GLOBAL FINANCING FACILITY IN SUPPORT OF EVERY WOMAN EVERY CHILD

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Why Renewed Focus on RMNACH?

The efforts of countries and support from donors resulted in dramatic drop in child and maternal morality rates from 1990 to 2013

• Under-5 mortality rate from 90 deaths per 1,000 live births to 46 • Maternal mortality rate from 380 deaths per 100,000 live births to 210

However more needs to be done• Annually 6.6 million children still die and many of them due to preventable conditions

like malnutrition, pneumonia and malaria• 11% of all births are to girls aged 15-19 years; complications linked to pregnancy and

childbirth second most common cause of death 2

Why: Global omentum to accelerate progress in RMNCAH…

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Under-five mortality rate(per 1,000 live births)

19901992

19941996

19982000

20022004

20062008

20102012

20140

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Maternal mortality ratio (deaths per 100,000 live births)

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Significant additional investments are required to close the funding gap

• Over the past decade, the 75 highest burden countries spent nearly US$60 billion of domestic government resources on RMNCAH which is complemented by donor disbursements of an estimated US$9-9.5 billion.

• Despite these increases, a significant financing gap still remains

• Urgent need for a “grand convergence “ to accelerate the Investments in Women’s and Children’s Health and the Lancet Commission on Investing in Health• US$28-30 billion of additional financing (US$ 5.24 per person) is needed, in

large part due to up-front health systems strengthening investments (particularly in low-income countries)

• By 2030, the total additional financing gap is projected to fall considerably to about US$8 billion, or US$1.23 per person, due to a combination of increased domestic financing and reduced health systems strengthening costs

• Civil registration and vital statistics (CRVS) system is a critical platform for promoting women and children’s health. • over 100 developing countries lack well-functioning CRVS systems. • almost 230 million children under the age of five are not registered. • progress with death registration has been slow globally

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Why GFF?

Build on the unprecedented level of global support for the SDGs and the Strategy for Every Woman and Every Child provide an opportunity to step up efforts and achieve the ambitious but realizable goal of “convergence” by 2030.

Facilitate the grand coalition to bring together the domestic and external financing for RMNCAH • Family Planning 2020, • the H4+ Partnership, • the Health Results Innovation Trust Fund, • the Thematic Trust Fund for Maternal Health, • the Global Program to Enhance Reproductive Health Commodity

Security, • The Bridge Fund, • the Pledge Guarantee for Health and the RMNCH Trust Fund.

Realize the benefits of accelerated investment that would help to prevent a total of 4 million maternal deaths, 107 million child deaths, and 22 million stillbirths between 2015 and 2030 in the Countdown countries

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Outline of the GFF

Smart

Scaled

Sustainable

Results

1. County Investment Cases for RMNCAH

2. Health financing strategies

The “what” of the GFF The “how” of the GFF The “who” of the GFF

The GFF Partnership

The GFF Trust Fund

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What: Smart “best buy” interventions cut across sectors

Clinical service delivery and preventive interventions

Health systems strengthening

Multisector approaches

End preventable maternal and child deaths and improve the health and quality of life of women, children, and adolescents

Serv

ice

deliv

ery

appr

oach

es

CRVS

Equity, gender, and rightsMainstreamed across areas

• Country led process • Strong evidence base (Best buys relevant for the country context) • Equity:

• Underinvested areas (e.g., family planning, nutrition) and groups (e.g., adolescents)• Underserved populations

• Innovations to improve service delivery (e.g., integration, task-shifting, community health workers, private sector)

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The RMNCAH Investment Case

Core analytics

Consultation

Agreement on 2030 results

(impact-level) and

main obstacles to be focused

on

Agreement interventions

(long- and short-term) to

address obstacles and

expected results; and

costs & benefits

Analysis of obstacles for • demand • supply • enabling

environment• Multi-

sectoral factors

High-level vision of the Country Detailed diagnosis and prioritization

Investment Case

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Complementary financing of the Investment CaseInvestm

ent Case

Government

Donor 1

Donor 2

GFF Trust Fund +

IDA/IBRD

GAVI or GFATM

Private

sectorDonor

2

Donor 1

Donor 3

Private sector

Government

Improving alignment to reduce gaps and overlaps as financiers increase funding for RMNCAH and technical support e.g. from H4+ partners

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The investment case and financing strategy in tandem

RMNCAH investment case• Timeframe: 3-5 years implementation, nested in a longer term vision for 2030• Includes RMNCAH needs assessment, identification of prioritized smart

interventions (clinical, health systems, multi-sectoral)• County relevant innovations for scaling-up : delivery strategies to get better value

for domestic and harmonized donor resources

Financing strategy• Health sector-wide• Timeframe: through 2030• Identifies approach for sustainable financing (public and private) for achieving UHC• Includes financing assessment, Domestic resource mobilization and pooling,

Strategic purchasing and efficient payment supported by relevant policy changes, public finance and administration reforms

GFF is informed by four frontrunner countries

• Front runner countries:• DRC, Ethiopia, Kenya and Tanzania

• Second round countries: Bangladesh, Cameron, India, Liberia, Mozambique, Nigeria,

Senegal, Uganda

• Other countries will be identified in future

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