The GFF’s Catalytic Role
The GFF Catalytic Role provides details on the GFF support for Mauritania’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: Development of the country’s investment case (IC) is ongoing, concurrent with creation of a new health strategy and finalization of the latest Mauritania Demographic Health Survey (DHS). This timing ensures increased partner alignment and allows the GFF to provide catalytic funding to implement the IC.
- Prioritizing and implementing health financing and systems reforms: The government has developed a national health finance strategy to reach universal health care, which includes health finance reforms such as establishment of a common health fund, transitioning to budget programming, and increased efficiency and equity of primary health care spending. These reforms are supported by GFF and partners. Further support for integration of adolescent health and redefinition of the primary health care packages is also discussed.
- Strengthening the country platform and convening financial and technical partners at country level: The development partners’ health coordination group, led by the European Union, serves as one of the current platforms for alignment awaiting the re-establishment of the national health coordination committee, led by the Ministry of Health. The GFF and partners have supported the inclusion of national civil society organizations in the health processes.
- Improving data for decision making: The GFF is supporting a national health information software system and results-based financing portal assessment to look at data quality. The new DHS on its way will allow recent and updated data for decision-making.
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 pandemic forced several countries to cancel or re-schedule plans for survey data collection in 2020.
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.
Population-Based Survey Coverage Indicators
The RMNCAH-N coverage data includes a standard set of 9 RMNCAH-N coverage indicators from available population-based surveys from 2010 to 2020. 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.
Mauritania is in the process of finalizing their new national health strategy this year from which the investment case (IC) will be extracted. Due to the COVID-19 situation, the resource mapping exercise designed to go hand in hand with the development of the health strategy and the IC was delayed. The data collection tool has been developed and tested. When launched, the tool will collect and analyze the data to inform the health strategy and IC priorities.
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.