BUSINESS - Global Financing Facility

Global Financing Facility in Support of Every Woman Every Child

BUSINESS PLAN

JUNE 2015

BUSINESS PLAN

Global Financing Facility in Support of Every Woman Every Child

Contents

List of acronyms. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . v Executive Summary.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . vii 1.Why: The Need and the Vision. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

A.Why a Global Financing Facility Is Needed. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 B.Vision of the Global Financing Facility. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 C.The Global Financing Facility and the GFF Trust Fund. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 2.What: Smart, Scaled, and Sustainable Financing for Results. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5 A.Smart Financing. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6 B.Scaled Financing. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7 C.Sustainable Financing. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8 D.Achieving and Measuring Results. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10 3.How: Key Means to Deliver Results. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13 A.Investment Cases for RMNCAH.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13 B.Mobilization of Financing for Investment Cases. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16 C.Health Financing Strategies Focused on Sustainability. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20 D.Investments in Global Public Goods that Support RMNCAH Results at the Country Level. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21 4.Who: The Country Platform. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23 position.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23 B.Structure.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24 C.Functions. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24 5.The GFF Trust Fund. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27 A.Eligibility and Resource Allocation. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27 B.Roll-Out.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28 C.Operational Approach. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28 ernance. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 31 7.Theory of Change, Risk Analysis, Results Framework, and Accountability. . . . . . . . . . . . . 35

Annex 1: List of Organizations Participating in the Oversight Group and/or Business Plan Team. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . A1 Annex 2: Methodology for the Resource Needs, Financing Flows, and Health Impacts. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . A2

A.Foundational Elements. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . A2 B.Estimating Resource Needs. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . A3 C.Estimating Financing Flows. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . A4 D.Estimating Overall Resource Gaps and GFF "Savings". . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . A6 E.Estimating Health Impacts. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . A7 Annex 3: Methodology for the Investment Case. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . A8 A.Scope. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . A8 B.Key Steps. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . A11 Annex 4: Health Financing Strategies.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . A19 A.Scope. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . A19 B.Key Steps. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . A19 Annex 5: Technical Assistance and Capacity Building.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . A25 Annex 6: Minimum Standards for Country Platforms. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . A27 Annex 7: List of Countries Eligible for GFF Financing. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . A28 Annex 8: Resource Allocation Methodology and Roll-Out Costing. . . . . . . . . . . . . . . . . . . . . . A30 Annex 9: The GFF Trust Fund and World Bank Operations. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . A33 Annex 10: Global Theory of Change and Results Framework. . . . . . . . . . . . . . . . . . . . . . . . . . . . . A35

List of acronyms

CoIA CRVS EWEC GDP GFF HRITF IBRD IDA IFC IHP+ MMR PHC PMNCH RMNCAH SDGs SRH UNDP UNFPA UNICEF USAID WHO

Commission on Information and Accountability Civil registration and vital statistics Every Woman Every Child Gross domestic product Global Financing Facility Health Results Innovation Trust Fund International Bank of Reconstruction and Development International Development Association International Finance Corporation International Health Partnership+ Maternal mortality ratio Primary health care Partnership for Maternal, Newborn and Child Health Reproductive, maternal, newborn, child, and adolescent health Sustainable Development Goals Sexual and reproductive health United Nations Development Programme United Nations Population Fund United Nations Children's Fund United States Agency for International Development World Health Organization

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Executive Summary

The past two decades have seen unprecedented progress in improving the lives of women, adolescents, and children. However, as the global community enters a post-2015 world of Sustainable Development Goals (SDGs), a considerable part of the agenda with regard to reproductive, maternal, newborn child, and adolescent health (RMNCAH) remains unfinished. Far too many newborns, children, adolescents, and women still die from preventable conditions every year, and far too few have reliable access to quality health services. A large funding gap remains--US$33.3 billion in 2015 alone in high-burden, low--and lower-middle-income countries, equivalent to US$9.42 per capita per year--that can only be addressed by dramatic increases in financing from both domestic and international sources.

The Global Financing Facility in Support of Every Woman Every Child (GFF) was announced in September 2014 to respond to this challenge. The goal of the GFF is to accelerate efforts to end preventable maternal, newborn, child and adolescent deaths and improve the health and quality of life of women, adolescents and children, thereby preventing up to 3.8 million maternal deaths, 101 million child deaths, and 21 million stillbirths in high-burden countries by 2030. The GFF aims to reduce inefficiency in health spending over time, ultimately resulting in a reduction of the incremental resource needs for RMNCAH of approximately 15% by 2030, which would lower the resources required by more than US$6 billion per year. Additionally, the GFF aims to mobilize more than US$57 billion from 2015 to 2030 by crowding-in domestic resources, and by attracting new external support and improving coordination of existing assistance. The need for external support is frontloaded, with domestic resources progressively taking over for development assistance. Prompt initiation of GFF support creates more opportunities to plan for economic growth and capture its benefits in ways that shift countries onto trajectories toward sustainable financing, which would enable nearly 20 countries to graduate from receiving GFF funding by 2030 as their resource gaps close completely.

The GFF acts as a pathfinder in a new era of financing for development by pioneering a model that shifts away from a focus solely on official development assistance to an approach that combines domestic financing, external support, and innovative sources for resource mobilization and delivery (including the private sector) in a synergistic way. The GFF will serve as a major vehicle for financing the proposed SDG on healthy lives and will play a special role in scaling up financing to support the UN Secretary-General's renewed "Global Strategy for Women's, Children's, and Adolescents' Health".

The GFF brings partners together to provide smart, scaled, and sustainable financing to achieve and measure RMNCAH results at country level:

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