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1. Prioritizing Public Spending on Health in Lower-Income Countries: The Role of the Global Financing Facility for Women, Children and Adolescents

Author:
Janeen Madan Keller, Rachel Silverman, Julia Kaufman, and Amanda Glassman
Publication Date:
12-2022
Content Type:
Working Paper
Institution:
Center for Global Development (CGD)
Abstract:
The Global Financing Facility (GFF), launched in 2015, is a partnership backed by a multi-donor World Bank trust fund that aims to “prioritize and scale-up evidence-driven investments to improve reproductive, maternal, newborn, child, and adolescent health and nutrition (RMNCAH-N) interventions” in low- and lower middle-income countries. A major component of the GFF’s operational model is centered around the investment case, described by the GFF as “a description of the changes that a country wants to see with regard to reproductive, maternal, newborn, child, and adolescent health (RMNCAH) and a prioritized set of investments required to achieve these results.” Looking retrospectively at investment cases and associated ongoing World Bank operations, this paper aims to shed light on specific aspects of the GFF’s operating model, approach, theory of change, and results to date related to the “development of a costed and prioritized investment case,” and whether the investment case helps to prioritize public spending on health in the real world. The portfolio-wide findings suggest that the GFF delivers a clear value-add within the global health architecture by directing more funding to flow directly through governments via increased World Bank lending for RMNCAH-N (especially in the context of COVID-19-related service disruptions and fiscal contractions). The role of the investment case in aligning and prioritizing resources behind a consensus set of highest-value RMNCAH-N interventions within a specific funding envelope is less well documented in the public domain; GFF efforts to directly influence government RMNCAH-N spending decisions and their efficiency seem to occur primarily through follow-on resource mapping and expenditure tracking. The paper concludes with three recommendations for the GFF and its donors: (1) pursue a deliberate strategy for prioritization of RMNCAH-N services and products within the realistic budget constraint to advance evidence-based decisions on certain trade-offs; (2) increase transparency and public visibility into GFF-supported activities and funding, especially related to RMNCAH-N product procurement and overall resource tracking; and (3) explore incentives for increased donor co-financing within the framework of World Bank projects as a strategy to pool and channel more resources through government coffers.
Topic:
Health, Children, Women, Public Spending, and Gender
Political Geography:
Global Focus

2. Addressing the COVID-19 Crisis’s Indirect Health Impacts for Women and Girls

Author:
Carleigh Krubiner, Megan O'Donnell, Julia Kaufman, and Shelby Bourgault
Publication Date:
04-2021
Content Type:
Policy Brief
Institution:
Center for Global Development (CGD)
Abstract:
As donor institutions and governments seek to provide relief and support recovery from the COVID-19 pandemic and global recession, CGD’s COVID-19 Gender and Development Initiative aims to ensure that their policy and investment decisions equitably benefit women and girls. We seek to support decision-makers in understanding the gendered impacts of the COVID-19 pandemic; assess health, economic, and social policy response measures with a gender lens; and propose evidence-based solutions for an inclusive recovery. Recognizing that the dialogue to date has largely emphasized challenges facing women and girls in high-income settings, our analysis centers on women and girls in low- and middle-income countries. In this policy brief, we summarize the findings of a CGD working paper, Addressing the COVID-19 Crisis’s Indirect Health Impacts for Women and Girls. We examine how the pandemic is affecting women’s and girl’s health, including their sexual and reproductive health; some of the ways national governments and donor institutions have sought to maintain the provision of essential health services; and existing gaps, opportunities, and promising strategies donors and governments should pursue to address indirect harms to women’s and girl’s health during and beyond the COVID-19 crisis.
Topic:
Health, Children, Women, Pandemic, COVID-19, and Health Crisis
Political Geography:
Global Focus