Operationalising the Global Financing Facility (GFF) model: the devil is in the detail

Salisbury, Nicole; Asiimwe, Gilbert; Waiswa, Peter; Latimer, Ashley E.

doi:10.1136/bmjgh-2018-001369

Cited by 6 publications

(8 citation statements)

References 1 publication

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“…More should be done by the GFF Secretariat and country partnerships to track this on the GFF website. Concerns have been expressed about capacity at country level to support the GFF process and its alignments with national planning processes [ 28 , 29 ]. Country planners may focus on the World Bank’s commitments concretised in the Project Appraisal Document and neglect other stakeholders.…”

Section: Discussionmentioning

confidence: 99%

Are rhetorical commitments to adolescents reflected in planning documents? An exploratory content analysis of adolescent sexual and reproductive health in Global Financing Facility country plans

et al. 2021

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Background The Global Financing Facility (GFF) offers an opportunity to close the financing gap that holds back gains in women, children’s and adolescent health. However, very little work exists examining GFF practice, particularly for adolescent health. As momentum builds for the GFF, we examine initial GFF planning documents to inform future national and multi-lateral efforts to advance adolescent sexual and reproductive health. Methods We undertook a content analysis of the first 11 GFF Investment Cases and Project Appraisal Documents available on the GFF website. The countries involved include Bangladesh, Cameroon, Democratic Republic of Congo, Ethiopia, Guatemala, Kenya, Liberia, Mozambique, Nigeria, Tanzania and Uganda. Results While several country documents signal understanding and investment in adolescents as a strategic area, this is not consistent across all countries, nor between Investment Cases and Project Appraisal Documents. In both types of documents commitments weaken as one moves from programming content to indicators to investment. Important contributions include how teenage pregnancy is a universal concern, how adolescent and youth friendly health services and school-based programs are supported in several country documents, how gender is noted as a key social determinant critical for mainstreaming across the health system, alongside the importance of multi-sectoral collaboration, and the acknowledgement of adolescent rights. Weaknesses include the lack of comprehensive analysis of adolescent health needs, inconsistent investments in adolescent friendly health services and school based programs, missed opportunities in not supporting multi-component and multi-level initiatives to change gender norms involving adolescent boys in addition to adolescent girls, and neglect of governance approaches to broker effective multi-sectoral collaboration, community engagement and adolescent involvement. Conclusion There are important examples of how the GFF supports adolescents and their sexual and reproductive health. However, more can be done. While building on service delivery approaches more consistently, it must also fund initiatives that address the main social and systems drivers of adolescent health. This requires capacity building for the technical aspects of adolescent health, but also engaging politically to ensure that the right actors are convened to prioritize adolescent health in country plans and to ensure accountability in the GFF process itself.

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Section: Discussionmentioning

confidence: 99%

Are rhetorical commitments to adolescents reflected in planning documents? An exploratory content analysis of adolescent sexual and reproductive health in Global Financing Facility country plans

et al. 2021

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“…The GFF process is contingent upon the details of operationalisation at country level [13] and is also political in nature. The extent to which countries prioritize adolescent health, including sexual and reproductive health, is likely to have major in uence on the ultimate priorities and investments made.…”

Section: Discussionmentioning

confidence: 99%

“…However, the process for ensuring corresponding investments from other donors remains unclear from the planning documents accessed. Concerns have been expressed about capacity at country level to support the GFF process and its alignments with national planning processes [13,33]. Country planners may focus on the World Bank's commitments concretised in the Project Appraisal Document and neglect other stakeholders.…”

Section: Discussionmentioning

confidence: 99%

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

George¹,

Jacobs²,

Kinney³

et al. 2020

Preprint

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Abstract Background: The Global Financing Facility (GFF) offers an opportunity to close the financing gap that holds back gains in women, children’s and adolescent health is recognised as a key priority by the GFF leadership. However, very little work exists examining GFF practice. As momentum builds for the GFF, we examine the initial efforts of the GFF in addressing adolescent health.Methods: We undertook a content analysis of the first 10 GFF Investment Cases and Project Appraisal Documents available on the GFF website. The countries involved include Bangladesh, Cameroon, Democratic Republic of Congo, Ethiopia, Guatemala, Kenya, Liberia, Mozambique, Nigeria, Tanzania and Uganda. Results: While several country documents signal understanding and investment in adolescent health as a strategic area, this is not consistent across all countries, nor between Investment Cases and Project Appraisal Documents. In both types of documents commitments weaken as one moves from programming content to indicators to investment. Important contributions include how teenage pregnancy is a universal concern, how adolescent and youth friendly health services and school-based programs are supported in several country documents, how gender is noted as a key social determinant critical for mainstreaming across the health system, alongside the importance of multi-sectoral collaboration, and the acknowledgement of adolescent rights. Weaknesses include the lack of comprehensive analysis of adolescent health needs, inconsistent investments in adolescent friendly health services and school based programs, missed opportunities in not supporting multi-component and multi-level initiatives to change gender norms involving adolescent boys in addition to adolescent girls, and neglect of governance approaches to broker effective multi-sectoral collaboration, community engagement and adolescent involvement. Conclusion: There are important examples of how the GFF supports adolescent health as a priority area. However, more can be done. While building on service delivery approaches more consistently, it must also fund initiatives that address the main social and systems drivers of adolescent health. This requires capacity building for the technical aspects of adolescent health, but also engaging politically to ensure that the right actors are convened to prioritize adolescent health in country plans and to ensure accountability in the GFF process itself.

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“…The findings have successfully influenced Gavi/Global Fund policies and processes, and it has been suggested that these types of evaluations can be used for other global financing mechanisms or initiatives. 14 Our approach has shifted over time to reflect learnings gained through implementing these evaluations since 2013. 11 This article adds to the existing evaluation literature, and it expands on a complementary article from the Zambia FCE team's perspective 15 by taking a broader crosscountry view of lessons learned from 2 prospective mixed-methods evaluations.…”

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Lessons Learned From Implementing Prospective, Multicountry Mixed-Methods Evaluations for Gavi and the Global Fund

Carnahan¹,

Gurley²,

Asiimwe

et al. 2020

Glob Health Sci Pract

Self Cite

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Operationalising the Global Financing Facility (GFF) model: the devil is in the detail

Cited by 6 publications

References 1 publication

Are rhetorical commitments to adolescents reflected in planning documents? An exploratory content analysis of adolescent sexual and reproductive health in Global Financing Facility country plans

Are rhetorical commitments to adolescents reflected in planning documents? An exploratory content analysis of adolescent sexual and reproductive health in Global Financing Facility country plans

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

Lessons Learned From Implementing Prospective, Multicountry Mixed-Methods Evaluations for Gavi and the Global Fund

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