September 2017

Introduction to the GFF

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Two trends led to the creation of the GFF

The world is changing…• Development assistance is at record

levels but is only a fraction of private financing from remittances and FDI

• Domestic financing far exceeds external resources

Insufficient progress on maternal and child health (worst among MDGs), and traditional sources of financing are not enough to close the gap

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Need for a new model of development finance

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GFF is a financing partnership supporting country leadership to achieve results for Every Woman, Every Child

Country leadership

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Countries leading the way

The 16 countries account for 46% of the total financing gap across all GFF

countries

▪ Bangladesh

▪ Cameroon

▪ DRC

▪ Ethiopia

▪ Guatemala

▪ Guinea

▪ Kenya

▪ Liberia

▪ Mozambique

▪ Myanmar

▪ Nigeria

▪ Senegal

▪ Sierra Leone

▪ Tanzania

▪ Uganda

▪ Vietnam

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GFF objective: bridging the funding gap for women’s, adolescents’, and children’s health

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What results do we want to achieve?

Overall objective:

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

▪ MMR <70/100,000▪ U5MR <25/1,000▪ NMR <12/1,000▪ Universal access to SRHR

services▪ [Universal health

coverage]

SDG targets

Closing the financing gap would prevent 24-38

million deaths by 2030

How the GFF drives results

• Identifying priority investments to achieve RMNCAH outcomes

• Identifying priority health financing reforms

• Getting more results from existing resources and increasing financing from:-Domestic

government resources

- IDA/IBRD financing-Aligned external

financing-Private sector

resources

• Strengthening systems to track progress, learn, and course-correct

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Country ownership and leadership

Accelerate progress now on the health and

wellbeing of women, children, and adolescents

Drive longer-term, transformational changes to health

systems, particularly on

financing

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2. Coordinated

Support countries to get on a trajectory to achieve the SDGs:

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1. Driving improved results through prioritization

▪ Short-term: key investments (prioritized within resource constraints) needed to achieve RMNCAH results (Investment Cases):- Health systems strengthening and multisectoral approaches

alongside high-impact RMNCAH interventions- Focusing on equity

▪ Long-term: key reforms to health financing systems (health financing strategies/implementation plans)

2005 2010 2015 2020 2025 2030

Objective: identify what needs to happen to get on a trajectory to reach the SDGs

Current trajectory

SDGs

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2a. Mobilizing domestic resources for RMNCAH

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Resources that can be mobilized by increasing general government revenue as a share of GDP…

…or by increasing prioritization of health in government budgets

Conduct analytical work to assess the options for DRM (e.g., fiscal space

analyses)

Develop approaches for

DRM (e.g., strategy for introduction of

a “sin” tax)

Provide implementation support (e.g., TA to translate high-level

strategies into implementation plans)

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2b. Financing from IDA and IBRD

Operational link between GFF Trust Fund and IDA/IBRD creates enormous opportunities:• IDA commits ~US$19 billion annually (set to increase after largest IDA

replenishment in history US$75 billion for next three years)• IBRD commits ~US$24 billion annually

11 agreements linking US$307 million in GFF Trust Fund financing with ~US$1.8 billion IDA/IBRD financing every $1 grant financing linked to $5.8 IDA/IBRD financing

Mutually beneficial link:• IDA/IBRD financing benefits from

analytical work and engagement of partners behind common set of priorities

• GFF benefits from connection with large scale financing to health sector, broader economic policy dialogue, reduced administrative costs, World Bank governance and fiduciary standards

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2c. Aligned external financing

GFF process makes external financing more efficient and effective by:• Strengthening dialogue

among stakeholders under leadership of government

• Supporting identification of priorities that partners commit resources to achieving

• Identifying duplicationsleading to increased harmonization, highlighting areas for programmatic synergies

Strong engagement by a range of financiers,

both bilateral (Canada, Denmark, France, Germany, Ireland,

Japan, Sweden, UK, US) and multilateral (EC,

Gavi, Global Fund, Islamic Development

Bank, UN)

At least 3 financiers aligning financing in 8 GFF

countries to date

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2d. Leveraging private resources for RMNCAH

…and development assistance is now dwarfed by private flows

Three-pronged strategy to leverage private resources:

1. Developing innovative financing mechanisms to catalyze private sector capital for Investment Cases

2. Facilitating partnerships between global private sector and countries

3. Leveraging private sector capabilities in countries to deliver on Investment Cases

Sources: DHS data from PS4health; World Bank 2016

Poor women and children already rely heavily on the private sector for care…

FDI

Remitt-ances

Private debt & equity

ODA

0%10%20%30%40%50%60%70%80%90%

100%

Share private (for-profit and not-for-profit) Share public

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3. Strengthening systems to track progress, learn, and course-correct

▪ Core and optional indicators:- Programmatic,

health financing, health systems strengthening, and M&E capacity

- Taken largely from Global Strategy, SDGs, and WHO Core 100

▪ Capacity buildingcentral: initial rapid assessment of gaps in M&E systems enables inclusion of priorities in Investment Cases

▪ Dedicated resources for strengthening civil registration and vital statistics

▪ Cross-country sharing of experiences (in-person and virtual)

Practical examples of how the GFF drives results

• Identifying priority investments to achieve RMNCAH outcomes

• Identifying priority health financing reforms

• Getting more results from existing resources and increasing financing from:-Domestic government

resources- IDA/IBRD financing-Aligned external

financing-Private sector

resources

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1%

$9 $18

4.2% 2.35%

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Country platform

▪ Government▪ Civil society (not-

for-profit)▪ Private sector▪ Multilateral and

bilateral agencies▪ Technical

agencies (H6 and others)

▪ Not prescriptive about form build on existing structures while ensuring that these embody two key principles: inclusiveness and transparency

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Bringing together partners at the global level:GFF Investors Group

Mechanism to support the GFF partnership: the GFF Trust Fund

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▪ US$573 million pledged to date from the governments of Canada, Norway, and the United Kingdom, the Bill and Melinda Gates Foundation and MSD for Mothers

▪ Flexible grant resources operationally linked to IDA/IBRD financing- 11 projects approved: ~US$1.8b in IDA/IBRD financing and

US$307m in GFF Trust Fund financing $5.8 concessional financing to every $1 grant financing

- 8 additional projects under preparation: ~US$770m IDA/IBRD, ~US$107m GFF Trust Fund

▪ Country selection- Eligibility: 67 low and lower-middle income countries- Must be willing to commit to increasing domestic resource

mobilization and interested in using IDA/IBRD for RMNCAH

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Learn more