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.