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Assessment of the Status and Effectiveness of National Multistakeholder Country Platforms Used to Implement the Global Financing Facility

Analysis

This assessment provides a detailed analysis of the existence and status of the Global Financing Facility (GFF) multistakeholder country platforms (MCPs) in terms of their effectiveness and functionality in providing strategic coordination of stakeholders and funding sources for reproductive, maternal, newborn, child and adolescent health and nutrition (RMNCAH+N) country investment cases (ICs). Guided by the minimum standards provided in the Guidance Note: Inclusive Multi-stakeholder Country Platform in Support of Every Woman and Every Child checklist, the assessment highlights the status of GFF countries’ processes and the existence of the MCPs, the composition and representation of various MCP constituencies and how well the country-level MCP structure assumes its roles and responsibilities.

This assessment was supported by PAI, through its Civil Society GFF Resource and Engagement Hub and the GFF Civil Society Coordinating Group hosted and coordinated by The Partnership for Maternal, Newborn & Child Health.

The assessment targeted respondents from 27 of the 36 GFF countries, excluding the nine new countries that joined the GFF in August 2019. An online questionnaire — mainly targeting civil society and World Bank country focal points, as well as GFF Ministry of Health focal points — was completed by respondents. Respondents from a total of 25 (93%) countries completed the survey with a response rate of 85% from targeted respondents. A descriptive cross-sectional study design was used which included a mixed-method approach, using both qualitative and quantitative variables. The results were also used to develop a scoring methodology for a scorecard to illustrate findings across GFF countries.

Existence of the MCPs

All 25 GFF countries had some structure or mechanism that is used as an MCP; however, divergent responses from respondents in half of the countries indicate a lack of awareness among the constituencies of the MCPs.

Composition and Representation

There are gaps in MCP composition and representation in GFF countries, particularly in terms of representation of youth and adolescents, the private sector and Ministries of Finance and Planning. Out of all respondents, 56% viewed the constituent member selection process as transparent, 17% as not transparent and 27% were unsure.

MCP Implementation and Functionality

Only three (12%) GFF countries (Guatemala, Indonesia and Myanmar) had clear, public MCP terms of reference. Effective and meaningful MCP engagement requires members to be invited to and involved in regular meetings where they can provide strategic direction. Meetings should have clear agendas, reports should be openly shared and reviewed and member roles and responsibilities should include course-correction on the implementation process of the country IC. MCPs in only 10 of the 25 countries consulted on RMNCAH+N issues. No regular meetings were held in any of the 25 GFF countries. Clear RMNCAH+N and/or GFF agendas were also not included in country platforms or reports shared with constituent members. Therefore, MCPs in GFF countries are not effective or operating optimally as mandated by the guidance documents.

Challenges affecting MCP formation and effective functioning include governance issues, particularly around host government stewardship, inadequate financial resources, poor communication and engagement and inadequate technical assistance. Respondents in front-runner, second wave and third wave countries ranked challenges differently. However, inadequate technical assistance was most notable in third wave countries.

GFF MCP Scorecard

The scorecard compares MCP performance across GFF countries with results clearly indicating a gap in effective functioning, which is compounded by the lack of formal platforms and clear stewardship, as well as inadequate financial resources leading to irregular meetings.

Conclusions

The GFF is implemented through government-led MCPs that bring together different actors working to advance RMNCAH+N. The existence of these platforms in GFF countries is positive. The GFF’s guidance around inclusiveness and functionality of these platforms can ensure that all stakeholder contributions to the GFF partnership are realized and have impact. However, our research shows that in most GFF countries surveyed, these minimum standards are not being met.

Civil society in GFF countries is committed to supporting and engaging in these country platforms but does not have the power to ensure platform functionality. Leadership from other actors — the GFF Secretariat, other development partners and governments themselves — is needed to develop a plan to strengthen these country platforms to implement the GFF partnership as intended.

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