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
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, the Federal Ministry of Somalia (FMoS) developed an Investment Case to identify priority reforms across the health sector. The Investment Case included a breakdown of the Essential Package of Health Services (EPHS) as well as five Health System Strengthening (HSS) priority areas from the Somalia Health Sector Strategic Plan 2022-2026. To implement the Investment Case effectively, the MoH partnered with the GFF to conduct a resource mapping exercise against the investment case to identify gaps in resources available as well as ensure alignment around key government priorities. Notably, the assessment was also intended to contribute to broader alignment efforts across partners to adhere to the ‘Somalia Aid Architecture 3.0: Proposal for a renewed Partnership with the International Community’ by improving transparency and generating evidence for streamlined support.
Building on the EPHS costing work that had been conducted in 2021, the MoH conducted the RMET assessment and gap analysis across the EPHS and HSS priority areas. The assessment revealed a significant gap in funding across the EPHS priority areas and highlighted the need for the MoH to prioritize the package. Specifically, the exercise indicated that the resources available were insufficient to fund EPHS coverage of just 20% of the population. In line with the outcomes of the exercise, the MoH endorsed the need to phase the package, starting with ‘Phase I’ to ensure the feasibility and quality of services over time.
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
Somalia Interactive Theory of Change Linked to Focus Areas of the GFF Engagement
The Country Engagement Framework highlights reforms prioritized by the country, and links them to output and outcome indicators which represent the measurable results that the reforms intend to help achieve. By selecting a specific reform within the drop down menu, the user can see the intended results that correspond with that reform as represented by specific output and outcome indicators. Where implementation progress is mature and data are available for output and outcome indicators, users can click on the arrow to access results in data section below.
Implementation Progress Data
The data in this section is aligned with the Somalia Theory of Change and data 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.
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.
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: