Global Financing Facility (GFF) is bolstered by a new collaboration with USAID’s Bureau for Global Health
to accelerate gains in primary health care

  • Since the start of investment case implementation, with GFF support, countries have ensured access to:

    • More than 96 million pregnant women with 4 or more antenatal care visits
    • Over 103 million women with safe delivery care
    • 111 million newborns with early initiation of breastfeeding
    • More than 500 million users of modern contraceptives, averting more than 187 million unintended pregnancies
  • While many countries are making progress in terms of increasing service coverage rates, inequities remain and are at risk of widening due to overlapping health and economic crises. For example, 60 percent of GFF supported countries have seen an increase in geographic inequity for postnatal care.

November 14, 2022 – The GFF Annual Report 2021-2022, released today, demonstrates that countries with continued commitment to primary health care (PHC) are achieving better health outcomes for women, children and adolescents. Investments in PHC are strengthening resilience and supporting progress, despite overlapping crises. At the same time, stark equity gaps in health service coverage within countries continue to impact lives and will require additional investment.

Long-term commitment is translating into better health

Since 2015, the GFF has been supporting countries to develop and implement their own investment cases for women, children, and adolescent health, and align financing to fund these plans. In countries that have partnered with the GFF the longest, coverage of essential health services is increasing.

These gains are testament to countries’ strong commitment to improving health of women, children and adolescents and demonstrate that when they are in the lead in developing stronger primary health systems, and focused on implementing highest-impact interventions for the most vulnerable people, systemic change happens.

  • 71% of GFF partner countries implementing investment cases for women, children and adolescents for 5 or more years report improvements across essential care, including assisted deliveries, pregnancy and newborn care, childhood immunization – compared with 43% of countries doing so for fewer than 3 years.
  • The GFF has a catalytic effect on World Bank resources. Following GFF engagement, the share of World Bank financing in GFF partner countries allocated to RMNCAH-N increased by more than 15 percent by the end of FY21. An additional US$1.7 billion was allocated to RMNCAH-N in GFF supported countries between 2015 and February 2020, alone.

One of the promises of the GFF model, since its inception, has been to enable more and better financing to support women, children and adolescent health. This year shows strong evidence of progress:

  • The GFF works with governments to increase domestic resource for health, and incentivizes health financing reforms. Across 2020-22, $19.1 billion has been committed for women, children and adolescent health plans. Of this total, domestic governments allocated 56% while global partners committed 38% and the GFF/World Bank pledged 6%.

Path to progress remains uneven and insufficient

Commitments from countries and service adaptation have helped to mitigate some of the negative impacts of COVID-19, however countries continue to experience disruptions. Health systems have experienced unprecedented pressure, which further exposed their fragility and exacerbated inequities. While some countries were able to weather the disruptions caused by COVID-19, 60 percent of GFF supported countries saw an increase in geographic inequity for postnatal care.

Further, gender disparities continue to be a key driver of lack of access to health, with female-headed households between a fifth and three times more likely to forgo healthcare as male-headed households.

Underfunding of PHC, a lack of trained health care workers, weak supply chains for medicines and other health products are undermining efforts to increase resiliency and reduce equity gaps. The fragility of health systems is revealing the need for dramatically scaled up investment amid overlapping crises.

New collaboration with USAID

USAID’s Bureau for Global Health and the Global Financing Facility (GFF) are pleased to announce a new collaboration to accelerate gains in PHC -- the frontline of country health systems across the globe. USAID and GFF will intensify collaboration to focus attention on a select group of countries to advance measurable improvements in PHC. USAID and GFF will leverage opportunities to increase the reach and impact of global and country resources and PHC monitoring.

Our alignment focuses on further optimising health systems at the PHC level offering integrated, well-coordinated services across individuals’ lifespans, delivered by an adequate and skilled health care workforce, across communities and facilities, to ensure those most in need access essential health services. USAID and GFF are aligned in our commitment to support country leadership, building on previous lessons and investments, and optimising use of existing resources to deliver fit-for-purpose PHC services.

Both USAID and GFF will continue to advocate for increased effective domestic resource allocation and use, enhanced civil society engagement, and effective private sector participation to effectively align country level PHC investments. USAID plans to work with the GFF to convene country stakeholders through a series of global meetings over the next year to accelerate coordination and monitoring to advance impact in PHC priority countries.

Atul Gawande, Assistant Administrator for Global Health, USAID:
“We are proud to intensify our collaboration with the GFF in supporting partner countries to advance primary health care with strengthened health systems and workforces. Primary health care is the essential scaffolding of achieving equity in how long people can hope to live and how much burden of disease they must endure. Doing so will further accelerate impact and local capacity for sustaining results.”

Juan Pablo Uribe, Global Director for Health Nutrition and Population at the World Bank and Director of the GFF: 
“The annual report shows the tangible, long-term progress that countries are making in delivering systemic changes to health systems that can withstand shocks now, and in the future. We are at a pivotal time in global health as countries want to double down on their commitment to women, children and adolescent health. We are thrilled to launch a new collaboration with USAID. Together, we will accelerate efforts and transform primary health care systems, saving lives and advancing opportunities for women children and adolescents.”

Mariama Abdou Gado, medical student and youth advocate, Niger:
“Empowered people with the right support and resources can make the right change. We are seeing exactly that with the GFF: the partnership and collaboration between all the stakeholders including CSO & youth has showed that with this guiding principle we can implement efficient health strategies and achieve sustainable results.”

Lia Tadesse, Minister of Health for Ethiopia, and co-chair of the GFF Investors Group:
“Adapting and building primary health care in a way that is sustainable takes time, energy, financing, and political will. It’s evident that the support of the GFF partnership for countries is an enabler for systemic change to happen. Millions more women and children survive and thrive as a result."

Joshua Tabah, Director General for Global Health at Global Affairs Canada, and co-chair of the GFF Investors Group:
“Investing in the GFF is one of the best buys that any government can make. Canada is proud to be part of this innovative and transformative partnership that is making a meaningful impact on women, children, and adolescent health outcomes, and we look forward to supporting countries in making further progress in the year ahead.”

For more information, please contact Nansia Constantinou | nconstantinou@worldbankgroup.org  

Access the Annual Report site and social media messages

About the Global Financing Facility (GFF)

The GFF is a multistakeholder partnership of the World Bank that supports country-led efforts to improve the health of women, children and adolescents. With the GFF, countries are making smarter, more prioritized, results-focused investments toward greater impact on the health, nutrition and well-being of women, children and adolescents; building capacity for more sustainable funding for this agenda; and exploring more innovative ways to work with the private sector. Since the GFF was founded in 2015, partner countries have made significant progress to improve maternal and child health.