CIVIL SOCIETY GUIDE TO THE GFF Suzanna Dennis, October 2016

Transcription

1 CIVIL SOCIETY GUIDE TO THE GFF Suzaa Deis, October 2016

2 ABOUT THE CS COORDINATING GROUP ON THE GFF This guide was commissioed by the Civil Society (CS) Coordiatig Group o the GFF, which represets global, regioal ad atioally-focused civil society orgaizatios that come together to share iformatio, coordiate, ad egage i the GFF. To lear more, please cotact pmch@who.it. ACKNOWLEDGEMENTS This guide beefits hugely from the may idividuals ad orgaizatios who were ivolved i shapig the cocept, reviewig early drafts, ad cotributig their experieces ad tips for success. The author would like to thak Kadidiatou Toure (PMNCH), Amiu Magashi Garba ad Sarah Fox (Africa Health Budget Network) for their helpful suggestios, guidace ad cotributios throughout the developmet of this guide. The guide was greatly eriched by the followig idividuals cotributig their valuable experiece ad tips: I Tazaia, Halima Shariff (CCP Tazaia) ad James Mlali (Health Promotio Tazaia); I Ugada, Moses Muwoge (Samasha Medical Foudatio) ad Erica Belager (IPPF); ad i Keya, Agelie Mutuga (JHPIEGO/ Advace Family Plaig) ad Melissa Kirowo (Maagemet Scieces Keya). May thaks for the isights cotributed from the reviewers of drafts: Daielle Heiberg (Global Health Coucil), Erica Belager (IPPF), Joh Towsed (Populatio Coucil), Kjersti Koffeld (Save the Childre Norway), Maty Dia, Mesfi Teklu (Save the Childre), ad Susaah Hurd (Global Health Visios). The guide beefitted greatly from the feedback, guidace ad editig skills of PAI s Elisha Du-Georgiou, Joatha Rucks, Dilly Severi; as well as valuable cotributios from Tary Couture. This documet also beefitted from the wealth of kowledge that CSOs have already produced o the GFF, particularly Global Fiacig Facility (GFF) Coutry Cosultatios Fact Sheet: Lessos Leared from GFF Frot Ruer Coutries Keya ad Tazaia ad Civil Society Egagemet i the Global Fiacig Facility: Aalysis ad Recommedatios, both of which are listed i the resources. Ay errors or omissios are the resposibility of the author. I 2 I

3 TABLE OF CONTENTS Itroductio... 1 About the Guide...1 Part 1. Overview of the GFF GFF Coutries GFF Goverace...2 GFF Secretariat...2 Ivestors Group...3 Trust Fud Committee...3 Part 2. CSO Egagemet i the GFF... 4 Part 3. The GFF Process ad Opportuities to Egage Coutry Selectio Formatio of the Coutry Platform Health Fiacig Strategy Ivestmet Cases Steps ad Opportuities...12 Results framework Prioritizatio ad Divisio of Labor Sources of Fudig for the GFF Project Implemetatio World Bak-Fuded Projects Formal Review ad Accoutability Coclusios...20 Edotes...20 Aex 1. List of Resources o the GFF...21 Aex 2. GFF Coutry Platforms ad CSO Cotacts...22

4 LIST OF ACRONYMS CIP Family Plaig Costed Implemetatio Pla CRVS Civil Registry ad Vital Statistics CS Civil Society CSO Civil Society Orgaizatio DHS Demographic ad Health Survey GFF Global Fiacig Facility i Support of Every Woma Every Child HENNET Health NGOs Network (Keya) IG Ivestors Group M&E Moitorig ad Evaluatio PAD Project Appraisal Documet (World Bak) PID Project Iformatio Documet (World Bak) RHMSU Reproductive Health ad Materal Services (Keya) RMNCAH Reproductive, Materal, Newbor, Adolescet ad Child Health SDGs Sustaiable Developmet Goals

5 INTRODUCTION The Global Fiacig Facility i Support of Every Woma Every Child (GFF) is a ew fiacig mechaism with the potetial to help ed prevetable materal ad child deaths ad improve the quality of life ad health of wome, childre, ad adolescets. The GFF is importat as a vehicle that fuders are usig to support reproductive, materal, ewbor, child ad adolescet health (RMNCAH). The GFF is also ifluecig coutry-level RMNCAH goverace, through facilitatig the developmet of a sigle, collaborative strategy for RMNCAH ad log-term fiacig. The GFF is see as a pathfider, ad the World Bak is lookig to itroduce this as a ew fudig modality i other sectors. Civil society orgaizatios (CSOs) play a importat role i advacig RMNCAH through techical expertise, costructive egagemet with decisio makers, represetig commuities, ad holdig the govermet, doors ad other key actors accoutable. It is importat that CSOs are able to meaigfully cotribute i the developmet, implemetatio ad moitorig of the GFF. About the Guide This guide was commissioed by the Civil Society (CS) Coordiatig Group o the GFF to help CSOs workig i GFF coutries meaigfully egage i the various stages of the GFF. The CS Coordiatig Group represets global, regioal ad atioally focused civil society orgaizatios that come together to share iformatio, coordiate, ad egage. The iteded audieces for this guide are CSOs workig o RMNCAH i GFF coutries, or coutries beig cosidered for the GFF. This icludes CSOs already active i atioal-level dialogues aroud the GFF ad RMNCAH, as well as a broader group of local CSO parters that are lookig for ways to meaigfully egage. We welcome that it may be useful to a wider rage of stakeholders. Although the GFF is relatively ew, there is a cosiderable amout of iformatio available about it. Oe of the great challeges i writig this guide is to streamlie this iformatio to what is essetial to facilitate meaigful CSO egagemet. I this spirit, we have prioritized iformatio that is either: (1) critical for CSOs to uderstad ad evaluate the cotext i which there are operatig; or (2) helps CSOs ifluece the GFF, particularly at the coutry level. Additioal resources are icluded i a aotated bibliography i Aex 1. Part 1 gives a overview of the GFF s goals, geographic coverage ad goverace, settig the broad cotext for the GFF s operatios. I Part 2, we highlight the value of CSOs i cotributig to RMNCAH, ad describe the challegig experiece of CSOs egagemet i the GFF thus far. Part 3 discusses the GFF process i-coutry, ad highlights importat iformatio ad opportuities to egage. Throughout the guide, we share opportuities to egage (or lack thereof) based o CSOs experieces. We also highlight tips desiged to help CSOs meaigfully egage i the GFF, based o CSOs experieces to date. We have also bolded importat words that are defied throughout the text. I1I

6 PART 1. OVERVIEW OF THE GFF The GFF is a multi-stakeholder partership i support of the Uited Natios Secretary-Geeral s Global Strategy for Wome s, Childre s ad Adolescets Health ad the Sustaiable Developmet Goals (SDGs). It has five objectives: BOX 1. GFF COUNTRIES SEPTEMBER 2014 (FIRST WAVE) JUNE 2015 (SECOND WAVE) 4 SEPTEMBER Fiace atioal plas to scale-up RMNCAH ad measure results; Support coutries trasitio toward sustaiable domestic fiacig of RMNCAH; Fiace the stregtheig of civil registratio ad vital statistics (CRVS) systems; Fiace the developmet ad deploymet of global public goods that support strog health systems; ad Democratic Republic of Cogo Ethiopia Keya Tazaia Bagladesh Cameroo Liberia Mozambique Nigeria Seegal Ugada Guatemala Guiea Myamar Sierra Leoe 5 Cotribute to a better-coordiated ad streamlied RMNCAH fiacig architecture. 1 The GFF s log-term visio is to mobilize sigificat additioal resources to fill fudig gaps for RMNCAH, ad improve the efficiecy of spedig over time. Thus far, the GFF Trust Fud has US $815 millio worth of commitmets. I a attempt to fill fudig gaps ad shift away from a primary focus o door fudig, the GFF brigs together a mix of domestic ad exteral sources of fudig i support of RMNCAH. Domestic fudig for health from the public sector (govermet) ad the private sector (isurace for example) plays a importat role i achievig this goal GFF COUNTRIES The GFF is curretly active i 16 coutries: four firstwave, or frotruer coutries, eight secod-wave coutries, ad aother four third-wave coutries (Box 1). These coutries are at differet stages of the GFF process, with some just startig the process, ad others already begiig implemetatio. These sixtee coutries are part of the full set of 62 highburde low- ad lower-middle-icome coutries which are eligible to participate i the GFF. 3 The GFF iteds to support the full set of eligible coutries, but has ot yet determied how. 1.2 GFF GOVERNANCE I order to egage i the GFF i a meaigful way, it is importat to uderstad the istitutioal arragemets at the global level (GFF Secretariat, Ivestors Group, Trust Fud Committee) because their decisios ad practices ifluece the GFF s egagemet at the coutry level. We highlight opportuities to ifluece these istitutios decisios where it is realistic, although experieces will vary. GFF Secretariat The GFF Secretariat is the team hosted at the World Bak headquarters i Washigto, D.C. that is resposible for the day-to-day operatios of the GFF. The Secretariat supports GFF implemetatio i coutries. They maage the GFF Trust Fud, ad support the goverace of the GFF icludig the Ivestors Group ad the GFF Trust Fud Committee (explaied below). The GFF Secretariat is also resposible for resource mobilizatio ad ecouragig door ivestmet i the GFF. 5 GFF SECRETARIAT How ca this iformatio help me? The GFF Secretariat is a good source of iformatio o the GFF s operatios that cut across coutries. The GFF Secretariat also kows the focal poits i GFF coutries, ad should be able to put you i touch with them. How ca I reach someoe? To cotact the GFF Secretariat, GFFSecretariat@worldbak.org I 2 I

7 Ivestors Group The GFF is govered by a Ivestors Group (IG) which oversees the activities of the GFF. The IG has four core fuctios: (1) buildig high-level support for the GFF; (2) mobilizig resources for ivestmet cases; (3) moitorig the GFF s performace ad esurig accoutability for results; ad (4) supportig learig ad iovatio aroud fiacig approaches. I these roles, IG drives fudig decisios across GFF coutries, ad is resposible for fudraisig for ivestmet cases. The IG also reviews the operatioal policies ad guidace documets developed by the Secretariat. Curret members of the IG are the govermets of Caada, Norway, the Uited States, Japa ad the Uited Kigdom, the Office of the UN Secretary Geeral, UNFPA, UNICEF, the World Bak, Gavi, the Global Fud to Fight AIDS, Tuberculosis ad Malaria, the Bill ad Melida Gates Foudatio, ad the Partership for Materal, Newbor ad Child Health (PMNCH). Implemetig govermets of Ethiopia, Keya, Liberia ad Seegal are also o the IG. The private sector is represeted by two seats o the IG. 6 Two civil society seats o the IG are filled by members of PMNCH s CSO costituecy o a rotatig basis. The curret CSO represetatives are Mesfi Teklu Tessema, vice presidet, health ad utritio, World Visio, Keya ad Joa Carter, executive director of Results. The PMNCH is resposible for facilitatig the process to elect the two CSO represetatives to the GFF IG. At the ed of 2016, two ew CSO represetatives ad alterates will be elected by the PMNCH NGO costituecy ad PMNCH Board from a pool of omiees. For a curret list of idividual represetatives of IG members, go to the IG webpage ( globalfiacigfacility.org/ivestors-group), click o Documets related to the latest IG meetig, ad ope the membership list ad attedace. Trust Fud Committee The Trust Fud Committee is made up of all the doors of the GFF, plus the chair or vice chair of the Ivestors Group. It determies the fudig approach ad priorities for the GFF Trust Fud, icludig determiig the fiacig arragemets betwee the Trust Fud allocatio, World Bak fudig, ad ifluecig domestic fiacig. The Trust Fud Committee also agrees o the aual work pla ad budget for the GFF Secretariat, ad oversees the performace of the Trust Fud. INVESTORS GROUP How ca this iformatio help me? The IG members are privy to a wealth of iformatio about the GFF operatios ad future plas. They make decisios regardig GFF operatios that cut across coutries, as well as fudig decisios related to specific coutries. I this role, they ca be a importat advocacy target ad ally. How ca I reach someoe? Most of the members of the IG are high-level, ad are ot accessible to most CSOs. The CSO represetatives to the IG represet civil society, so they eed to uderstad the challeges ad cocers of CSOs workig i GFF coutries. They are a great poit of cotact for ay issues. The CSO Coordiatig Group o the GFF available at pmch@who.it ca coect you with the perso or iformatio that you re lookig for. TRUST FUND COMMITTEE How ca this iformatio help me? Decisios aroud Trust Fud allocatios are determied by Trust Fud Committee members, i cosultatio with govermets ad GFF Secretariat staff. It will be extremely challegig to ifluece these decisios. How ca I reach someoe? It will be challegig to reach a member of the Trust Fud Committee. To get iformatio you may eed o GFF Trust Fud allocatios, you will likely eed to go through the GFF Secretariat or Miistry of Health officials. I 3 I

8 PART 2. CSO ENGAGEMENT IN THE GFF CSO egagemet i the GFF is critical to the success of the partership. But CSOs have had challeges meaigfully egagig, particularly i GFF coutry platforms which are resposible for implemetig the GFF at the coutry level. Coutry platforms are supposed to embody two key priciples: iclusiveess ad trasparecy. The GFF set very basic Miimum Stadards for coutry platforms through which these priciples should be adopted. 7 While the GFF s focus o priciples is iteded to accommodate the diversity of cotexts i which the GFF is operatig, it meas that there is o requiremet from the GFF that CSOs be icluded i decisio-makig processes. It is up to govermets to decide whe ad how to egage with CSO stakeholders, ad which CSOs to egage with. A extesive review of CSO egagemet reveals cosiderable gaps i frotruer coutries: Lack of cosistet ad timely commuicatio ecessary for meaigful egagemet; Timelies for CSOs to atted cosultatio meetigs are ofte rushed with little advace otice; Lack of adequate resources to support CSO egagemet i cosultatios ad the GFF broadly; Represetatio of civil society is ot systematic or trasparet, leadig to a ubalaced represetatio by iteratioal CSOs ad those with prior relatioships with govermet; No widespread recogitio of the value that CSOs brig to the GFF; ad Lack of space, fudig, ad techical assistace to support multi-stakeholder egagemet i coutry platforms. BOX 2. PROOF POINTS: CSOS IMPORTANT ROLES IN ADVANCING RMNCAH CSOs possess cosiderable kowledge, expertise ad access essetial to improvig the health ad wellbeig of wome, childre ad adolescets. Govermets have officially recogized CSOs as idepedet developmet actors i their ow right whose efforts complemet those of govermets ad the private sector. 9 The GFF itself says, Civil society plays a importat role i advocacy ad social mobilizatio, as well as accoutability ad service delivery. Advocacy ad social mobilizatio by affected populatios is similarly critical to esurig accoutability ad strog atioal resposes, i additio to uique isights ito approaches to service delivery. 10 CSOs fill a diversity of roles, icludig: Amplifyig the voices of local commuities to esure that they are ivolved i decisios that affect them. I some cotexts, CSOs ca gai access to commuities where govermet actors caot. 4 This is particularly importat i coflict ad humaitaria settigs, where half of all materal, ewbor ad child deaths occur. 12 Coutry plaig ad implemetatio: CSOs depth of techical support complemets ad ehaces the work of govermet, doors ad the private sector i coutry plaig ad implemetatio oe of the three itercoected pillars that uderpis the implemetatio of the Global Strategy. 13 Healthcare service delivery: CSOs are importat health providers i may coutries where govermet services caot reach all people. For example, the Christia Health Associatio of Malawi (CHAM), a associatio of church-owed health facilities ad traiig colleges, provides a estimated 37% of all health care services ad trais up to 80% of health workers i Malawi. 14 CHAM also provides 9% of cotraceptive services i the coutry. 15 Fiacial ad policy advocacy: I may coutries, CSOs egagemet with govermets cotributes to the mobilizatio of ew resources for importat health areas. For example, i Zambia, Plaed Parethood Associatio of Zambia ad the Cetre for Reproductive Health ad Educatio (CRHE) worked with the govermet to reistate the budget lie for reproductive health supplies fuded at US$9.3 millio, of which US$1.9 millio came from locally geerated reveue. 16 CSOs are also importat stakeholders i the developmet of health policies ad strategies that doors ca support. Accoutability: CSOs play a essetial role i holdig govermets ad doors accoutable through targeted review, moitorig, ad actios at the global, regioal ad coutry levels. 17 Whe doe well, accoutability activities amplify the voices ad draw o the experieces of local commuities, thereby brigig citizes voices to atioal ad global policymakers. I 4 I

9 BOX 3. RECOMMENDATIONS FOR EFFECTIVE CSO ENGAGEMENT IN RMNCAH COUNTRY PLATFORMS You ca use these recommedatios to ecourage stakeholders i charge of GFF coutry platforms to esure that CSOs valuable perspectives ad iputs are icluded. 11 To promote iclusiveess ad participatio, coutry platforms should: Reserve at least two seats for CSO represetatives, plus CSO observers. Represetatives should be selected i a participatory ad trasparet maer. Give priority to CSOs represetig coalitios. CSO represetatives should be fully ad actively ivolved at all stages i the GFF process. Develop a stakeholder egagemet pla for egagig CSOs outside the coutry platform. CSO represetatives o coutry platforms must cosult with other CSOs for broader iput. The platform should provide fudig for these cosultatios. To esure trasparecy, coutry platforms should: Release detailed documets about the coutry platform procedures, membership, rules, etc. They should be published o Miistry of Health ad GFF websites, ad dissemiated to a listserv with volutary registratio. Circulate draft documets for iput with clear timelies o whe feedback is eeded. Circulate meetig miutes, specifyig timelies ad resposible parties for ay actio items. Aouce cosultatio meetigs at least two weeks i advace icludig all documets, with a list of participats with s so that represetatives ca be reached ahead of time. Make meetigs available through live webcast. To promote idepedece ad accoutability, the coutry platforms should: Alig accoutability ad moitorig processes with ad build o other atioal processes, such as aual health sector reviews. Iclude a workig group to develop a accoutability strategy for the implemetatio of the ivestmet case. Strategy implemetatio should be fuded idepedetly from the GFF. Establish mechaisms for hearig ad remedyig grievaces related to the GFF process ad implemetatio. A review of adherece to coutry platforms priciples of iclusio ad trasparecy should be coducted at least every two years, ad iform a update of coutry platform procedures. The GFF Ivestors Group should establish a ombudsma ad grievace mechaism ad redress policy as a backup to the coutry mechaisms. If you are havig to justify why CSOs should be part of the GFF coutry platform, you ca adapt the proof poits i Box 2 to help make the case for what CSOs ca cotribute. You ca bolster your poits by addig local examples. I respose to these ad other ogoig challeges, a learig meetig held i Nairobi i November 2015 brought together civil society represetatives from 10 of the 12 GFF coutries. The participats idetified the eed to stregthe the eablig eviromet to support CSO egagemet i the GFF. 19 Buildig o previous efforts, this group produced very specific recommedatios for ehacig egagemet of civil society ad other stakeholders i coutry platforms. These recommedatios to ehace the GFF s Miimum Stadards for RMNCAH coutry platforms iclude measures to improve iclusiveess i CSO participatio, trasparecy ad access to timely iformatio, as well as specific recommedatios aroud fosterig accoutability (Box 3). Participats also called for the establishmet of a coordiatig group brigig together global, regioal ad atioal civil society orgaizatios that have bee substatially egaged aroud the GFF. Uitig CSOs is importat to esurig better coordiatio ad avoidace of duplicatio of efforts. This CS I 5 I

10 BOX 4. GFF CS COORDINATING GROUP The goal of the CSO coordiatig group is to promote meaigful egagemet of civil society i the GFF processes both at atioal ad global levels. Specific objectives are to: 1 Advocate for civil society (CS) priorities ad iterest; 4 Act as a resource group for the GFF CS IG represetatives; 2 Coordiate GFF-related CS efforts to esure efficiet use of limited CS resources; 5 Act as a pool of experts to work o various GFF related workig groups; 3 Promote access to iformatio by CS for optimal egagemet i the GFF processes at all levels; 6 Dissemiate to ad cosult broader etworks o questios related to the GFF. Coordiatig Group o the GFF was formed i Jauary 2016 (Box 4) ad cotiues to play a active role i coveig webiars, sharig iformatio, ad supportig the civil society represetatives of the Ivestors Group ad coutry level egagemet. 20 Kadidiatou Toure, the PMNCH focal perso for the CSO Coordiatig Group o the GFF ca be ed at: pmch@who.it. The CS Coordiatig Group produces a bimothly ewsletter o the GFF, compiled by the Africa Health Budget Network. You ca view old editios of the ewsletter here: campaig-archive1.com/home/?u=7a402c1f5b39 bc7d6d0c9e413&id=7b01e99d1f, ad ahb@evidece4ctio.et to be added to their mailig list. PMNCH ad Global Health Coucil covee regular webiars to support CSO egagemet. Cotact pmch@who.it to be added to the ivitatio list. The Reproductive Health Supplies Coalitio Advocacy ad Accoutability Workig Group covees regular meetigs with CSOs to esure that RH supplies are prioritized i the GFF, ad geerally support CSO egagemet. Cotact secretariat@rhsupplies.org if you are iterested i joiig the list. CS Efforts to Egage I-Coutry I a effort to respod to the lack of CSO egagemet to date i GFF coutries, CSOs with similar iterests have orgaized themselves outside the GFF coutry platform, sometimes with other like-mided stakeholders, through cosultatios ad iformal meetigs. For example, i Seegal, PMNCH coveed CSOs for a two-day meetig ahead of a official GFF iformatio meetig hosted by the World Bak ad the Miistry of Health. This preparatory meetig gave CSOs a opportuity to start comig together i oe atioal coalitio, as opposed to fragmeted platforms workig towards the same goals. 21 I the Democratic Republic of Cogo (DRC), the Multi-sectoral Permaet Techical Committee o Family Plaig 22 orgaized a pre-meetig, supported by Advace Family Plaig, ahead of the official GFF cosultatio. At the pre-meetig, a diverse rage of stakeholders came together behid key priorities for the GFF ivestmet case. Oe CSO represetative ad the presidet of the CTMP atteded the official GFF cosultatio. As a result of these preparatios, the Miistry of Health recogized priorities from the Natioal Family Plaig Strategic Pla for iclusio i the GFF ivestmet case. 23 If you are iterested i gettig ivolved i efforts to ifluece the GFF i your coutry, cotact members of reproductive ad child health coalitios i your coutry to get iformatio ad to team up with others who are ivolved. If coutry-level colleagues caot help, the global CSO coordiatig group o the GFF may be able to put you i touch with other CSOs who are ivolved i your coutry. I 6 I

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12 FIGURE 1. GFF PROCESS AND OPPORTUNITIES FOR CSO ENGAGEMENT 1 COUNTRY SELECTED FOR GFF 2 FORMATION OF GFF COUNTRY PLATFORM USE EXISTING RMNCAH PLATFORM(S) ESTABLISH A NEW PLATFORM COUNTRY PLATFORM PRODUCES HEALTH FINANCING STRATEGY *Health Fiacig Strategy 3 4 COUNTRY PLATFORM PRODUCES INVESTMENT CASE & RESULTS FRAMEWORK 5 COUNTRY PLATFORM USES AN EXISTING RMNCAH STRATEGY AS THE INVESTMENT CASE *Ivestmet Case COUNTRY PLATFORM DEVELOPS NEW INVESTMENT CASE WITH RESULTS FRAMEWORK *Ivestmet Case & Results Framework COUNTRY PLATFORM SOMETIMES HAS TO DEVELOP A SHORTER INVESTMENT CASE AND/OR RESULTS FRAMEWORK TO ACCOMPANY THE INVESTMENT CASE *Short Ivestmet Case ad/or Results Framework I 8 I

13 GOVERNMENT IDENTIFIES OBJECTIVES/ ACTIVITIES IT WILL FUND 6 PROJECT IMPLEMENTATION PRIORITIZATION & DIVISION OF LABOR: FUNDERS DECIDE WHO WILL FUND WHAT RMNCAH PRIORITIES BILATERAL (COUNTRY) DONORS IDENTIFY OBJECTIVES AND ACTIVITIES THEY WILL SUPPORT INTERNATIONAL INSTITUTIONS IDENTIFY OBJECTIVES AND ACTIVITIES THEY WILL SUPPORT 6 6 PROJECT IMPLEMENTATION PROJECT IMPLEMENTATION 7 FORMAL REVIEW AND ACCOUNTABILITY Project specific review Health sector review Coutry platform holds review Other accoutability structure holds review IDA AND GFF TRUST FUND IDENTIFY PROJECTS IN THE PIPELINE; IDA, GFF DISBURSE FUNDING *PID *Grat Agreemet With The World Bak 6 PROJECT IMPLEMENTATION *PAD LEGEND * Documets produced that ca be used for iformatio ad accoutability There are little or o opportuities for CSOs to ifluece this step Sometimes this is a opportuity to egage, or very advaced advocacy is possible here There is typically space for CSOs to ifluece this step Next step Next step does ot always follow sequetially Accoutability Opportuity I 9 I

14 PART 3. THE GFF PROCESS AND OPPORTUNITIES TO ENGAGE As we discussed i the previous sectio, CSOs have had challeges meaigfully egagig i the GFF i may coutries throughout all stages of the process. This guide is desiged to help remedy this situatio: to prepare CSOs with the kowledge to avigate the process, idetify opportuities ad resources, ad esure that ivestmets arisig from the GFF beefit from valuable CSO perspectives. This sectio outlies the process of implemetig the GFF i focus coutries. This is a complex process that does ot follow the same sequece i all coutries. However, there are some broad steps that happe i all coutries which we outlie here, ad are show i Figure Coutry Selectio Curret GFF coutries were selected through a multistep process. Decisio makers at the GFF used a set of criteria icludig RMNCAH idicators, domestic resources, ad World Bak fiacig for health to geerate a log list of potetial coutries. This list was the compared to coutries that GFF fuders had prioritized for their work. Cosultatios were the held with govermets to gauge their iterest i participatig. The fiaciers to the GFF Trust Fud made the fial selectio of first ad secod-wave coutries. 24 The coutry selectio process takes place outside the reach of most CSOs. There is little space to ifluece this decisio. To fid out if your coutry is beig cosidered for the ext wave of GFF coutries, try to access people i the Miistry of Health or other govermet officials that liaise with the World Bak, to fid out if the GFF has come up i recet discussios. Typically, a coutry has to go through a set of steps covered i Sectios before ay GFF Trust fudig or IDA fudig liked to the GFF is released. However, some coutries have received fudig liked to the GFF (as described i Sectio 3.5) before completig these steps. 3.2 Formatio of the Coutry Platform The GFF coutry platform is a govermet-led multistakeholder platform resposible for GFF operatios i each coutry. The GFF Busiess Pla, which describes how the GFF will operate, lists a umber of importat stakeholders who should be parters i the GFF process, icludig civil society. 25 Govermets typically use existig structures for RMNCAH plaig as the GFF coutry platform. For example, Cameroo is usig its health sector strategy committee as its coutry platform, supported by two techical workig groups. 26 A detailed list of coutry platforms by coutry is icluded i Aex 2: GFF coutry platforms ad Cotacts. Coutry platforms play a importat role i plaig for ad implemetig the GFF i coutry, icludig: Developig a ivestmet case (covered i sectio 3.4); Developig a health fiacig strategy (sectio 3.3); Mobilizig resources for differet areas of the ivestmet case (Sectio 3.5); Coordiatig techical assistace provided to assist i developig the ivestmet cases ad health fiacig strategy; ad Coordiatig moitorig ad evaluatio ad quality assurace (sectio 3.7). Give the importat role of the coutry platform, it is a importat structure for decisio makig ad its members are a good source of iformatio. Here are some tips: If you are tryig to reach someoe to lear more about the GFF stakeholder platform i your coutry, ask people i your professioal etwork if they kow which existig platform is beig used ad where ad whe the ext meetig will be held. Typically the official poit of cotact for the coutry platform is someoe i the Miistry of Health. I 10 I

15 If this does t work, you ca cotact the World Bak coutry office (see Aex 2) or the GFF Secretariat ad request that they put you i touch with the i-coutry focal perso for the GFF. You ca also reach out to the CSO Coordiatig Group o the GFF to lik up with other CSOs i your coutry that are workig o the GFF. Oce you kow who is o the coutry platform, figure out the key decisio makers ad their iterests. Are there ay members who are potetial allies for the issue(s) you work o? Figure out your best opportuities to egage. Ca you be added to the ivitatio list for the ext meetig, or ca your feedback be expressed by a existig ivitee? If CSOs are uder-represeted i the coutry platform, adapt the talkig poits i Box 2 to help make the case for why CSOs should have a seat at the table. Members of the coutry platform have the most up-to-date iformatio about the GFF i your coutry. Talk to members ad try to fid out: At what stage is the coutry platform i implemetig the GFF? What decisios are upcomig? What documets are beig cosidered by the members, ad how you ca provide meaigful iput? Use the Miimum Stadards for coutry platforms i the Busiess Pla to hold the coutry platform accoutable to the priciples of trasparecy ad iclusiveess, ad use the CSO recommedatios (Box 3) to make recommedatios for improvemet. 3.3 Health Fiacig Strategy The GFF supports coutry platforms i developig a health fiacig strategy, or a log-term strategy for fiacig the health sector i a sustaiable maer. It is developed typically alogside a ivestmet case. The strategy icludes a costed implemetatio pla that sets out shorter-term steps for achievig the strategy s milestoes ad ivestmets. 27 The health fiacig strategy is typically based o aalysis of the mai sources of health fudig, the fiacig systems, as well as processes, policies ad practices that shape the systems. Domestic govermet resources iterally geerated fuds, sovereig loas, ad aticipated door fuds that are o-budget are importat for log-term sustaiable health fiacig, so some mix of domestic resources will feature promietly i the health fiacig strategy. 29 Ultimately, CSOs wat the same results ad impact that the GFF is pursuig. Developig strog atioal fiacig strategies that ca ulock fuds for RMNCAH meas that more resources will be aliged to a focused ad coordiated implemetatio framework. Give that the GFF fudig mechaism requires matchig of fuds ad emphasizes domestic resource mobilizatio, it is importat to kow the targeted sources for this fudig as taxpayers ad for accoutability purposes. Here are some tips for egagemet: If possible, doate time to help with a importat iput for the strategy. Your feedback will be particularly importat if you ca cotribute a perspective that may be uder-represeted by the existig team draftig the strategy, such as experiece with resource mobilizatio. Coect with CSO colleagues workig o budget moitorig ad expediture trackig. They typically have kowledge of domestic ad exteral fiacig i the coutry, ad ca potetially cotribute valuable perspectives to a health fiacig strategy. If there is o healthspecific budget orgaizatio i your coutry, affiliates of the Iteratioal Budget Partership typically have strog budget moitorig ad expediture trackig skills Ivestmet Cases Ivestmet cases are coutry-owed RMNCAH plas required to access GFF fuds. Coutries have flexibility i what their ivestmet case will look like, but it must iclude the iteded results the coutry wats to achieve; a priority set of ivestmets; a costig of the priority ivestmets that matches the available resource evelope; ad the moitorig ad evaluatio of progress towards the desired results. 30 If a coutry has a existig pla for improvig RMNCAH that meets these criteria, it ca be used as a ivestmet case. For example, Tazaia is usig its RMNCAH Oe Pla II as its ivestmet case. 31 Ethiopia is usig its ewly-completed Health Sector Trasformatio Pla to guide the ivestmet case ad health fiacig strategy. 32 May health strategies iclude similar compoets: idetificatio of problems ad activities to address the priority problems idetified, etc. If this strategy is still uder developmet, stakeholders ca use the suggestios below. CSO egagemet opportuities are very slim or oexistet whe a coutry chooses to use a existig strategy as its ivestmet case. If the existig policy is strog o RMNCAH, usig it as the ivestmet case is a good thig. Eve if it is ot strog o RMNCAH (or a particular issues), pushig for a separate GFF ivestmet case may be couter-productive or a waste of time ad resources. Either way, there are other opportuities to egage durig prioritizatio ad implemetatio. Skip ahead to the ext sectio. I 11 I

16 BOX 5. ENSURING POLICY COHERENCE IN UGANDA S INVESTMENT CASE I Ugada, CSOs workig to promote access to rights-based family plaig were able to overcome cosiderable obstacles to egage positively i the GFF process. They developed relatioships with World Bak cosultats ad coutry missio staff to gather iformatio about the GFF process ad decisiopoits. They the egaged with decisio makers i govermet to esure that family plaig was adequately prioritized. The GFF process i Ugada bega without ay CSO egagemet. CSOs were alarmed because they were ot aware what was happeig with the GFF, but had heard that cosultats had bee hired ad had commeced work. The process shifted i October of 2015, whe a meetig i Mukoo brought together govermet, developmet parters ad CSOs to discuss the proposed methods for developig the Ugada ivestmet case, ad to determie the bottleecks ad associated priority ivestmet areas. The Mukoo meetig was followed by a meetig of CSOs with the World Bak missio i November 2015, where the missio provided a detailed briefig ad addressed questios ad cocers from CSOs. World Bak missio staff demostrated a willigess to share iformatio ad accept feedback, ad took time to liste to CSOs ad explai the process. This meetig culmiated i the selectio of oe CSO represetative to the November, 2015 GFF Learig Meetig i Nairobi. The CSO represetative was sposored to atted the meetig. I November ad December 2015, two meetigs were held ivolvig the permaet secretary for health, CSOs ad World Bak missios. These meetigs icluded presetatios to CSOs o the progress made so far i developig the ivestmet case ad the priority ivestmet areas. Durig the presetatios, CSOs icludig Parters i Populatio ad Developmet Africa Regioal Office realized that Ugada s draft ivestmet case had ot utilized the Family Plaig Costed Implemetatio Pla (CIP). I fact, family plaig had ot bee prioritized as a ivestmet area, with the exceptio of post-partum family plaig. Subsequetly, more tha three meetigs were held at the Miistry of Health i the Materal Child Health Cluster, ad icluded meetigs with the World Bak missios that further explaied the process ad set expectatios. Durig oe of the meetigs, the CSO commuity i Ugada preseted a siged global petitio to esure a rights-based approach to family plaig was icluded i the ivestmet case. I Jauary 2016, a draft ivestmet case (Revised Sharpeed Pla) was shared amog stakeholders, ad family plaig was preseted as a costed priority ivestmet area for the GFF. The Ugada Family Plaig Cosortium, a CSO platform of the largest family plaig providers, was also actively ivolved i callig for iclusio of the CIP, ad worked closely with UNFPA to esure its iclusio. The CIP was a valuable resource for makig a strog case for RH iclusio i the ivestmet case, with detailed itervetios ad costed focus areas. I the costig ad fializatio of the ivestmet case, egotiatios bega betwee the govermet ad the World Bak. CSOs were ot icluded i this process. The ext step will be to seek parliametary approval. This presets a further opportuity for CSOs to be ivolved. Steps ad Opportuities For coutries developig a ew ivestmet case, the GFF Secretariat has outlied the followig potetial steps i a guidace documet. 33 At each step, we have idetified etry poits ad questios that ca lead to valuable iformatio. A few tips cut across steps: 34 Coordiate CSO leadership so that CSOs are orgaized through existig mechaisms or by broadeig existig coalitios or creatig a ew coalitio to egage i the GFF. Workig together, CSOs ca oriet each other o processes ad develop advocacy targets ad messages. Sice ot all CSOs will be ivited to all GFF cosultatios, it is importat to build cosesus aroud key advocacy priorities that the chose CSOs ca deliver. Egage i SMART advocacy where joit CSO objectives are specific, measurable, attaiable, realistic ad time-boud. CSOs ca the develop messages to reach differet GFF stakeholders i the Miistry of Health ad World Bak coutry offices, idetify messegers to egage with these stakeholders, ad improve the chaces of CSO advocacy priorities beig icluded i ivestmet cases. It is best to have multiple allies to represet CSO iterests ad advace the discussio. 35 I 12 I

17 CSOs ca elect official CSO represetatio to various decisio makig tables based o their relevat skill sets ad abilities to deliver the CSO ageda. For example, some CSOs are experts o what itervetios are most impactful for differet aspects of the cotiuum of care. They ca make sure a ivestmet case represets a techically-soud approach ad is i lie with iteratioal stadards, thereby playig a quality assurace role. 36 Itelligece ad iformatio gatherig is essetial for egagemet, but also very challegig. Whe pressed, GFF cosultats ad World Bak missio staff may share iformatio about the GFF process, which meetigs are plaed ad where meetigs will take place. CSOs may have to be persistet, ad sometimes atted meetigs to which they are ot ivited. Be sure to maitai the credibility of CSOs as valuable stakeholders i the process. Always use solid evidece to back up your advocacy. Pay attetio to speakers i meetigs, ad always be respectful whe raisig cocers with decisio makers. Whe is the first stakeholder cosultatio? Is adequate advace otice give? Are ay materials distributed i advace to help stakeholders uderstad the process? Who will be part of the coutry platform? Do govermet ad other officials uderstad the value of egagig with CSOs, or is more work eeded to brig them o board? How are ay CSO represetatives chose, ad by whom? Are there ay members of affected commuities that should be represeted but are ot? People from certai geographies? Are CSOs expected to be egaged throughout the ivestmet case developmet ad implemetatio, or just the iitial stages? What is the process for CSOs who are part of the coutry platform to egage the wider CSO commuity? How ca the wider CSO commuity support the CSO members of the coutry platform? Oce you kow who is decidig the compositio of the coutry platform, use the talkig poits i Box 2 to make the case for why CSOs should be at the table. STEP 1. Defie the approach to ivestmet case developmet: The govermet ad the GFF Secretariat come to agreemet o what form the ivestmet case should take. The govermet is supposed to produce a roadmap for the process: idetifyig timelies, stakeholder egagemet i the coutry platform, ad roles ad resposibilities. Some coutries have desiged their ivestmet case process to facilitate CSO iput. I Mozambique, the govermet reportedly developed a road map for the GFF ivestmet case productio, ad advertised it to esure that people kew whe ad where to egage. Ufortuately, CSOs were reportedly oly ivited for a half-hour meetig i Jue, ad very limited iformatio was shared afterwards. Defiig the approach is crucial to shape procedures aroud iclusio ad trasparecy, to esure that CSOs are egaged i a meaigful way: Who do you eed to ifluece to be part of the coutry platform? Which idividual i the Miistry of Health is decidig the compositio of the coutry platform? What is their proposed pla for developig the ivestmet case? How will the govermet egage CSOs? Are they developig a stakeholder egagemet pla? Use the CSO recommedatios i Box 3 to make suggestios o how CSOs ca be meaigfully egaged i the coutry platform. Get to kow your World Bak coutry office, which will likely be coordiatig the cosultats who will facilitate the GFF process ad develop the ivestmet case. These staff ad cosultats ca also be importat cotacts to egage ad share your core cocers with. STEP 2. Situatioal aalysis ad key results: The coutry platform outlies the coutry cotext to help idetify key priorities. It provides the startig place for idetifyig the iteded results. It should draw o existig research, ad may require additioal aalytical work. At this stage, it is importat to make sure that key CSO challeges ad priorities are appreciated by other stakeholders ad expressed i ay documets produced. Importat questios are: What are the biggest RMNCAH challeges i the coutry? Watch out for challeges that ca be politically sesitive but have a big impact o health outcomes, such as child marriage, cotraceptio for umarried youth, usafe abortio, harmful traditioal practices, or reproductive rights of ethic miorities, people with disabilities, or members of LGBTQ commuities. I 13 I

18 Do these challeges adequately traslate ito the iteded results? Was aythig left out that should be icluded? What kid of existig research is accepted i developig the coutry cotext? Is CSOproduced literature part of the review? If ot, are there ay govermet-sactioed sources that cotai the same iformatio? STEP 3. Bottleecks ad potetial ivestmets: The coutry platform idetifies the bottleecks (or challeges) that will be overcome, ad the priority itervetios for the ivestmet case. It may iclude addressig systemic or multi-sectoral challeges like supply chai problems, commodity shortfalls, health worker shortages, the eed for demad geeratio, or stregtheig civil registratios ad vital statistics. This key stage idetifies the potetial itervetios ad core strategies to address systemic bottleecks. At this poit, it is importat to uderstad: How the challeges idetified i the situatio aalysis are goig to be addressed. Are ay systemic issues beig overlooked? Are priority itervetios targetig commuities or populatios with the highest burde of poor RMNCAH? Are ay commuities or populatios beig overlooked? Does the geographic focus of the potetial ivestmets match where resources are most eeded? Has the ivestmet case draftig team sought feedback from the CSO commuity ad other importat stakeholders o potetial itervetios? Were members of commuities idetified for potetial ivestmet meaigfully cosulted i desigig how services will be delivered to them? Compare the bottleecks ad potetial ivestmets with the challeges ad priority itervetios suggested earlier i the process, ad highlight ay importat areas that have ot bee carried forward. To esure that your cocers are prioritized, offer evidece demostratig how a particular area of RMNCAH will produce results. The poit of the ivestmet case is to idetify the high impact ivestmets that are goig to deliver results. It is ot a list of approaches, ad some will be left out. STEP 4. Costig, cost-effectiveess ad resource mappig: Members of the coutry platform make comparisos betwee differet proposed itervetios ad strategies based o the combiatio of expected costs ad beefits. Officials icludig miisters of fiace help map domestic ad exteral resources. This step is importat backgroud for the prioritizatio that happes i the ext stage. Importat questios to ask here are: Have the cost-effectiveess estimates icluded variables that are hard-to-quatify, such as dimiished quality of life? Is the resource mappig realistic? Are there ay assumptios about risig out-ofpocket (cosumer) spedig, which ca push low-icome people further ito poverty or deter health seekig behavior? This is a largely techical exercise that CSOs may ot be ivited to participate i. If possible, it is importat to try to uderstad the assumptios behid the umbers, to make sure the right factors are beig couted. Review past govermet-led costig ad costeffectiveess activities such as family plaig costed implemetatio plas. Use this iformatio to idetify gaps with the curret list of proposals ad draw o the evidece used. STEP 5. Prioritizatio: I this importat step, the list of potetial itervetios is trimmed dow to fit the available resource evelope. Doors sometimes start fudig projects i support of the GFF before a ivestmet case is fial, so we discuss this step separately i Sectio 3.5: Prioritizatio ad Divisio of Labor. STEP 6. Moitorig ad evaluatio: Each ivestmet case should iclude a results framework with idicators for moitorig progress, as well as a pla for moitorig ad evaluatio. We discuss the results framework i the ext sectio, because i coutries usig a existig strategy as their ivestmet case, the results framework may be developed separately. The moitorig ad evaluatio (M&E) pla should iclude sources of data ad systems to track progress, which may iclude household survey data, facility-level survey data, CRVS, admiistrative systems such as health maagemet iformatio systems, ad systems for trackig govermet ad door fudig flows. The pla should also clearly idicate roles ad resposibilities. I 14 I

19 The M&E pla ca be a powerful tool for accoutability. It is importat to uderstad: Who is resposible for moitorig? Are they sufficietly idepedet from the GFF implemeters to preset a ubiased perspective? Who do they preset their fidigs to? Will moitorig be ogoig, aual, or bi-aual? How will the iformatio be preseted? Will there be a moitorig report? What role will coutry platform members have i moitorig? Will there be a opportuity for CSOs to review ad provide feedback o draft M&E reports? Is the data publicly available, so it ca be verified (or moitored) idepedetly? Give widely ackowledged problems with fiacial trackig systems, how will fudig be moitored from doors ad govermet? Results Framework The results framework is the set of targets ad idicators used by the govermet, parters, ad the GFF Ivestors Group to measure progress towards RMNCAH results they are tryig to achieve through the ivestmet case. The idicators ad targets i a results framework are take from the priority areas i a coutry s ivestmet case. The World Bak is also developig a set of idicators that must be icluded i each coutry s results framework. 37 The idicators will iclude fiacig idicators, a set of core, impact-level global strategy idicators, ad will be draw from additioal iteratioally recogized idicator frameworks. The results framework is importat for two reasos: (1) The idicators ad targets express a coutry s priorities withi RMNCAH ad suggest where resources should be directed; ad (2) measures of progress over time will be used to moitor what is workig well ad idetify areas that eed deeper attetio ad ivestmet. BOX 6. A BUMPY ROAD IN KENYA The cosultatios o the developmet of Keya s RMNCAH ivestmet framework started i Jauary The framework was vetted i forums with varied represetatio of stakeholders icludig couty govermets, civil society ad private sector amog others. CSOs are workig through the Health NGOs Network (HENNET), a existig etwork officially recogized as the platform through which CSOs egage i the GFF i Keya. At the first mai stakeholders meetig, the Miistry of Health shared a detailed timelie for the process. At the secod meetig, the uit of Reproductive Health ad Materal Services at the Miistry of Health preseted a proposed prioritized set of smart itervetios that could be scaled up durig the ext five years to rapidly improve the health outcomes of Keya wome, childre ad adolescets. A revised versio of the RMNCAH priorities alog with the first draft of the health fiace strategy was preseted at the largest forum which icluded the Health 6+ parters. Parters were the give a deadlie to submit iput as orgaizatios or as idividual experts. As i may other coutries, CSO ivolvemet did ot just happe. Gettig CSOs orgaized with appropriate ad timely messages for decisio makers, despite limited egagemet opportuities, made a huge differece i realizig prioritizatio of pertiet issues. However, the fial RMNCAH ivestmet framework was ot shared directly with Keya CSOs. Istead, it was made available to them ad the rest of the world oly whe it was posted o the GFF website. There has ot bee further egagemet with CSOs, as the health fiace strategy was fialized by the World Bak ad Miistry of Health. Reewed efforts by CSOs have yielded ew aveues for cotiued CSO egagemet aroud a accoutability framework. The HENNET secretariat, supported by Jhpiego/Advace Family Plaig, is spearheadig these efforts. By the ed of October 2016, it is expected that a cocept for a advaced accoutability mechaism for the GFF will be i place i cosultatio with Miistry of Health ad the World Bak Keya office. Dimiished CSO egagemet i the latter stages of framework developmet was a missed opportuity for iclusiveess ad mutual partership that could have set a immediate foudatio for success. CSOs have always ad will cotiue to successfully fudraise to support i-coutry work o RMNCAH. Embracig CSO potetial through close workig ties is likely to accelerate progress o GFF coutry goals. I 15 I

20 If your coutry is usig a existig strategy as its ivestmet case ad that strategy already has a results framework, the GFF will likely use those measures (as i Tazaia). If your coutry is usig a existig strategy as its ivestmet case ad that strategy does ot have a results framework, the coutry platform may eed to develop oe. Here are a few ways to help shape your coutry s results framework: fudig previously allocated for a coutry or issue area. Opportuity to ifluece these decisios may be limited. That said, here are a few tips: The GFF is supposed to be drive by coutry priorities (as expressed by the govermet). Your best approach may be egagig with govermet to clearly prioritize a particular set of issues i its ow ivestmets, ad its dialogue with exteral doors ad World Bak staff. Voluteer or appoit a CSO with techical expertise to be part of the draftig or review team, so you have a opportuity to esure that the most importat compoets of RMNCAH from the ivestmet case are beig prioritized. 38 Determie if the proposed idicators are useful for moitorig progress ad accoutability purposes. If ot, suggest alteratives. For example, icludig a idicator that is disaggregated by age group ca help reveal if a particular itervetio is helpig to improve outcomes for youg wome ad girls. Fid out what data sources will be used to track each idicator to make sure the iformatio is actioable. Do you have cofidece i the data? Is it publicly available? Are the data updated aually or semi-aually? Which areas of moitorig, evaluatio ad data collectio eed to be improved? Whose resposibility is it to make sure these systems are strog? If a key cocer comes out strogly i the ivestmet case, it will be difficult for decisio makers to igore it durig the prioritizatio ad implemetatio process. Brig key policymakers o board with your priorities early o i the process. CSOs ca help shape first-year ivestmet priorities by presetig a evidece-based positio paper o certai critical areas i the RMNCAH cotiuum of care that require urget ivestmet. For istace, i Keya, sice the ivestmet case has bee fialized, this paper is goig to ifluece aual priorities for immediate fudig. This meas workig closely with the Miistry of Health to address RMNCAH priorities already i the implemetatio pla. There may be opportuities to shape what gets prioritized based o emergig iformatio such as the release of ew data showig a alarmig rise i teeage pregacy, or declies i materal health. 3.5 Prioritizatio ad Divisio of Labor At this stage, the ivestmet case with results framework is usually fiished (or almost fiished). The ivestmet case icludes a list of RMNCAH priorities that urgetly eed to be fuded. But who decides what will be implemeted first? Ad where will the moey come from? Aswers to these questios will vary from coutry to coutry. To esure that your particular area of iterest is prioritized, develop advocacy messages to target specific GFF stakeholders who share your cocers. Workig i a coalitio is ofte more powerful tha actig aloe. Key parters ca help stregthe argumets for priority settig. For example, UNFPA was a valuable resource i Ugada i esurig the iclusio of family plaig. I this importat step, potetial fuders prioritize what ca be fiaced withi their available resources. Sometimes this step is part of the developmet of the ivestmet case; other times ivestmets are rolled out as the case is still beig developed. Sice fudig comes from govermet, World Bak, ad bilateral doors, they ultimately decide what parts of the ivestmet case are fuded ad whe. Most decisios aroud fudig from exteral doors (or istitutios) are made betwee door staff ad govermet officials, based o a particular door s Sources of Fudig for the GFF Although opportuities for CSOs to egage i prioritizatio is ofte limited, it is importat to uderstad the key players who fiace the GFF ad how. This iformatio ca help orgaizatios uderstad the cotext they are operatig i, idetify opportuities for egagemet, ad be able to critically evaluate the differet actors ad the GFF as a whole. CSOs ca also be a importat supportive force, particularly i domestic resource mobilizatio. I 16 I

21 Govermets must mobilize fuds i support of their coutries ivestmet cases. Domestic resources ca iclude iterally geerated fuds, door grats, loas, or a mix of these. GFF coutry govermets ca raise moey through taxes, or by borrowig moey from the World Bak, bilateral doors, or fiacial markets. Sovereig loas must be repaid, ad typically come with service fees ad iterest charges. Reproductive health advocates egaged i the GFF i Tazaia ad Keya have expressed cocer that the mobilizatio of domestic resources primarily based o loas is ot sustaiable. Domestic resource mobilizatio should be based o icreasig state capacity to collect taxes ad good goverace. 39 The private sector i GFF coutries is also a potetial source of domestic fiacig for health, but to date the private sector has bee more egaged at the global level. 40 The GFF Trust Fud is used to support the developmet of ivestmet cases. Oce a ivestmet case is fial ad fudig is approved, the GFF Trust Fud disburses a grat to support priorities idetified i the ivestmet case. The GFF Trust Fud Committee decides how much fudig from the GFF Trust Fud will be spet ad where. World Bak fudig always accompaies GFF trust fudig. It ca take the form of: (a) a grat from the Bak s Iteratioal Developmet Associatio (IDA), low-icome coutry fiacig widow; or (b) a IDA Credit, or loa with highly favorable terms that icludes a grat elemet. 41 I coutries where GFF fuds have already bee committed, fudig from IDA has teded to be three to six times larger tha amouts from the GFF Trust Fud. Bilateral Doors provide co-fiacig (or complemetary fiacig) that is explicitly aliged at coutry level with GFF Trust Fud ivestmets. 42 These doors are supportive of the GFF, but they do ot put their fudig ito the GFF Trust Fud. Istead, they provide fudig to govermets or project implemeters directly, or ito a pooled fud for the GFF i a specific coutry. Co-fiacig takes the form of both grats ad favorable loas. BOX 7. KENYA: HOW THE FINANCING FITS TOGETHER The fial atioal RMNCAH Ivestmet Framework proposes iovative supply-side performace icetives to address health system bottleecks pertaiig to huma resources for health, health commodity maagemet ad quality health maagemet iformatio systems, amog others. It also proposes vouchers ad coditioal cash trasfers to overcome socio-cultural, geographic, ad ecoomic barriers to health service utilizatio, ad emphasizes multi-sectoral itervetios, icludig itervetios aimed at stregtheig the civil registratio ad vital statistics systems ad improvig birth ad death registratio. To address equity ad icrease coverage, the RMNCAH Ivestmet Framework prioritized ivestmets i 20 couties selected o the basis of low coverage rates for RMNCAH services, large uderserved populatios ad margializatio. However, after further cosultatio with the couty govermets, it was agreed that implemetatio will take place i all the 47 couties. As such, the RMNCAH Ivestmet Framework is aliged with the Keya devolved health system ad guides the ogoig developmet of couty aual work plas focused o evidece-based, prioritized, ad locally-relevat solutios. The forthcomig health fiacig strategy aims at esurig sustaiable fiacig for achievig these results by I its early stages, the thikig was to stregthe domestic resource mobilizatio icludig haressig the potetial of the iformal ad private sectors. The World Bak recetly approved a $191 millio project to support primary health care services i Keya, icludig a $40 millio GFF Trust Fud grat liked to a $150 millio IDA credit. The UK s Departmet for Iteratioal Developmet, the Japaese Iteratioal Cooperatio Agecy, the Uited Natios Childre s Fud, ad the U.S. Agecy for Iteratioal Developmet have committed complemetary fudig to support Keya s RMNCAH Ivestmet Framework. Sources: GFF. Jue GFF Portfolio Update. World Bak. Jue Keya Receives $191.1 Millio to Support Primary Health Care Services. Press Release. I 17 I

22 Iteratioal orgaizatios icludig GAVI ad the Global Fud to Fight AIDS, Tuberculosis ad Malaria provide uspecified amouts of cofiacig i GFF coutries, icludig through pooled fuds. 43 At this poit there is o public source of iformatio that shows the total fudig committed or disbursed i support of a coutry s ivestmet case from the govermet ad doors. Fudig iformatio is shared by GFF Secretariat to the Ivestors Group ahead of each IG meetig. The latest public update is available followig a Ivestors Group meetig o the GFF website uder the Ivestors Group tab ( globalfiacigfacility.org/ivestors-group), Documets, ad Meetigs. We have icluded a example of how the GFF process ad fiacig is comig together i Keya (Box 7). 3.6 Project Implemetatio Opportuities to ifluece GFF-fuded projects durig implemetatio vary from place to place, ad by fuder. The majority of this sectio focuses o helpig CSOs access iformatio o GFFfuded World Bak operatios. These are typically implemeted by govermets, but there are some geeral tips o ifluecig projects fuded by other sources: There may be opportuities to shape implemetatio through egagig atioal ad sub-atioal level decisio makers to focus o critical emergig priority areas followig the release of ew data. For example, i Tazaia the RMNCAH Oe Pla II has key priorities already set. However, a ew Tazaia DHS survey shows that adolescet pregacy is o the rise. Decisio makers withi govermet, service delivery orgaizatios who are implemetig projects, as well as iteratioal istitutios could be iflueced to re-prioritize policy ad fudig i respose to this ew iformatio, as opposed to implemetig usig a busiess as usual model. Coutries may develop implemetatio documets that CSOs ca feed ito. For example, i Tazaia, parters workig o family plaig ad the Miistry of Health held discussios to review activities ad idicators to esure that they respod to the overall idicators i the Oe Pla II. The result of these discussios was a aual pla for implemetig the Oe Pla II. A importat opportuity is ifluecig the key actors decisio o what objectives/ activities should be give priority ad i which geographical sites/areas. I Tazaia, CSOs have bee part of the implemetatio process eve at times whe they have had difficulty i decidig o some of these atioal frameworks/plas. I a decetralized goverace system, CSOs ca ifluece prioritizatio ad divisio of labor for couties or districts after the fializatio of the atioal-level ivestmet case based o the latest health idicators i that particular locality. World Bak-Fuded Projects The GFF website ( icludes some iformatio about the status of the GFF process ad GFF-fuded operatios i each focus coutry. For example, at the time of writig, the Keya coutry page o the GFF website ( globalfiacigfacility.org/keya) gives a overview of the GFF process, icludes a lik to the Keya RMNCAH Ivestmet Framework (ivestmet case), as well as a press release about a $191.1 millio GFF-fuded project to support primary health care services. It also icludes a list of parters supportig the GFF i Keya, although it does ot specify their role i the coutry. From the GFF website, you ca tur to the World Bak project portal to access more detailed iformatio o GFF-fuded projects ad other projects i the pipelie ( projects). Two documets i particular provide a uique set of project details: A project iformatio documet (PID) describes a proposed project that is i the pipelie for fudig by the World Bak. Sometimes a project has differet PIDs for each stage of the project developmet, ad sometimes there is oly oe PID. 44 This documet is ofte publicly available while a project is still uder cosideratio. A recet PID for Keya s GFF-fuded project icludes proposed developmet objectives, compoets of the project, fiaced activities ad ay co-fiacig, how the project will be implemeted (icludig resposibilities ad ay hirig or capacity buildig required), ad a World Bak cotact for the project. 45 A project appraisal documet (PAD) is the Bak s feasibility assessmet ad justificatio for the project, ad is used to help decisio makers at the Bak approve or reject a project. It is published after a project is approved, uless a govermet approves it for earlier release. 46 A recet Tazaia PAD icludes: key outcome ad impact idicators, phasig of the project, icludig disbursemet amouts ad timeframe, cost of the project ad percetage covered by fuders ad Implemetatio arragemets, icludig roles ad resposibilities. 47 I 18 I

23 PIDs ad PADs ca be foud by searchig the health sector uder the projects ad operatios tab ( ad selectig Browse by Coutry/Area ad selectig a coutry. The you ca select the Projects tab, ad scroll dow for projects metioed o the GFF website. You ca also search for health sector projects to see if they are fuded by the GFF. PIDs ad PADs ca be used by CSOs for providig project iput, ad moitorig implemetatio i the followig ways: Moitorig the World Bak website for PIDs that are related to your coutry ad reviewig the documets. If your orgaizatio has questios ad commets, each documet lists a World Bak cotact perso to reach out to. Oce completed, the PADs are bidig agreemets betwee the govermet ad the World Bak. CSOs ca use the PADs to moitor ad hold the govermet accoutable for promises laid out i the documet. The FP2020 iitiative is producig a World Bak Operatios primer, which will provide a simple explaatio of how World Bak operatios are desiged, fiaced, ad implemeted. This ca be a importat overview of the World Bak for CSOs who are ufamiliar with its processes. 3.7 Formal Review & Accoutability We uderstad accoutability to be a cyclical process of moitorig, review ad actio that emphasizes huma rights priciples of equality, odiscrimiatio, ad partership. 48 Throughout this guide, we have highlighted opportue momets to promote accoutability. I particular, we emphasized holdig decisio makers accoutable for the priorities ad priciples they have committed to supportig, as expressed through the ivestmet case. There are a few formal mechaisms that ca be used to review progress o the GFF i a particular coutry, ad hold actors accoutable for their commitmets: Depedig o how it is set up, the coutry platform ad ay formal mechaism for moitorig the ivestmet case is probably the best startig place for accoutability efforts. Curretly, there is o process i place to address grievaces related to CSO ivolvemet i coutry platforms or GFF implemetatio. If a complait is related to a World Bak-fuded project, it may be covered uder the Bak s Evirometal ad Social Framework (formerly kow as Safeguards). New safeguards were recetly adopted, ad will be rolled out betwee 2016 ad More iformatio ca be foud at: EXTERNAL/PROJECTS/EXTPOLICIES/ EXTSAFEPOL/0,,meuPK:584441~pagePK: ~piPK: ~theSitePK: ,00.html. There are global accoutability processes that CSOs workig o accoutability at the atioal ad subatioal levels ca feed ito. For example, PMNCH is i the process of developig a Uified Accoutability Framework for the Global Strategy for Wome s, Childre s ad Adolescets Health. As part of the Framework, a idepedet accoutability pael (IAP) will develop a report o the State of Wome s, Childre s ad Adolescets Health to assess progress ad make recommedatios every year alogside the UN Geeral Assembly. The IAP s aual report will iclude strog, idepedet atioal ad subatioal assessmets of RMNCAH progress as log as those assessmets are coducted ad shared with the pael. 49 There is likely to be a ope call for submissios to the pael every year. At this momet, i most coutries there is a gap i idepedet moitorig ad accoutability mechaisms for RMNCAH, particularly at the subatioal level. However, CSOs are beig looked to as focal poits o accoutability for the GFF. To be able to serve as a idepedet watchdogs, CSOs may eed to quickly get orgaized to develop iovative ad cotextually relevat accoutability mechaisms. There are sigificat efforts that ca be adapted or applied. 50 For example: I Keya, a group of CSOs led by HENNET, Advace Family Plaig/Jhpiego, ad Maagemet Scieces for Health s Family Care Iteratioal Program are collaboratig to develop a accoutability framework for the GFF i Keya. This effort is beig led by civil society workig i coordiatio with govermet ad World Bak colleagues. If successful, this iitiative could serve as a model for other GFF coutries. Scorecards ca be a effective way to preset iformatio for accoutability purposes. For example, the Africa Health Budget Network is i the process of developig a scorecard to track effective CSO participatio i GFF coutry platforms across the Africa regio. The scorecard will assess differet idicators based o the stadards, ad assig a coutry gree, yellow, or red, based o its performace as measured through a variety of sources. The scorecard approach ca be adapted to moitor the priority areas of the GFF ivestmet case, or CSO egagemet at the coutry level. The product could the be used to iform advocacy with GFF decisio makers at the coutry level. I 19 I

24 CONCLUSIONS The success of the GFF ultimately rests o how well it will improve the health of wome, childre, adolescets ad ewbors. CSOs play a importat part i advacig RMNCAH, ad thus have a lot to cotribute to RMNCAH strategy developmet, implemetatio, ad accoutability for results. This guide is desiged to support CSOs to play this critical role. Edotes 1 P. 1, GFF Cocept Note. World Bak Idia was aouced with the secod wave of coutries, but seems to have withdraw GFF Busiess Pla. World Bak. 8 P. 10 Hurd, Wilso ad Cody Civil Society Egagemet i the GFF: Aalysis ad Recommedatios. Global Health Visios ad Catalysts for Chage. 9 September Accra Ageda for Actio. Orgaizatio for Ecoomic Cooperatio ad Developmet p. 65, Every Woma Every Child Global Strategy for Wome s, Childre s ad Adolescets Health: Survive, Thrive, Trasform. Every Woma Every Child. 12 Treds i materal ad child mortality from WHO, UNICEF, UNFPA, The World Bak, Uited Natios Populatio Divisio cited i p. 64, Every Woma Every Child P. 77, Every Woma Every Child More iformatio about CHAM ca be foud at: mw/idex.php/ /backgroud-of-cham. 15 Natioal Statistical Office ad ICF Macro Malawi Demographic ad Health Survey Zomba, Malawi, ad Calverto, Marylad, USA: NSO ad ICF Macro. 16 Kyogo, Bria ad Amos Mwale cited i Couture, Tary ad Suzaa Deis. July Towards A Commo Framework for Measurig Govermet Spedig o Family Plaig. Washigto, DC: PAI. 17 P. 72 Every Woma Every Child These are based o the CSO Recommedatios for Miimum Stadards for RMNCAH Coutry Platforms to Ehace Participatio, Trasparecy, ad Accoutability. See aex B of Hurd, Wilso & Cody 2016 for the full recommedatios. 19 Hurd, Wilso ad Cody See the Civil Society Coordiatig Group o the GFF Terms of Referece. 21 PMNCH CSOs Outlie Steps for Greater Egagemet Ahead of Global Fiacig Facility Learig Meetig. PMNCH. 22 The Comités Techiques Multisectoriels Permaets or CTMP is a platform that brigs together Miistry of Heath leaders, local ad atioal CSOs, as well as iteratioal parters to icrease the prioritizatio of family plaig. 23 P Hurd, Wilso & Cody P. 23, World Bak From supplemeted by upublished September 2016 GFF Portfolio Update. 27 p. 20 GFF. 2015; 28 p. 20 GFF. 2015; 29 A directory of BMET cotacts i 102 coutries is here: iteratioalbudget.org/budget-work-by-coutry/fidgroup 30 P. 3-4, GFF Guidace ote: Ivestmet Cases. World Bak Source: GFF Third Ivestors Group Meetig Portfolio Update. 33 GFF Most of the tips here are take from Mutuga, Shariff, Fredrick, Belager, Sudaram ad Marshall See the Advace Family Plaig Advocacy Portfolio for more guidace ad tools o SMART advocacy: advacefamilyplaig.org/portfolio. 36 For more, see: GFF. Quality Assurace of Ivestmet Cases. 37 GFF 2015; GFF 2016; 38 Aex 1, GFF Mutuga et al See: ad the GFF s Private Sector Egagemet Strategy for more. 41 Defiitios take from the World Bak s IDA Ledig Terms Effective as of April 1, 2016; DSA guide Bak Iformatio Ceter Ulockig the World Bak s Access to Iformatio Policy: Your key to the vault. 45 World Bak Trasformig Health Systems for Uiversal Care Project Iformatio Documet Appraisal Stage. 46 Bak Iformatio Ceter World Bak Iteratioal Developmet Associatio Program Appraisal Documet o a Proposed Credit i the Amout of SDR 145 Millio (US$200 Millio Equivalet) to the Uited Republic of Tazaia for the Stregtheig Primary Health Care for Results Program. 48 WHO, Every Woma, Every Child: from commitmets to actio: the first report of the idepedet Expert Review Group (ierg) o Iformatio ad Accoutability for Wome s ad Childre s Health, Cited i KS23_huma_rights.pdf 49 Hurd, forthcomig. 50 This sectio is excerpted from Hurd, forthcomig. I 20 I

25 ANNEX 1 LIST OF RESOURCES ON THE GFF Advace Family Plaig Advocacy Portfolio. Baltimore: Bill & Melida Gates Istitute for Populatio ad Reproductive Health at the Johs Hopkis Bloomberg School of Public Health Bak Iformatio Ceter Ulockig the World Bak s Access to Iformatio Policy: Your key to the vault. Washigto, DC: Bak Iformatio Ceter. Every Woma Every Child The Global Strategy for Wome s, Childre s ad Adolescets Health: Survive, Thrive, Trasform. Every Woma Every Child. Global Fiacig Facility Cocept Note: A Global Fiacig Facility i Support of Every Woma Every Child. Washigto, DC: World Bak. Global Fiacig Facility Busiess Pla. Washigto, DC: World Bak. Global Fiacig Facility Guidace Note: Ivestmet Cases. Washigto, DC: World Bak. Global Fiacig Facility page: Hurd, Susaah, Rachel Wilso, ad Aubrey Cody. February Civil Society Egagemet i the Global Fiacig Facility: Aalysis ad Recommedatios. Global Health Visios ad Catalysts for Chage. Hurd, Susaah. Forthcomig. GFF Accoutability Brief. Global Health Visios. Mutuga, Agela, Halima Shariff, Beth Fredrick, Erica Belager, Preethi Sudaram ad Aliso Marshall Global Fiacig Facility (GFF) Coutry Cosultatios Fact Sheet: Lessos Leared from GFF Frot Ruer Coutries Keya ad Tazaia. Iteratioal Plaed Parethood Federatio, Advace Family Plaig ad the Reproductive Health Supplies Coalitio. Raja, Sageeta World Bak Operatios Primer. Washigto, DC: FP2020. (Forthcomig) Sochas, Laura ad Suzaa Deis. October Raisig the Bar: Recommedatios to Stregthe the GFF Miimum Stadards to Coutry Platforms to Ehace Participatio, Trasparecy, ad Accoutability. Washigto, DC: PAI ad Lodo: Africa Health Budget Network. Note: This paper was the basis for discussio at the fall, 2015 Nairobi learig meetig. For the fial CSO recommedatios, see Aex B of Hurd, Wilso ad Cody (2016) Sudaram, Preethi. Jue Briefig o Global Fiacig Facility. Lodo: Iteratioal Plaed Parethood Federatio. World Bak projects & operatios page: I 21 I

26 ANNEX 2 GFF COUNTRY PLATFORMS AND CSO CONTACTS COUNTRY COUNTRY PLATFORM GFF CONTACT BANGLADESH Accordig to the latest GFF portfolio update, Bagladesh has strog existig parterships ad coordiatio mechaisms i place that will be used for the GFF process N/A CAMEROON Accordig to the latest GFF portfolio update, Cameroo will use its Health Sector Strategy Steerig Committee, supported by techical workig groups to oversee the work related to both its ivestmet case ad health fiacig strategy World Bak Coutry Office Nouvelle Route Bastos Yaoudé, Cameroo Tel : ohebga@worldbak.org DEMOCRATIC REPUBLIC OF CONGO Accordig to the latest GFF portfolio update, The DRC has a established platform already i place World Bak Coutry Office Louise Mekoda Egulu 49, Boulevard Coloel Tshatshi Kishasa/ Gombe, RDC Tel : legulu@worldbak.org ETHIOPIA Joit Core Coordiatio Committee (JCCC) World Bak Ethiopia Coutry Office Gelila Woodeeh Africa Aveue (Bole Road) Addis Ababa, Ethiopia Tel : gwoodeeh@worldbak.org KENYA Miistry of Health Materal ad Newbor Health Techical Workig Group (TWG) & Health Fiacig TWG. CSOs are mobilized through HENNET World Bak Coutry Office Peter Warutere Delta Ceter Meegai Road, Upper Hill P.O. Box Nairobi, Keya Tel : pwarutere@worldbak.org LIBERIA Accordig to the latest GFF portfolio update, Liberia s coutry platform is composed of two techical workig groups, oe that works o health fiacig; ad the other o RMNCAH. Both are oversee by a health sector coordiatio committee World Bak Coutry Office Michael Nyumah Sahr Germa Embassy Compoud Tubma Boulevard, Oldest Cogo Tow Morovia, Liberia Tel : / msahr@worldbak.org I 22 I

27 COUNTRY COUNTRY PLATFORM GFF CONTACT MOZAMBIQUE Accordig to the latest GFF portfolio update, the Miistry of Health (MISAU) established a task force led by the director of public health to lead the GFF process World Bak Coutry Office Rafael Saute Av. Keeth Kauda, 1224 Maputo, Mozambique Tel : rsaute@worldbak.org NIGERIA Accordig to the latest GFF portfolio update, a techical workig group created as a result of the ew Natioal Health Act serves as the coutry platform. There is a thematic sub-committee o health fiacig which will develop the health fiacig strategy World Bak Coutry Office Obadiah Tohomdet 102 Yakubu Gowo Crescet Opposite ECOWAS Secretariat P.O. Box 2826, Garki Abuja, Nigeria Tel : otohomdet@worldbak.org SENEGAL Accordig to the latest GFF portfolio update, a RNMCAH platform that was istalled at the ed of April ad will likely be formally lauched i Jue. Bureau de la Baque modiale Mademba Ndiaye Coriche Ouest X Rue Leo Gotra Damas Dakar, Seegal Tel : mdiaye@worldbak.org TANZANIA Tazaia is usig the Sector Wide Approach health sector coordiatio mechaism World Bak Coutry Office Loy Nabeta 50 Mirambo Street P. O. Box 2054 Dar es Salaam Tel : labeta@worldbak.org UGANDA Ugada is usig a existig health sector coordiatio mechaism World Bak Coutry Office i Keya Peter Warutere Delta Ceter Meegai Road, Upper Hill P.O. Box Nairobi, Keya Tel : pwarutere@worldbak.org I 23 I

28 th Street NW, Suite 200 I Washigto, DC USA I PHONE : (202) I sdeis@pai.org