The GFF’s Catalytic Role
The GFF Catalytic Role provides details on the GFF support for Burkina Faso’s Reproductive, Maternal, Neonatal, Child, and Adolescent Health and Nutrition (RMNCAH-N) agenda. Details on past and ongoing work are provided along with plans for future support. The GFF Catalytic Role focuses on support provided in the areas of the Investment Case (IC), Health Financing and systems reforms, the country platform, partner alignment, and data use for decision-making.
- Developing a costed and prioritized investment case: The GFF provided impetus for revising the investment case (IC) for Burkina Faso to focus on resilience and response to insecurity, health insurance, and community health. IC priorities expanded to respond to emerging needs and pave the way for universal health care. In addition to helping mobilize donors around these objectives, the GFF contributed to mapping resources and supported an allocative efficiency study and the use of the Equist tool with a focus on equity. Facilitated by the GFF, civil society organizations (CSOs) participate in national platforms and play a critical role in the monitoring and revision of the IC along with advocating for an increase of government funding.
- Prioritizing and implementing health financing and systems reforms: The GFF is supporting reforms such as the expansion of Burkina Faso’s free health care model, which will deliver free family planning and care for children under-five and pregnant women. The National Health Insurance Fund underway aims to strengthen social protection and provide insurance for the poor. As part of this effort, the strategy to strengthen community health includes significant community health infrastructure investments as well as the training of skilled health workers.
- Strengthening the country platform and convening technical and financial partners at country level: Within the country platform, the GFF has helped to strengthen CSO engagement and promote effective private-public dialogue. Stronger alignment has incentivized the GFF, Gates Foundation, GAVI, the Global Fund, and the World Bank to agree on a common agenda and participate in joint missions to monitor the IC, focusing on data systems evaluation, supply chain, and health financing. The GFF supported capacity building in stakeholder engagement, service delivery adaptation to the COVID-19 context and market management for health. The alignment agenda is also supported by the GFF through the “One Plan-One-Budget- Report” approach.
- Improving data for decision making: The GFF has coordinated a collaboration between the government, Countdown to 2030, and Johns Hopkins University to build capacity for data collection to enable monitoring of IC implementation. In addition, the GFF is collaborating with the World Bank on analysis of service delivery related data in the context of COVID-19. Efforts to strengthen civil registration and vital statistics systems, with GFF assistance, will boost child protection and access to basic services, education, and social protection as well as facilitate planning for services such as vaccinations and growth monitoring.
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 these past two years.
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.
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.
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.
A resource mapping of the UHC strategy (2020–24) was conducted in 2020. The GFF investment case is an essential element of the UHC strategy, as it was revised with the purpose of becoming the central document for the upcoming high level UHC financing forum. The resource mapping focuses on RMNCAH and health system strengthening priorities for 2020 and 2021. The analysis shows that the government of Burkina Faso is maintaining its engagement in funding the UHC strategy and remains the main source of funding in 2020 and 2021. Sixteen donors are aligned to the UHC strategy in 2020 and 2021. The funding gap slightly increased between 2020 and 2021 due to an increase in cost of the UHC strategy from 2020 to 2021 (see figure). Funding gap analysis by priority area highlights nutrition, malaria, child health, and community health are particularly underfunded while the health system strengthening component appears to be slightly overfunded underlining room for improving allocative efficiency. Further analysis needs to be conducted by the Ministry of Health to better understand reasons behind underfunding of key priorities to reach UHC targets and define strategies to make existing resources more efficient.
Monitoring The Country-led Process
The GFF Logic Model highlights key elements of a GFF co-financed country-led process that contribute to the expected impact of improved RMNCAH-N outcomes over time. The GFF has developed a core set of indicators to monitor implementation of the GFF approach, considered as inputs and activities in the model, that emphasize prioritization and alignment to capitalize on efficiencies to improve transparency and accountability as well as health outcomes. Process monitoring includes tracking investment case development, country stakeholder engagement, health financing and the inclusion of gender and equity approaches.
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.