en Year joined GFF
Investment Case timeframe
World Bank co-financed project effective
World Bank co-financed project effective

Core RMNCAH-N Impact Indicators

The 8 GFF core impact indicators reflect updates aligned with the in-country survey schedule which optimally occurs once every three to five years to determine population-based changes in important health and nutrition outcomes. These indicators are core to the GFF Logic Model, to reflect impact of aligned interventions over time.  Collected by governments and development partners, these indicators are also used to monitor the Every Woman Every Child Initiative and the 2030 Sustainable Development Goals (SDGs) for RMNCAH-N. The country survey data includes Demographic Health Surveys (DHS) and Multiple Indicator Cluster Surveys (MICS), which are funded by domestic resources as well as by the World Health Organization (WHO), UNICEF, USAID and other multi- and bilateral organizations. The Covid-19 pandemic forced several countries to cancel or re-schedule plans for survey data collection in early 2020 to early 2022.

CORE RMNCAH-N IMPACT INDICATORS
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The GFF highlights progress between the two most recent point estimates from population-based surveys approved by countries.  The timing of the data points is dependent on when survey data are available, which introduces lags.  In addition, it has been demonstrated that stillbirths tend to be under-reported in population based surveys1.  For many of the indicators highlighted in this table, annual estimates are produced through global processes.  The globally produced estimates can be found through the following sites:

Core Health Financing Indicators

The six GFF core health financing indicators track changes to country budget and expenditures with a focus on health spending, to monitor the expected impact of increasing the total volume and value of funding allocated to health and nutrition. The GFF partnership supports financing reforms by engaging with ministries of finance and ministries of health to strengthen mobilization of domestic resources as well as allocative and technical efficiency. These indicators are tracked through country-specific data sources such as BOOST, NHA, and budget reports. Expenditure data are tracked through the Global Health Expenditure Database (GHED), for which data are available through the end of 2018. Through measurement of budgets and expenditures, the GFF partnership aims to accelerate the expansion of interventions that are high-impact, cost-effective, affordable, and feasible to accelerate progress on universal health coverage and in achieving SDG targets.

CORE HEALTH FINANCING INDICATORS
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Survey and Estimated RMNCAH-N Coverage

The RMNCAH-N coverage data includes a standard set of 9 RMNCAH-N coverage indicators from available population-based surveys from 2010 to the most recent available survey. These indicators show progress towards key goals across maternal, child, and adolescent health and nutrition outcomes. Additional key nutrition-specific and/or education-specific coverage indicators are presented for countries where the GFF co-finances a nutrition-focused World Bank project or where education is a strong focus of the IC. 

The RMNCAH-N coverage data are sourced from the most recent available population-based surveys. Data on immunization are presented from the WHO/UNICEF joint reporting process and recent population-based surveys.  

In Afghanistan, coverage of core RMNCAH-N indicators has shown improvement over the most recent decade, with particular gains in maternal health indicators including skilled attendant at delivery and institutional deliveries.

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Population-Based Survey Coverage Indicators
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Resource Mapping

Resource mapping is a key component of the GFF approach. The resource mapping exercise helps countries assess funding gaps, align donor and government resources, and improve the efficiency and equity of health spending. Resource mapping data for each country varies based on whether countries have completed one or more resource mapping exercises.

In 2020, Afghanistan published data from a resource mapping exercise that captured actual health resources available for fiscal year (FY) 2018/19 and forward-looking budgets for FY 2020/21 for the government and development partners captured. The mapping was commissioned to support health budget alignment and harmonization and take stock of both on- and off-budget health resources at national and subnational levels. The resource mapping noted  a significant portion of funding for health was on-budget (62%) in aggregate. However, allocations of these budgets varied significantly across provinces. The report also highlighted several key recommendations including suggestions to: 1) move from off-budget to on-plan is key to facilitate alignment and allocative efficiency; 2) revise resource allocation between provinces in order to achieve health sector strategic goals; 3) efforts should be made to regularly conduct annual resource mapping exercises and work to better understand expenditure patterns; and 4) expand the resource mapping effort in the health sector to include humanitarian assistance directed at health priorities. Since the change of government in 2021, it is unclear whether any of these recommendations have been taken forward. In the current situation in 2022, development partners, led by WHO, are working to jointly conduct a resource mapping of development partner funds and humanitarian assistance to ensure alignment of health sector support.

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Resource Mapping
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Note: Government of Afghanistan includes on-budget contributions from IDA, GFF TF, and Afghanistan Reconstruction Trust Fund (USAID, Global Affairs Canada, and the EU.

Implementation Progress

The data in this section is provided for a selection of indicators from the Investment Case Results Framework, Health Financing priorities, and the World Bank Project as applicable. Please select indicators from the dropdown menu to view the data for each indicator. Where subnational data is available, the map will display subnational trends over time or the latest data available. Hovering over the map will display additional data for the select indicator. Clicking on a region will add it to the chart on the right. All data, including source information, may be downloaded by selecting the arrow to the right of the indicator dropdown menu.

Implementation Progress
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* National data only.
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Note: Levels of quality and completeness of data from national HMIS systems vary substantially across and within countries. The GFF is working closely with partner countries and other technical partners to improve the quality and completeness of national HMIS systems and other key country-led data systems.