The COVID-19 pandemic has had wide-ranging health, social, and economic impacts. Among the ripple effects, disruptions to essential health services are having devastating consequences, particularly for women, children and adolescents. The crisis is far from over. COVID-19 continues to disrupt health systems, further widening existing inequities with long-lasting impacts on women. But thanks to commitments and investments made in earlier years, some countries have been able to limit the damage and reclaim the gains. Against this context, this year’s annual report presents a mixed picture: While some countries were able to maintain and even accelerate gains, others saw progress slow or even reverse. And despite the challenges this year, the GFF Logic Model shows the partnership’s foundational support is producing results with progress across the portfolio for nearly all key indicators.

Muhammad Ali Pate
Minister Lia Tadesse Gebremedhin
Minister of Health,
Federal Democratic Republic of Ethiopia
Co-chair, GFF Investors Group
Muhammad Ali Pate
Joshua Tabah
Director General, Health and
Nutrition, Global Affairs Canada
Co-chair, GFF Investors Group

"The GFF has been supporting partner countries to balance the complex requirements for COVID-19 tools and delivery, maintaining essential health services, and strengthening country health systems. At the center of these efforts is transformational country leadership driving for change and seizing the opportunity to transform the trajectory."

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Muhammad Ali Pate
Juan Pablo Uribe
Director, GFF

"Above all, an inclusive and responsive recovery will require us to be ambidextrous. We will need to tackle the pandemic and build back better by strengthening health systems. I believe we can – and must – do both at once."

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Muhammad Ali Pate
Monique Vledder
Head of Secretariat, GFF

"As we work together to end this pandemic, we have our eye on the future. The GFF remains focused on ensuring the investments we and our partner countries make now are done with a view toward getting back on track as soon as possible and building toward a better, healthier future for all women, children and adolescents."

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COVID-19’s far-reaching and devastating consequences for women, children and adolescents

2020 saw the onset of an unprecedented global pandemic with wide-ranging health, social, and economic impacts. Among the devastating ripple effects, disruptions to essential health services caused by COVID-19 have ignited a secondary health crisis — particularly for women, children, and adolescents. Some counties have experienced up to a 25% drop in essential health services, threatening years of hard-earned progress.

Across some of the poorest countries, the estimated increase in mortality caused by drops in the use of essential health services is more than double the officially reported COVID-19 death toll.

Infographic about progress in maternal and child health
Estimates show, as a result of Service Disruptions across 18 GFF Partner Coutnries
Infographic about positive results in four countries including Cambodia, Cameroon, Kenya, and Uganda
Magnifying Glass
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The Good News

Strong country leadership and commitment are giving hope to what's possible.

Over the past 18 months, the crisis has been met with an extraordinary response — from frontline health workers, to youth advocates, civil society organizations, and governments — to double down on the commitment to women, children, and adolescents.

Thanks in part to strong commitments and investments made through previous years to improve the health of women, children, and adolescents, some countries have been able to limit the damage and reclaim the gains.

Pauline Irungu

Pauline Irungu
PATH and CSO representative

"This year's report shows the power of the GFF partnership whose collective action has helped countries to chart the path towards a more inclusive recovery, but there is a closing window of opportunity and urgent action is needed now. Through its country-led model, and with increased investments from donors and partner governments, countries and communities can continue to drive the step changes needed to deliver on the right to health for all women, children and adolescents."

Muhammad Ali Pate

Mme Traoré Mariam Sidibé
President of Women’s Association, Mali

"Women must be at the forefront of addressing these challenges.  We are identifying strategies to strengthen our financial autonomy and plan the actions needed to increase attendance in health centers."

Muhammad Ali Pate

Dr. Williamatta S. Williams-Gibson
Medical Director,
Redemption Hospital, Liberia

"Based on the experience we had with Ebola, we put all the necessary precautions into place. We set up infection and prevention control units, had trainings and secured protective personal equipment which boosted the morale of the staff."

Investing in systems.

Empowering communities.

Ensuring ALL are included.

The rollout of the GFF’s 2021–25 strategy has already helped to reduce inequities by supporting the most disadvantaged and vulnerable populations. It helped strengthen primary health systems and safeguard more and better financing for health — making these systems more responsive to global health shocks and the needs of women, children, and adolescents.

The impacts of COVID-19 and the economic knock-on effects have worsened existing inequities, hitting women and children hardest. Between 2019 and 2020, across half of GFF's partner countries, the gap in coverage of essential health services within countries widened.

But there are glimpses of hope:

  • In Rwanda, the GFF is working with the government and partners to make sure the poorest households receive cash transfers to improve their nutrition and that emergency cash transfers reach the right families.
  • In Guinea and Tanzania, equity gains were protected due to more resilient frontlines built with national leadership and support from the GFF and other partners.
  • Progress was made in gender equality through the GFF’s Gender Equality Roadmap in countries such as Niger, Liberia, Ethiopia and Tanzania.

Resilient health systems and stronger primary health care in the frontlines and communities are the backstop to flattening the COVID-19 curve. The GFF is helping countries to make the system changes necessary to maintain essential services and scale up equitable delivery of COVID-19 vaccines and tools.

  • With help from the GFF, Mozambique invested in mobile medical outreach and mobilized community health workers and NGOs to expand services and methods of contraception that do not require adolescents to visit health facilities. During the first half of 2021 and despite school closures, over 56,000 adolescent boys and girls have been counseled in SRHR.
  • The GFF partnered with the IFC on the Africa Medical Equipment Facility to help small businesses to access up to US$300 million in loans and leases across East and West Africa to purchase equipment. A US$10 million deal signed with the Co-operative Bank of Kenya is already enabling the bank to lend up to US$20 million to health care facilities with the aim to strengthen health care delivery for the poorest and most vulnerable populations, including women and children.
  • 21 countries included CRVS strengthening in their investment case and 13 countries allocated GFF grants and IDA funding to CRVS for a total of US$95 million.

As countries worked to stabilize and strengthen their health systems, the GFF helped governments determine the impact of COVID-19 on health spending, map resources and track expenditures, and mobilize more resources for health.

  • The GFF has been intensifying collaboration with Gavi, Global Fund (GF), World Health Organization (WHO), and the World Bank under the GAP health financing accelerator.
  • Rwanda increased the health budget execution rate from 87 percent to 101 percent and the budget share allocated to health from 7.4 to 8.8 percent, between 2019 and 2020.
  • GFF-supported policy dialogue in Ethiopia on domestic resource mobilization at the regional and district levels triggered discussions to invest in community-based health insurance.
  • In the DRC, a health financing analysis and policy dialogue led by the GFF, Gavi, and Japan helped develop a social spending component in the IMF’s Extended CreditFacility for the DRC. As a result, the government committed to increase funding for primary health care for the next three years.
  • In Malawi, resource mapping and expenditure tracking found that supplies and equipment comprised the largest cost of the COVID-19 response plan and produced the largest funding gap. In Niger, significant funding gaps existed for infection control, service delivery capacity, and building and equipping isolation sites.
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