The GFF’s Catalytic Role
The GFF Catalytic Role provides details on the GFF support for Cambodia’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-supported investment case (IC), built around stakeholder alignment, prioritizes reducing maternal and child undernutrition, neonatal mortality, and adolescent fertility. The IC also focuses on closing equity gaps in seven priority provinces. To support delivery of the IC, a US$10 million GFF grant is cofinancing the Cambodia Nutrition Project, which invests in maternal and child health and nutrition.
- Prioritizing and implementing health financing and systems reforms: The GFF’s technical assistance and financing supports the government’s health financing reform agenda to mobilize domestic resources for the health and nutrition of women, children, and adolescents; enhance efficiency of existing resources; and provide financial protection for the poor. The reforms build on the success of the Health Equity Fund (HEF) and service delivery grant (SDG) systems. HEF provides financial protection for the poor seeking care at public health facilities, while SDGs channel flexible funds to public health facilities.
- Improving the coordination and quality of health and nutrition services: The GFF contributes to improved integration of health and nutrition service delivery and defragmenting of financing. In collaboration with the Cambodia Nutrition Project partners, KfW, KOICA, DFAT, IDA and the Royal Government of Cambodia along with UNICEF, Alive & Thrive, and a consortium of local and international NGOs, the GFF is financing technical assistance to strengthen the health system, enhance nutrition and maternal, newborn and child health service delivery, and improve the nutrition behaviors and health and nutrition outcomes of mothers, infants, and young children.
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.
Cambodia’s investment case (IC) is focused on three key issues: reducing newborn mortality, reducing child undernutrition, and decreasing adolescent fertility. The Cambodia Nutrition Project, or CNP (2019–24), a US$53 million investment lending operation, will fund an estimated 80% of the activities included in the IC and is closely aligned with its strategic priorities. The CNP harmonizes financing from IDA, GFF, German KfW, Australian DFAT, and the Health Equity and Quality Improvement Project multi-donor trust fund (pooling financing from Australian Aid, German KfW and KOICA) and includes 23% of domestic resources from the Royal Government of Cambodia. A detailed resource mapping exercise of the IC was planned in early 2020, but has been delayed due to the COVID-19 pandemic; discussions on resumption of this exercise is ongoing. The resource mapping will identify funding gaps by priority and will show trends in domestic resource mobilization and donor alignment around the IC.
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.