GLOBAL FINANCING FACILITY IN SUPPORT OF EVERY WOMEN EVERY CHILD Adapted from WB and WHO - Kenya Consultation-21 January, 2015 ; Business plan – March, 2015

2 What is GFF

Global Financing Facility The Global Financing Facility (GFF) for RMNCAH was announced at 2014 UN General Assembly in September by the World Bank Group and governments of Canada, Norway, and the US. The GFF will provide an additional funding mechanism for RMNCAH similar to the World Bank’s Health Results Innovation Trust Fund (results-based financing). Will supplant Every Woman Every Child.Health Results Innovation Trust Fund Seeks to mobilize support for developing countries’ plans to accelerate progress on the MDG’s - end preventable maternal, newborn, and child deaths by 2030.

Some milestones on the Every Woman Every Child journey  GAVI Alliance  Global Fund  UNITAID  World Bank hosted Health Results Innovations Trust Fund  Global Strategy for Women’s and Children’s Health  Every Woman Every Child  Commission on Information and Accountability (CoIA)  UN Commission for Life Saving Commodities  Committing to Child Survival: A Promise Renewed (APR)  Family Planning 2020 (FP2020)  UN Special Envoy for financing health related MDGs  RMNCH Steering Committee and proposed ‘RMNCH Trust Fund’  PMNCH Financing Harmonisation Group for RMNCH initiatives  IHP+  PEPFAR 2007  GAIN  Global Action Plan for the Prevention and Control of Pneumonia and Diarrhea  Every Newborn: An Action Plan to End Preventable Deaths 2005  Partnership for Maternal, Newborn and Child Health (PMNCH)  Millennium Development Goals  independent Expert Review Group (iERG) 2014  Proposed Global Financing Facility  Sustainable Development Goals – Open Working Group  Ending Preventable Maternal Mortality  Innovation Working Group (IWG)  Muskoka Initiative

…but challenges remain MDG 4 and 5 unfinished agenda Large remaining funding gap - significant additional investments from both domestic and international resources needed Equitable and sustained progress under threat as countries transition from low- to middle-income status Poor state of civil registration and vital statistics systems 5

6 The ultimate goal of the GFF is to drive achievement of the SDGs Between , scale up in high burden countries could prevent up to: 4 million maternal deaths 107 million child deaths 22 million stillbirths End preventable deaths and improve the quality of life of women, children and adolescents by significantly scaling sustainable investments in RMNCAH

7 GFF Approach and Investment Case

EWEC Conceptual framework 8

9 Three mutually reinforcing characteristics of the GFF approach Smart Scaled Sustainable Focus on high impact, cost effective interventions and results Financing RMNCAH at scale through significantly increased domestic and international financing Support transition to long- term sustainable domestic financing for RMNCAH

GFF in-country approach: Focuses on targets to be achieved by 2030 and what’s required to get there from 2015 baseline: Scaled Financing: Full costing to deliver “best-buy” interventions (health/other sectors) at scale Full financing drawing from domestic (public/private) and international resources Smart Financing: Results-focused delivery to encourage innovation and maximize value-for money Sustainable Financing: Aligns with national health sector strategies, public-sector budget processes ODA is “additional” and catalyzes growth in domestic resource mobilization over time Convergence Goals in Preventable Mortality for 2030 GFF will help countries achieve the 2030 SDGs for EWEC through scaled, smart and sustainable financing approaches

11 The country investment case is at the heart of GFF RMNCAH investment case Timeframe: 3-5 years Identifies priorities that multiple financiers can support Includes RMNCAH needs assessment, best buy interventions (clinical, health systems strengthening, multi-sectoral), delivery strategies, costing and resource mapping Financing strategy Health sector-wide Timeframe: through 2030 Identifies approach to long-term financial sustainability (public and private) Includes financing assessment, domestic resource mobilization strategy, policy changes, public finance and administration reforms

Equity, gender, and rights Mainstreamed across intervention areas 12 The investment case includes priorities for financing across three intervention areas: clinical, HSS and multi-sectoral Clinical Interventions Health Systems Interventions Multi- sectoral, including CRVS End preventable maternal and child deaths and improve the health and quality of life of women, children, and adolescents Service delivery approaches

13 Examples of health systems interventions Health Workforce Numbers, skills and distribution of the health work force for RMNCAH Pre-service and in-service training Provision of incentives to enhance quality, retention, etc. Health information Real time data and use of data for planning and implementation Linking national system for CRVS linked to HMIS Creating feedback loops including at the community level; etc. Medical Products and Technologies Performance management to foster demand and “pull” in supply chain Support for convergence/consolidation of supply chain distribution, More effective forecasting and procurement Leadership & Governance Investing in strengthening the overall governance of the health system to ensure better accountability for RMNCAH results Strengthening mgmt capacity at national and sub-national levels Quality assurance of service delivery, update of evidence based norms, standards, policies Financing As a core function of the GFF, this dimension is critical both in terms of how to make more effective and efficient use of resources, but also on how to best set-up more sustainable means of financing the health sector (this is further detailed in the chapter on Financial Sustainability WHO Health System Pillars

Examples of targeted, cost-effective multi-sectoral interventions that are critical to achieving RMNCAH results Education Nutrition Water & Sanitation, Environment  Conditional cash transfers to keep adolescent girls in schools  Food fortification  Micro-nutrient supplementation  Access to clean water and sanitation  Personal hygiene; hand-washing  Reduction of in-door air pollution 14

GFF aligning and leveraging across all financing sources GFF grant IDA Development assistance for health, including private sector Domestic resources Performance-based approaches Legal agreements and MoUs Legal agreements and MoUs with MoF Matching contributions 15

16 Key GFF Model Concerns

GFF Concept Gaps – Advocates/Activists Lack of clarity on how the GFF will interact with current RMNCAH financing architecture- new/redirecting existing funding? Not explicit that the GFF will cover financing for the full range of SRHR services, not just results-based; No countries needs prioritization restrictions Prioritise family planning within the GFF Strike a balance between medium and long term investments Clarify how the GFF will relate to the Financing for Development process Ensure civil society formal participation /role Strong accountability and transparency mechanisms

18 Where is the process now?

19 Q & A and discussion on Addressing Challenges