The GFF’s Catalytic Role
The GFF Catalytic Role provides details on the GFF support for Viet Nam’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 Health Financing and systems reforms, the country platform, partner alignment, and data use for decision-making.
- Supporting the government of Vietnam’s push to strengthen the primary health care system: In alignment with the government’s focus on strengthening the primary health care system, the GFF is cofinancing the World Bank project, Investing and Innovating for Grassroots Health Service Delivery. The project aims to improve PHC and address unmet care needs by enhancing efficiency, quality, and utilization of commune-level health services. The project covers all regions of Vietnam and prioritizes rural and remote communities. Nine of the 13 project provinces are among the poorest in the country. Accordingly, project objectives include improving continuity of care and collaboration across levels of the health system, enhancing electronic medical records technology, upgrading infrastructure, and improving organization around key medical conditions at the grassroots level.
- Prioritizing and implementing health financing and systems reforms: The GFF supports health financing reforms, including social health insurance, by helping to align donor financing and providing technical assistance for revision of legislation and associated policies. With GFF support, the World Bank conducted a study to assess progress and barriers to health-related public-private partnerships. The GFF supports the transition to diagnostic-related grouping payments to help reduce hospital costs and increase efficiency.
- Improving data for decision making: The GFF is helping address gaps in health management information systems and improving health data availability, quality, and use, especially at the grassroots level, including by enhancing interoperability between central and subnational data systems. The GFF has helped align independent civil registration and vital statistics (CRVS) initiatives toward a common goal and supported the development of a detailed CRVS action plan. GFF resources have already led to improvements in cause-of-death reporting, one of the weakest aspects of CRVS in the country.
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.
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.
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.
Vietnam is no longer highly dependent on external assistance for the health sector, with external financing accounting for 2.7% in 2014. But some major development partners (e.g., the European Union, Gavi, and the Global Fund) have completed or are reducing the scale of their assistance, necessitating a shift to government budget or health insurance. The recently approved Grassroots Health Service Delivery Project, under implementation beginning May 2020, fills an important financing gap for Vietnam. The project is supported by an IDA-Transitional Support (IDA-TS) credit of US$80 million, a cofinancing grant of US$5 million from the Integrating Donor-Financed Health Programs Multidonor Trust Fund (MDTF) funded with Australian support, a cofinancing grant of US$3 million from the Tackling Non-Communicable Diseases Challenges in Low- and Middle-income Countries MDTF (Pharmaceutical Governance Fund), and US$21.25 million from the government of Vietnam, in addition to the U$17 million GFF financing for the IDA-TS credit buydown.
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.