I had a brief but stimulating conversation with civil societies over a breakfast in Harare, Zimbabwe after a one week hectic training on Health Budget Advocacy convened by Harmonization for Health in Africa (HHA) from 19th -23rd January 2015. Our breakfast discussion centered on the new mechanism ‘Global Financing Facility’ expected to be launch in July this year. A passionate advocate among us observed that “why another facility mechanism when we already have many and why can’t some of our countries influence this and insist on harmonization and continuity of the previous ones”. I sipped my mixed fruit juice, smiled and told her that “it will be difficult for any African country to influence the new facility, many of the Africa’s health budget are largely financed by international aid, without it, many of our health sector will collapse, so unless they are willing to put something substantial on the table, it will be difficult to influence and shape the discussions on this new mechanism”.
This brought us to the report of the consultations on updating the Global Strategy for Women’s, Children’s and Adolescents’ Health: Perspectives on the Global Financing Facility which was led by the Partnership for Maternal, Newborn and Child Health (PMNCH).
The report has been developed to provide a timely and constructive input to the Global Financing Facility business plan development process, in the context of supporting the 2015 update to the Global Strategy for Women’s, Children’s and Adolescents’ Health. It is the first report in a consultation process that will extend through the early part of 2015 around the development of the next Global Strategy for Women’s Children’s and Adolescents’ Health under the Every Woman Every Child banner.
Summary of some its findings
- A high level of agreement with the central aim of the GFF to build long-term domestic financing for women’s and children’s health in the context of an updated Global Strategy for Women’s, Children’s and Adolescents’ Health.
- Strong agreement with the ambition to mobilize additional financing for reproductive, maternal, newborn, child and adolescent health (RMNCAH). The prospect of a new financing instrument was cautiously but generally welcomed.
- Strong commitment to the idea of building sound national plans, backed by broadly agreed financing roadmaps that together reflected country leadership, country priorities, and country decision-making processes.
- Concerns were expressed over the potential conflict between harmonisation goals and the objective aimed at increasing global funding to RMNCAH and concern about timing, transition to the GFF of existing funding commitments, the risk of gaps and lost momentum.
- A sense that the GFF needed to become something more ambitious (more broadly owned and with wider possible beneficiaries) than a World Bank Trust Fund and that to be truly global it needed to have a critical mass of partners working together with shared ambition linked clearly to the objectives of the Global Strategy for Women’s, Children’s and Adolescent’s Health specifically and the sustainable development goals (SDGs) more generally.
- Strong interest in clarifying how the operational model of the GFF will advance and champion a rights-based approach and in particular, how it will promote, protect and expand access to sexual and reproductive health and rights services (SRHR).
- Near universal interest in and commitment to the importance of accountability, robust arrangements to track inputs, outputs and outcomes, inclusive decision-making, transparency and openness at every stage of the process.
Some of the Report’s Recommendations;
- Build coalitions: To achieve its ambitious objectives, the GFF should seek to build a much broader based coalition of partners among donors, countries, and health and non-health sector stakeholders, taking the time to develop shared understanding about the ambition, scope, operational model and implications of the GFF for health financing.
- Develop a political advocacy strategy: The development of such a coalition could be underpinned by a much more active and concerted political advocacy strategy with the dual aim of: (i) fostering better understanding about the GFF within and beyond the health sector (for example, among ministry of finance colleagues in both donor and partner countries, and all the donor nations who support IDA); and (ii) lifting the GFF away from being a World Bank managed Trust Fund and towards an instrument with global stature that could operate alongside GAVI and the Global Fund.
- Integrate the GFF into a broader vision for financing women’s, children’s and adolescents’ health: The GFF should be developed and implemented in the context of a larger, more joined-up/ shared vision around global financing for women’s, children’s and adolescents’ health in the coming years..
- Build a clear SRHR policy and approach: The GFF should seek to work with representatives from the SRHR community to build clear policy addressing SRHR in its broadest sense including a range of potentially sensitive issues (for example, female genital cutting, violence against women and girls, abortion, and early marriage).
- Build on what is already working in countries: The GFF should be explicit about building on country processes already in place and operational by creating a flexible approach to the roadmap development process to ensure the GFF adds momentum to what is on the ground already rather than creating competing or alternative processes that drain time and capacity.
- Develop (and test) a comprehensive accountability structure: The accountability framework should include global and country level mechanisms linked to the Global Strategy and drawing on what has worked well elsewhere.
These recommendations should be followed closely and tenaciously to ensure they are incorporated in to the GFF business plan.
1st published in Daily Trust Newspaper of 27th Jan 2015 by Dr Aminu Magashi Publisher Health Reporters (healthweekly@yahoo.com)
