Abstract
BackgroundThe 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.MethodsWe 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.ResultsWhile 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.ConclusionThere 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.
Highlights
The Global Financing Facility (GFF) offers an opportunity to close the financing gap that holds back gains in women, children’s and adolescent health
Given the recognition of adolescents as a key group central to realising RMNCAH-N goals and the momentum building behind the GFF process, we examine initial efforts of the GFF in addressing adolescent sexual and reproductive health as one part of a comprehensive agenda for realising adolescent health
Adolescent health is noted by GFF leadership as a key priority, and several country planning documents signal this recognition
Summary
The Global Financing Facility (GFF) offers an opportunity to close the financing gap that holds back gains in women, children’s and adolescent health. Launched in 2015, the Global Financing Facility (GFF) aims to address the USD $33 billion annual funding gap that holds back countries with the greatest reproductive, maternal, newborn, child, adolescent health and nutrition (RMNCAH-N) needs from meeting the 2030 Sustainable Development Goals [1]. Hosted by the World Bank, the GFF is designed to strengthen country ownership by developing a multistakeholder platform and national planning process prioritising RMNCAH-N interventions and health systems investments. It aims to unlock sustainable financing by encouraging national resource mobilisation, donor coordination, and private sector contributions. The approach builds on the comparative advantage the World Bank has in mobilising domestic financing, given that it works directly not just with Ministries of Health, and with Ministries of Finance [2]
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