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A M A N I A D I D J A , M D M P H H E A D O F C H I L D A N D N E W B O R N H E A L T H
M O H C A M E R O O N
The GFF PROCESS IN CAMEROON
.
Investment Case
Safe Mothers & Newborns Leadership Workshop Nairobi, Kenya, 11th - 16th June 2017
CAMEROON
6/18/17
q Population:19.4 million inhabitants (RGPH, 2007) q Average annual population growth rate: 2.6% q Median age of the population: 17.7 years q Population under 15 years: 43.6% q Women: 51% of the population. q population living in Extreme poverty : 40 % q Life expectancy :51 years. q National health budget : 5% of the GDP
RMNCAH CHALLENGES
� MMR: 782 / 100,000 in 2011 (DHS 2011). � Infant- child mortality remains high in poor parts of the
country,(173 & 154 /1,000 LB) � Households bear the largest share of health
expenditure: 70.42% � Insecurity : Boko-Haram � Quality of care is undermined by limited HR,
infrastructure, poor governance; � Inter–region equity gap+ intra-region equity gap � Lack of robust data for decision- making, transparency
and accountability.
WHAT IS THE GFF?
� Launched in 2015 � “the key financing platform in support of the UNSG’s
EWEC global movement, with the aim to accelerate efforts to end preventable MNCAH deaths and improve the health and quality of life of women, adolescents and children by 2030
� Goal: increase resources spent on maternal and child health in 63 of the world’s poorest countries.
� Cameroon is one of the 12 GFF Trust Fund supported countries.
LE PROCESSUS D’ELABORATION DU DOSSIER D’INVESTISSEMENT ET SON OPERATIONALISATION
6/ Elaboration de la
cartographie de ressources
11/ Rédaction du dossier d’investissement
10/ Budgétisation
12/ Restitution du dossier d’investissement
7/ Elaboration des cadre logique et de suivi évaluation, et des activités
8/ Consultation des régions
14/ Adoption du dossier d’investissement
15/ Rencontres bilatéraux d’appui technique aux PTF et secteurs privés pour
5.3/ Identification des solutions aux goulots
5.2/ Identification et analyse des goulots d’étranglement
5/Atelier de réflexion technique 6.1 Identification des problèmes et interventions à haut impact appropriées
4/Réunions de plaidoyer pour l’implication technique de tous
3/Analyse situationnelle (EQUIST)
2/ Constitution des comités d’élaboration et de suivi du processus
1/ Ralliement des parties prenantes et lancement officiel
16/ Rencontres régionaux d’assistance technique pour l’opérationalisation
9/ Atelier de consensus technique sur le cadre logique, le cadre de suivi évaluation, et les activités
13/ Rencontres bilatéraux de plaidoyer avec le secteur privé et partenaires techniques
SUIVI REGULIER
DU PROCESSUS
FIN DEBUT
INVESTMENT CASE DESIGN Preparatory work � Official Launching of the GFF process at national level � Validated chronogram for the investment case. � Coordination platform created and operational � Priorization workshop held with participation of main
stakeholders (UN, CSO, others public sectors, parliamentarians, Bilaterals, INS, private sectors , mobile phones companies)
� Inclusive and participative process Review of national data � Source of data: DHS (2004, 2011), MICS (2011, 2014),
EmONC2015, CRVS, Qualitative studies � Tools: EQUIST (for RMNCH), One Health
INVESTMENT CASE DESIGN (2/2)
� Finalize the situation analysis: include adolescent needs assessment, CRVS evaluation
� Prioritize the interventions � Develop of the investment case based on the
existing Reproductive, Maternal, Newborn, Child and Adolescent National Strategic plan 2014-2020
� Costing : Budgeting: One Health Tool
INVESTMENT CASE A comprehensive National RMNCAH Investment Case o Evidence informed o Equity-focused and logical o Main causes of deaths per target group o Coverage of high impact interventions, o All this linked with geographic/regional and
urban/rural differences o Identified interventions by the 3 service delivery
platforms o Highlight key bottlenecks, causes of bottlenecks
and priority, solutions/strategies
IMPLICATION OF THE PRIVATE SECTOR: THE CASE OF DIB (1/2)
� Development Impact Bond- Results-based financial instrument
� Private investors who agree to subscribe � Gov. make payments if KMC succeed � GCC- Invest C$7 Million by leveraging private
Sector � The Government contribute C$2 M through
the GFF � Donors: MINSANTE, BM / GFF Trust Fund,
GCC, Micronutrient Initiative
IMPLICATION OF THE PRIVATE SECTOR: THE CASE OF DIB (2/2)
� Funds available in advance; � Project concentrated in areas of high needs � Contractual focus on results - # inputs � Financial returns of investors related to
independently verified results. � Improved outcomes for low birth weight infants;
Estimate = 4,000 per year � Comparative Advantage: DIB combines GCC,
GFF, Government, and Cameroon's experience in performance-based financing
� Launch of DIB in September 2017
CHALLENGES
� Ensuring a coherent approach in the country: inclusiveness + alignment is needed at country level with different strategic documents;
� Align the HSS and GFF process timelines, outcomes :that has to be aligned and coherent not only with the SDGs targets but also the country strategic documents.
� harmonization of indicators , but also the need to be ambitious in other to meet the SDGs goal
LESSONS LEARNED(1/2) � Improve data quality and completeness
upfront : adolescent health, CRVS, RMNCH sub national data with equity breakdown, and structural barriers
� Inclusive capacity building on the prioritization tool(EQUIST) accelerated the consensus+ appropriation
� Prioritizing VS. Compromising. All stakeholders wants their issue to be fully addressed, with disregard of value for money
LESSONS LEARNED (1/2)
� Harmonize the cost categories used both in the budget and in the resource mapping in anticipation of the generation of funding gaps
� A consensus on the logical framework and interventions must be obtained before budgeting is done
CONCLUSION
� RMNCAH is still a big challenge � The GFF was a great opportunity
¡ to design and sharpen the health financing policy ¡ Generate discussion and a UHC strategy ¡ To identify and reduce sources of inefficiencies ¡ To design a CRVS strategic plan and reinforce the HIS ¡ to optimize our work with private sector, test innovative
strategies like the DIB for KMC