A presentation from the Global Financing Facility (GFF) in Support of Every Woman Every Child Workshop, held in Nanyuki, Kenya.

1. Global Financing Facility in support
of Every Woman Every Child
Investing for RMNCAH results

2. The big picture: what are we trying to accomplish?
• Smart financing: improving efficiency by approximately 15% in 2030
• Scaled financing: crowding-in domestic resources and attracting new
external support – mobilizing a cumulative total of >US$57 billion between
2015 and 2030)
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3. What do we need to focus on?
• Implementation challenges: Implementation
barriers and evidence-based strategies to
overcome them for achieving results
especially for groups such as adolescents,
urban slum dwellers, or rural women
• Maximizing the returns on investment:
Agreeing and aligning on a set of priorities
that can be implemented given the resources
available (while mobilizing additional
resources)
• Smarter, scaled, and sustained financing:
Addressing the fact that financing for
RMNCAH has been characterized by gaps,
overlaps, and funding for areas outside of
national priorities
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Acceleration
of results

4. Why do we need an Investment Case: theory of change
4
Nationalstrategicframework(s)
InvestmentCase
Government
Donor
1
GFF Trust
Fund +
IDA/IBRD
Gavi, Global
Fund, other
multilateral
Donor
2Donor
1
Donor
3
Private
sector
Government
The Investment Case aims to drive agreement among key stakeholders on a set of
priorities that can feasibly be implemented given the resources available, and then to
shape the financing of such priorities

5. 5
Scope of Investment Cases
Clinical service delivery and
preventive interventions
Health systems
strengthening
Multisectoral
approaches
End preventable maternal and child deaths and improve the health and quality of
life of women, children, and adolescentsServicedelivery
approaches
CRVS
Equity, gender, and rights
Mainstreamed across areas
• Prioritizes interventions with a strong evidence base demonstrating impact
• Emphasizes issues (e.g., family planning, nutrition) and target populations (e.g.,
adolescents) that have been historically underinvested in
• Further focuses on improved service delivery to ensure an efficient national
response (e.g., through task-shifting, integration of service delivery, community
health workers, private sector service delivery environment)

6. Investment
Case
road-map
• Roles
• Timeline
• Milestones
• Potential TA
needs
• Agreement
on country
platform
Core analytics
• Equity
• Sub-national
differences
• Efficiency
• Multisectoral
determinants
• Upcoming
structural
shifts
Costed options
and resource
map
• Costed set of
interventions
and strategies
(including
multisectoral
components)
• RMNCAH
resource
landscape by
program,
location and
partner
Prioritized
Investment Case
• Set of priority
interventions/strate
gies that fit within
available resources
• If appropriate,
scenario analysis
with different sets
of interventions and
strategies based on
different scenarios
of resource
availability
• Results framework
with plans for
monitoring and
evaluation
Commitments
and alignment to
Investment Case
• High level
agreement on
co-financing
between
government
and partners,
and within
government
between
ministries of
health and
finance
Costing, cost-
effectiveness
, and
resource
mapping
Approach to
Investment
Case
development
Implement
Core set of
interventions and
strategies
• Agreement on
2030 targets and
5 year
milestones
• Identification of
priority high-
impact
interventions
• Core strategies
to address
system
bottlenecks
• Multi-sector
interventions
including CRVS
Overview of process and outputs towards a quality Investment Case
Results and key
interventions
and strategies
Agreement on
repartition of
financing for
the Investment
Case
Core
analytics
Prioritization and
maximization of
returns on
investment
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7. Key issues: core analytics
• Significant improvements in recent years – many countries
more analytical in assessments of changes in epidemiology
and in coverage
• GFF brings sharper focus on:
– Equity
– Sub-national differences
– Efficiency
– Multisectoral determinants
– Upcoming structural shifts (e.g., economic growth,
urbanization, demographic changes, climate change)
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8. Key issues: results and key interventions and strategies
• GFF approach:
– Definition results that a country wants to achieve over the
longer term
– Mix of interventions and service delivery modalities that are
appropriate for the epidemiological context
– Focus on core systemic bottlenecks and inefficiencies, including
identifying long-term transformational initiatives
– If appropriate given core analytics, multisectoral investments
(including CRVS)
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9. Key issues: costing, cost-effectiveness, and resource mapping
• Improvements in costing in recent years, but cost-
effectiveness not systematically assessed and resource
mapping efforts uneven
• GFF approach:
– Costing based on existing approaches in use
– Effectiveness should be quantified to the extent possible
– Resource mapping should include fiscal space analysis (but idea
is not an exhaustive exercise -> practical, rough estimates for to
guide decision-making)
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10. Key issues: prioritization
• Limited progress in many countries
• GFF approach:
– Investment Case should contain prioritized set of interventions
and strategies that can be implemented within resource
envelope
– Scenario planning may be useful, given uncertainties about
resource availability and desire to include “full need” scenario
• GFF brings sharper focus on:
– Optimizing inputs: focus on efficiency gains
– Maximizing outcomes: cost-effectiveness analysis
– Addressing the specific health needs of vulnerable groups:
identification and targeting
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11. Key issues: agreement on repartition of financing
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InvestmentCase
Government
Donor
1
GFF Trust
Fund +
IDA/IBRD
Gavi, Global
Fund, other
multilateral
Repartition of financing will not occur automatically
Two key processes: dialogue between MoH and MoF, and among external financiers
1. Key issue is institutionalization of priorities, particularly through budgets and
MTEFs; requires sustained dialogue between MoH and MoF, facilitated by analytical
work that will speak to MoF concerns; GFF can support that through a range of
mechanisms (next slide)
2. A number of key donors (e.g., USAID,
JICA, DFID, Canada, Norway, Gavi,
Global Fund) have expressed
willingness to support Investment
Cases, but achieving this requires
sustained dialogue at the country level
(ideally both through government-
donor dialogue and among donors)

12. What lessons learnt and need to be learnt?
• Country platform
• Inclusion of previously neglected program areas and
population groups
• Prioritization
• Technical assistance
• Quality assurance
• Relationship with implementation
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