandemic has caused a significant death toll as well as serious health and economic problems. This impact has been felt across all demographics, prompting stakeholders to realign their priorities. The COVID-19 pandemic has altered how healthcare is managed, affecting how the government, individuals, and stakeholders approach healthcare. COVID-19
has also resulted in greater integration of hospital IT systems. The government's priorities have shifted to suit the management of COVID-19from diagnostics to treatment. The pandemic exacerbated existing inadequacies and gaps in health-care systems. Health services were overburdened, with the focus moving to the fight against COVID-19, which was often carried
out in severely understaffed and under-resourced institutions.

Some of the progress made to preserve women's and children's health, such as access to free maternal deliveries and restricted funding for family planning alternatives, was set aside by the government. Governments must evaluate shifting financial priorities and put a mechanism in place to avoid moving funds meant for essential health services such as RMNCAH-N. COVID-19 impacted all agencies (governments, donors, CSOs, and local communities) involved in supporting RMNCAH-N projects, resulting in a redirection of resources and emphasis areas away from RMNCAH-N programs and toward COVID-19 reaction. Some of the government's COVID-19 mitigation measures disrupted health services for mothers, Adolescent girls and young women, and children. Pregnant mothers had limited access to health care due to a night curfew. Governments also reduced financing for family planning programs, reproductive health clinics, and child health services in order to support the important health services identified by COVID-19 that affect young women, children, and adolescents.

Pregnancies among teenagers and young women have increased. Lockdowns and stay-at-home restrictions imposed by the government restricted people's travels away from their houses. Unfortunately, adolescent’s girls and young women were not safe at home as witnessed by an increase in teenage pregnancies and increased cases of Gender based violence.

These gains that have been made overtime have been reversed and are still at a great risk of being further reversed. To meet the massive demands on health care delivery brought on by the pandemic, telehealth was fast-tracked last year, with patients being seen and diagnosed by health practitioners via virtual portals. In a fast-evolving crisis like COVID-19, responders and decision-makers needed timely data about the spread of the disease in order to protect the communities. Innovative use of digital solutions has been identified as a safe and effective way to reach people.

Civil society organizations have continued to support the GFF through advocacy in the GFF implementing countries eg CSOs in Senegal, for example, reported that their participation in all stages of the investment case development contributed to the national decision to go beyond traditional health issues and include nutrition, national statistics (such as birth registration), and
gender equality as investment case priorities. Scorecards were produced by CSOs in implementing countries to improve financial accountability and transparency. These scorecards assess the progress of initiatives established to support RMNCAH-N programs in their respective nations to enhance joint accountability.

CSOs are mobilizing support for investments to support RMNCAH-N projects. Civil society organizations are pushing donor markets to invest in the GFF resource mobilization. CSOs in recipient countries are working to persuade governments to invest domestic resources and also do solidarity pledges during the GFF resource mobilization efforts. CSOs have been essential in
supporting and urging governments to identify and solve critical health issues. CSOs have played an important role in country decision-making processes, as well as in monitoring community concerns and needs in order to protect and promote crucial services, as well as accelerate progress on health outcomes for women, children, and adolescents.

The use of scorecards and the “CSO how to Guide” developed by advocates has made it easier to understand the GFF framework at national level and the scorecards to track government expenditure, resulting in greater support and allocations to RMNCAH-N services in implementing countries. In Ethiopia – CSOs participated in a GFF workshop in Nigeria, where they were learnt on how to evaluate their investment case and identify the quantities of funding available from the World Bank and IDA. Sierra Leone- CSOs used the GFF How to guides to engage with World Bank and government authorities to promote information sharing, resulting in greater openness in the use of funds. CSOs in Liberia CSOs were able to track success at the facility level, assisting in identifying progress of RMNCAH-N programs in their country and unlocking more monies from donors. CSOs were allowed to request access to information on how the GFF monies were being used by the Ministry of Finance by using the scorecards and
how to Guides.

In the course of implementing the advocacy initiatives CSOs face many challenges such as i. inadequate collaboration amongst CSOs though a lot of efforts have gone into this ii. Countries do not have coordinated health plans showing linkages between the various country efforts that they are aiming to be met iii. The lack of country focus was also noted in meeting vaccination
needs of children and maternal health. Some countries (e.g., Angola) were noted to have budgets for COVID-19 but not funds for other diseases that adversely affect their populations e.g., Polio, Malaria. iii. CSOs also lack the capacity around budget advocacy and analysis iv. There is little transparency around Government’s funding and how disbursements and expenditure is done.

The GFF financing mechanism focus on smart financing, bringing programs to scale by leveraging much larger sums of domestic government resources, International Development Assistance (IDA) and International Bank for Reconstruction and Development (IBRD) financing, aligned external financing, and private sector resources. The GFF employs a variety of tactics and processes to achieve its objectives. Among them are:

1. investment cases, which are nationwide, evidence-based plans that prioritize high-impact interventions to achieve results and identify bottlenecks to achievement;
2. financing mobilization for investment cases;
3. complementary financing of the investment case;
4. increased government investment forRMNCAH-N;
5. innovative engagement of global and local private sector resources; and (vi)
   health financing strategies focused on sustainability.

As of June 2020, the GFF had directly spent roughly USD 602 million in grants linked to approximately USD 4.7 billion in World Bank IDA/IBRD funding and assisted in aligning significantly greater quantities of domestic and foreign financing in support of GFF partner country investment proposals.

The GFF has been instrumental in supporting Ministries of Health (MoH) to mobilize additional funding for RMNCAH-N. For example, Kenya’s RMNCAH+N investment case recognized that sustained and additional domestic financing would be critical to the successful implementation of RMNCAH-N activities in the country. MoH Kenya developed a roadmap for Universal Health
Coverage (UHC) and a health financing strategy geared toward additional domestic resources and aligning support from development partners to achieve UHC in order to ensure sustainable financing for RMNCAH-N and address health financing fragmentation.

During the previous GFF replenishment in Oslo in 2018, USD one billion in pledges were generated and linked to an extra USD 7.5 billion in World Bank IDA/IBRD resources for the health and nutrition of women, children, and adolescents. The Bill & Melinda Gates Foundation, Burkina Faso, Canada, Côte d’Ivoire, the European Commission, Denmark, Germany, Japan, Laerdal Global Health, the Netherlands, Norway, Qatar, and the United Kingdom were among those who contributed to the fund. Norway was the greatest contributor to the fund, accounting for 35.8 percent of the money raised. The $1 billion in contributions was critical in achieving the GFF’s goal of expanding its presence to 50 countries with the greatest needs in order to alter how health and nutrition are funded. Following the replenishment, the GFF announced nine new nations have joined in May 2019, bringing the overall number of GFF-supported countries to 36.

The GFF We Want & Love

Tackling the greatest health and nutrition issues affecting women, children, and adolescents

      Helping to mobilize local resources to ensure sustainability and local ownership

            Empowering communities to strengthen their health systems by funneling resources to countries

Going the extra mile to resource CSOs & youth to drive critical action around healthcare and equality

Fighting to contain the impacts of the Covid 19 pandemic and to reclaim the gains

Focusing on driving country-specific priorities to strengthen health systems

Working to increase countries’ ability to thrive in the global economy

Ensuring that women and girls are empowered as leaders whose voices are considered

Working with CSOs to facilitate local monitoring and accountability for mobilized funds

Advocating for domestic and international resource mobilization for RMNCAH+N

Not leaving anyone behind

                     That is the GFF We Want and Love!