Complementary Financing for the Investment Case USAID’s Engagement with the Global Financing Facility June 24 2016, Geneva

USAID’s current modalities Direct contribution to country-specific trust funds; Alignment of components within the bilateral program with the country’s investment case; Technical input to various technical working groups and task teams at the global level.

Through global programs Contribute to the development of the Business Plan, and various TWGs and task teams; Work to align global strategies and approaches, such as: Commodities’ systems, market shaping, Results-based financing, Results measurement, Private sector. Partner on other assistance agenda supporting women’s and children’s health (G7).

At the country level Direct financial contribution through single donor trust funds at the country level; Participate in developing investment cases and health financing strategies; Shape and align new activities with the investment case (Uganda FP Project, RBF in Tanzania, Uganda, DRC and Kenya); Contribute to the dialogue on tracking resource flows and program outputs / results.

Tanzania USAID Single Donor Trust Fund: $22 million over 5 years, co-financing the government’s RBF program. Technical assistance project implementers support monitoring and results verification systems. USAID health systems strengthening project provides technical support on public expenditure management to enable fiscal autonomy at district level. Additional technical support from MCH and FP projects to improve quality of service delivery.

Kenya Multi-Donor Trust Fund: $18 million / year (USAID commitment: $10 million) The trust fund will support technical assistance to 47 counties to address: operational bottlenecks, develop health finance strategy and related reforms, supply chain management and partner coordination, in parallel to the JICA/WB-financed project. Additional TA will be provided through USAID-bilateral projects on MCH and FP service delivery and health systems strengthening (total funding: $44.2 Million).

Nutrition (Millions US$) USAID’s assistance to maternal and child survival in GFF Trust Fund countries Country FP (Millions US$) MCH (Millions US$) Nutrition (Millions US$) Total (Millions US$) Kenya 26 14 4 44 Ethiopia 32 39 19 90 DRC 17 35 11.2 63.2 Tanzania 13 7.8 46.8 Senegal 15 9 4.5 28.5 India 28 Bangladesh 27 30 21 78 Liberia 7 11 18 Mozambique 6.3 34.3 Cameroon 10 1 Nigeria 48 2.5 85.5 Uganda 16 17.6 61.6 Total 249 245 94 589

Lessons to Date USAID’s decentralized architecture requires consistent communications and information flow between HQs and field teams. Aligning with investment case components (e.g. WB financed RBF) enables USAID support to serve hard to reach areas. The ownership and readiness of key stakeholders on the country platform is critical. Limited civil society participation in some countries.