June 28, 2022 — Country and international partner representatives of the Global Financing Facility for Women, Children, and Adolescents (GFF) have agreed on key steps toward supporting countries to strengthen primary health systems to improve women, children, and adolescents health outcomes. At the governance meetings held early this month in Paris, the Investors Group (IG) and Trust Fund Committee (TFC), which together comprise the governing body* of the GFF Secretariat, reasserted the GFF’s unique role in supporting countries to build capacity and in mobilizing funds for health—and discussed how the GFF’s approach to country-led primary health care (PHC) operates as an integral part of the GFF model.
Key decisions included:
- Endorsement of a consolidated PHC agenda: Ministers of Health from Burkina Faso, Central African Republic, Liberia, Rwanda, Sierra Leone, Tajikistan, Tanzania, and Uganda underlined the importance of continued coordinated investment and advocacy for health systems strengthening, with a special focus on fiscal capacity and investment in PHC. Partners highlighted the importance of aligning resources, indicators, and methods across PHC, particularly standardization of better indicators to measure PHC quality and results. The IG provided guidance on four key areas for the partnership engagement on PHC, including bringing financing and services closer to communities through demand- and supply-side investments, and the development of joint country-specific results framework and joint advocacy. The TFC approved a US$10 million new essential health services grant for Tajikistan, leveraging a US$40 million new International Development Association (IDA) financing for PHC service delivery and financing reform. A GFF PHC operational plan will further outline the specific impact of GFF catalytic resources and technical assistance (TA) as well as the role of the partnership and alignment with existing initiatives and partners.
- Priority investments for sexual and reproductive health and rights (SRHR): While SRHR is core to achieving better health outcomes for women, children and adolescents, it is at risk of being deprioritized, overlooked, or challenged during conflict as well as other economic crises or pandemics as many countries are experiencing today. Continued disruptions risk becoming long term problems unless urgent action is taken. The IG and TFC agreed on the importance of increased financing for SRHR, for it to be an important part of country-led reforms, and the need of high-quality technical assistance, and strong youth and civil society organization (CSO) participation in furthering this agenda. Additional partnership opportunities and collaboration with specific GFF partners could be developed at the country and global levels for advancing the priority investment areas. A working group from the partnership, specifically focused on adolescent SRHR, will further refine and support the operationalization of the GFF’s approach to SRHR.
- Empowering frontline health workers to provide high quality services: Many systemic issues hinder an effective health workforce, including fiscal space for investment, ability to recruit in conflict or post-conflict situations, imbalances in rural and urban health worker density, and the need for better planning for future health worker capacity, together with training as a long-term investment. Building on a human resources for health (HRH) policy paper discussed with the IG, an operational plan will be cocreated by the IG with support from the GFF Secretariat. The operational plan will look at the role of the partnership in supporting countries to center HRH within health financing and expenditure reviews as well as how to enable them to develop, retain, and sustain the community health workforce. A focus on scaling effective health workforce training and skills development for essential health services including and gender responsive actions will be integrated within the operational plan. Additionally, the TFC allocated US$8.54 million to support the scale up of “safer birth bundle of care,” an evidence-based training program proven to reduce neonatal deaths by 47 percent and fresh stillbirths (FSB) by another 24 percent. This scale-up builds on a pilot project supported by the UNICEF–GFF partnership on innovation to scale supported by Laerdal with promising early results.
- Exceptional support to Ukraine: In light of the devastating impact of the war on women, children, and adolescent health in Ukraine, the TFC approved an exceptional funding allocation of up to US$25 million for strengthening primary health services within relief and recovery efforts in Ukraine—US$10 million of which will be allocated from existing resources, and up to a further US$15 million, which could be made available from additional fundraising efforts.
- Approval by the TFC of the development of a technical assistance and implementation support plan to be endorsed in fall 2022: The development of the renewed TA and implementation support effort will be done in close engagement with TFC members and GFF TA partners and will look at solidifying and improving the planning, funding, and monitoring of TA and country implementation support for delivering the strategy. Efforts will focus on strengthening multistakeholder engagement and country leadership, improving the quality of the country’s investment case (IC) and synergies with cofinanced IDA and International Bank for Reconstruction and Development (IBRD) projects, filling critical technical gaps and improving mutual accountability for results.
- Endorsement of approach for implementation research and evaluation strategy: The TFC expressed strong support for the strategy, which seeks to achieve the following objectives: (1) strengthen country leadership of the design and use of implementation research and evaluation; (2) advance learning and improvement agenda aimed at strengthening IC development and implementation processes; (3) generate knowledge and enable learning; and (4) strengthen transparency and mutual accountability for achievement of measurable results within the GFF partnership, while elucidating areas for adaptation and improvement. The Secretariat will provide a process update at the fall 2022 governance meetings.
The Investors Group meeting was cochaired by the Honorable Dr. Lia Tadesse, Minister of Health, Ethiopia—who also joined the TFC meeting for the first time to ensure country representation and continuity across the governing bodies, and Joshua Tabah, Director General for Health and Nutrition, Global Affairs Canada. Mamta Murthi, World Bank Vice President for Human Development, chaired the TFC.