Pushing the envelope through the Global Financing Facility: potential impact of mobilising additional support to scale-up life-saving interventions for women, children and adolescents in 50 high-burden countries

Abstract

IntroductionThe Global Financing Facility (GFF) was launched to accelerate progress towards the Sustainable Development Goals (SDGs) through scaled and sustainable financing for Reproductive, Maternal, Newborn, Child and Adolescent Health and Nutrition (RMNCAH-N) outcomes. Our objective was to estimate the potential impact of increased resources available to improve RMNCAH-N outcomes, from expanding and scaling up GFF support in 50 high-burden countries.MethodsThe potential impact of GFF was estimated for the period 2017–2030. First, two scenarios were constructed to reflect conservative and ambitious assumptions around resources that could be mobilised by the GFF model, based on GFF Trust Fund resources of US$2.6 billion. Next, GFF impact was estimated by scaling up coverage of prioritised RMNCAH-N interventions under these resource scenarios. Resource availability was projected using an Excel-based model and health impacts and costs were estimated using the Lives Saved Tool (V.5.69 b9).ResultsWe estimate that the GFF partnership could collectively mobilise US$50–75 billion of additional funds for expanding delivery of life-saving health and nutrition interventions to reach coverage of at least 70% for most interventions by 2030. This could avert 34.7 million deaths—including preventable deaths of mothers, newborns, children and stillbirths—compared with flatlined coverage, or 12.4 million deaths compared with continuation of historic trends. Under-five and neonatal mortality rates are estimated to decrease by 35% and 34%, respectively, and stillbirths by 33%.ConclusionThe GFF partnership through country- contextualised prioritisation and innovative financing could go a long way in increasing spending on RMNCAH-N and closing the existing resource gap. Although not all countries will reach the SDGs by relying on gains from the GFF platform alone, the GFF provides countries with an opportunity to significantly improve RMNCAH-N outcomes through achievable, well-directed changes in resource allocation.

How do decision-makers use evidence in community health policy and financing decisions? A qualitative study and conceptual framework in four African countries

“…Indeed, much critique of various thresholds (and in some cases, any thresholds at all) for cost-effectiveness has been levelled in the literature over the last 10 years ( Newall et al , 2014 ; Marseille et al , 2015 ; Ochalek et al , 2015 , 2018 ; Woods et al , 2016 ). In response to the push for UHC, the last 5 years have seen the development of a dizzying suite of investment cases, strategies targeting non-traditional donors and innovative approaches to promote consistent, sufficient financing of community health ( Singh et al , 2013 ; Global Financing Facility, 2016 ; Community Health Financing Compendium, 2017 ; Fernandes and Sridhar, 2017 ; Chou et al , 2018 ; E&K Consulting, 2018 ; Community Health Roadmap, 2019 ). In most cases, this represents progress towards integration of community health into broader health systems, though priorities often continue to reflect donor concerns (likely in response to the fact that community health systems are still primarily funded by external financing in most countries).…”

Is the Glass Half-Full or Half-Empty? A Content Analysis of Adolescent Sexual and Reproductive Health in Global Financing Facility Country Plans

“…The GFF approach aims to be fully embedded in country planning and programming cycles, especially the overall health sector strategic plans and the associated RMCNAH-N program plans. If prioritised RMNACH&N interventions within the country planning process are funded, the GFF could result in signi cant health gains [10]. These modelled impacts do not yet consider the investment returns from adolescent health interventions [4,11] as they are rarely integrated into costing models [12].…”

On results reporting and evidentiary standards: spotlight on the Global Fund

“…The specific relationship between institutional investment in the GFF and impact of the broader partnership remains unclear. 16 Each entity claims to save many of the very same lives, making it difficult to distinguish comparative advantage or the investment case for each funding, or technical assistance instrument.…”