The Global Financing Facility (GFF) is at a pivotal moment in its mission to improve the health and well-being of women, children and adolescents in the world’s poorest countries. As the GFF nears the mid-point of its 2021-2025 strategic plan, a comprehensive mid-term evaluation is underway to assess its progress, identify challenges and recalibrate its strategies.
As an active member of the GFF’s civil society and youth constituency, Wemos is closely following the developments of the mid-term evaluation and providing input to the civil society and youth representatives on the steering committee. To contribute to a well-informed evaluation, we have submitted a list of relevant publications to the steering committee, mainly addressing two key issues: (1) alignment and coordination, and (2) the impact of blended finance on health equity.
The evaluation is a defining moment not only for the future of the GFF but also for partner countries and the global health ecosystem, of which the GFF is part. The outcomes will reflect the GFF’s progress and shape upcoming actions – both for the remaining years of the current strategy period and for the development of the next strategy 2026-2030.
Planned to be completed and published by November 2024, ahead of the 19th Investors Group meeting, this evaluation is a crucial opportunity to ensure that the GFF delivers more effective and sustainable support where it is needed the most. That is why we are actively engaged in this process.
The steering committee, responsible for overseeing and reviewing the final evaluation report, includes two representatives from the civil society and youth constituency. Through these representatives, we have been providing feedback to the steering committee and also monitoring the evaluation process. This involvement helps guarantee the evaluation addresses the most pressing issues and leads to impactful outcomes.
Launched in 2015, the GFF aims to accelerate efforts to end preventable maternal and child deaths and improve the health and nutrition of women, children, and adolescents. It leverages health financing reforms and multi-stakeholder partnerships to support country-led health programmes. The current strategic plan (2021-2025) focuses on several key areas: resilient health systems, sustainable health financing, gender equality, nutrition, and reproductive, maternal, newborn, child, and adolescent health and nutrition (RMNCAH-N).
Given the GFF is a multi-faceted global health initiative, its evaluation could touch upon numerous elements. The evaluation steering committee had to carefully prioritize from a broad list of potential questions, selecting a core of the most suitable and strategic ones. At a high level, the evaluation questions will focus on:
Drawing from our expertise, we present the main points we would like to see the GFF include in their evaluation.
At Wemos, we strongly advocate for better alignment with country priorities and plans, and improved coordination among global health initiatives. We celebrate the GFF’s efforts to enhance donor alignment at country level by implementing its Alignment Framework. This framework includes multi-stakeholder consultations to conduct diagnostic exercises and a ‘maturity model’ to (1) track the process of alignment, (2) evaluate the adherence to ‘one plan, one budget, one report’, and (3) develop mechanisms to improve alignment (see more: Alignment working group – progress update 2022).
On top of that, in 2023, the GFF and other global health initiatives (ie, the Global Fund and Gavi, the Vaccine Alliance) endorsed the recommendations of the Lusaka Agenda, which emphasize the need for further harmonization among initiatives and alignment with governments’ health systems and priorities.
We expect the mid-term evaluation to critically assess the GFF’s own contribution to alignment with country plans and coordination with other global health initiatives. This evaluation should generate actionable suggestions to improve alignment and coordination for the next five-year strategy period.
We also expect the GFF to critically assess its blended finance approach, considering the evidence on the negative impact of private-for-profit health investments on equity. Blended finance is a strategic approach that combines public and private investment to leverage additional capital for development projects, particularly in emerging markets. It aims to attract private sector investment into areas that typically lack sufficient funding by reducing the investors’ risks. In the last couple of years, the GFF has implemented this approach through collaborations with the International Finance Corporation (IFC), the private sector arm of the World Bank Group.
However, Wemos’ research from 2022 has shown that the first co-financing project between the GFF and the IFC – the Africa Medical Equipment Facility in Kenya – is unlikely to contribute to equitable access to healthcare and reach the people most in need.
Since fighting inequalities is central to the GFF’s mission, the mid-term evaluation should explicitly assess the effects of blended finance on sustainable health systems. This topic may be examined both under the question on the GFF country engagement model and on the results of the quality of health services and health system strengthening.
The mid-term evaluation is an important and necessary process for assessing the GFF’s effectiveness and impact on health systems worldwide. We appreciate the inclusion of civil society and youth in the evaluation, making it more transparent and accountable. This comprehensive process will not only guide the remainder of the current strategic plan but also shape the GFF’s future directions, strengthening its ability to remain a vital force in improving health outcomes for women, children, and adolescents in the world’s poorest countries.
Wemos has been conducting extensive research and analysis on the GFF’s programs, as part of our ongoing efforts to promote stronger, more equitable health systems worldwide. To learn more about our findings, we invite you to read the following publications:
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