The GFF’s Catalytic Role
The GFF Catalytic Role provides details on the GFF support for Guinea’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 is supporting the investment case (IC) that focuses primarily on community health care and the application of a package of community health services. The IC also promotes multisectoral coordination to operationalize civil registration and vital statistics (CRVS) operations and resource mapping and expenditure tracking to align donor resources around priorities.
- Prioritizing and implementing health financing and system reforms: The IC aims to increase budgeting capacity and execution at the central and decentralized levels and improve spending efficiency and delivery efficiency of health services through results-based financing. Modernizing the CRVS system is also a priority area supported in collaboration with the Centre of Excellence, the European Union, UNICEF, UNFPA, and others. Efforts to enhance health services delivery also include reorganization of the strategy and development for the Ministry of Health and development and implementation of a comprehensive strategy for community health workers.
- Strengthening the country platform and convening financial and technical partners at country level: The GFF strengthens the country platform by expanding engagement with civil society organizations and the private sector, building an accountability agenda and developing a communication plan. In addition, GFF technical support contributed to the development of an active technical working group for health financing management. The GFF is also supporting increased collaboration with the European Union and other partners on the health financing agenda for Guinea.
- Improving data for decision making: The GFF supports the collaborative development of a results framework with baselines, targets, and systems to monitor the IC. In partnership with the Global Fund and GAVI, the GFF continues to focus on strengthening health management information systems.
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 Guinea team collaborated with Countdown to 2030 and GFF in an analysis workshop in Nairobi, Kenya, on 13-17 June 2022. As a result of that workshop, the team produced a report analyzing data quality and estimating coverage of key service delivery indicators. Please find the final report here.
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
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.
Resource mapping shows that the Guinean government’s health budget allocation for investment case priorities represents only 1% of such funds available in 2021, while there is substantial increase at 20% in 2022, indicating a strong commitment by the government to reposition the RMNCAH-N priorities high on the health agenda.
In 2021, the entire IC financing is from technical and financial partners and the funding gaps represents 10%. The Global Fund (20%), USAID (20%), the World Bank (16%), GAVI (10%), and the European Union (6%) are the five largest financial partners. Their combined contributions make up about 72% of the total IC funding for the fiscal year 2021 (US$ 89.6 million out of a total of US$ 113.2 million).
In 2022, If the state respects its commitment to support 20% of the IC funding, this will cover the funding gap. In addition to the major partners, i.e., the Global Fund (21%), USAID (12%), the World Bank (11%) and the European Union (7%), there are significant commitments from the Islamic Development Bank, which will account for 13% of the overall financing of the IC in 2022.
A new resource mapping exercise will not only identify resources for 2023 and beyond, but also track the expenditure in 2021 and 2022 of previously mapped funding.
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.
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.
Monitoring of Essential Health Services
The GFF supports routine monitoring of disruptions to essential health services. The essential health services data included in the graph below are sourced from country routine health information systems and shown monthly starting at the beginning of 2020. The analysis compared the observed service volume to what would have been expected had the pandemic not occurred, and reports the difference as a percentage. Positive values indicate a surplus of services, 0 indicates the expected level of services, and negative values indicate a lower volume than expected based on pre-pandemic values. In some countries, these changes in volume could be due to non-Covid-19 reasons.
The number of monthly deaths from Covid-19 is reported as a measure of the pandemic’s reach. The data on deaths from the Covid-19 pandemic were sourced from Johns Hopkins University (JHU) dashboards and compiled into monthly aggregates. The data used in this report were sourced 8/24/2021.