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. 2024 Dec 31;17(1):2329369.
doi: 10.1080/16549716.2024.2329369. Epub 2024 Jul 5.

Global Financing Facility investments for vulnerable populations: content analysis regarding maternal and newborn health and stillbirths in 11 African countries, 2015 to 2019

Mary Kinney  1 , Meghan Bruce Kumar  2   3 , Issa Kaboré  4 , Joël Kiendrébéogo  5   6   7   8 , Peter Waiswa  9 , Joy E Lawn  10
Affiliations

Global Financing Facility investments for vulnerable populations: content analysis regarding maternal and newborn health and stillbirths in 11 African countries, 2015 to 2019

Mary Kinney et al. Glob Health Action. .

Abstract

Background: The Global Financing Facility (GFF) was launched in 2015 to catalyse increased domestic and external financing for reproductive, maternal, newborn, child, adolescent health, and nutrition. Half of the deaths along this continuum are neonatal deaths, stillbirths or maternal deaths; yet these topics receive the least aid financing across the continuum.

Objectives: To conduct a policy content analysis of maternal and newborn health (MNH), including stillbirths, in GFF country planning documents, and assess the mortality burden related to the investment.

Methods: Content analysis was conducted on 24 GFF policy documents, investment cases and project appraisal documents (PADs), from 11 African countries. We used a systematic data extraction approach and applied a framework for analysis considering mindset, measures, and money for MNH interventions and mentions of mortality outcomes. We compared PAD investments to MNH-related deaths by country.

Results: For these 11 countries, USD$1,894 million of new funds were allocated through the PADs, including USD$303 million (16%) from GFF. All documents had strong content on MNH, with particular focus on pregnancy and childbirth interventions. The investment cases commonly included comprehensive results frameworks, and PADs generally had less technical content and fewer indicators. Mortality outcomes were mentioned, especially for maternal. Stillbirths were rarely included as targets. Countries had differing approaches to funding descriptions. PAD allocations are commensurate with the burden.

Conclusions: The GFF country plans present a promising start in addressing MNH. Emphasising links between investments and burden, explicitly including stillbirth, and highlighting high-impact packages, as appropriate, could potentially increase impact.

Keywords: Global Financing Facility for Women, Children and Adolescents: Examining National Priorities, Processes and Investments; Maternal; health financing; neonatal; newborn; policy analysis; pregnancy; stillbirth.

Plain language summary

Main finding: Maternal and newborn health care packages are strongly included in the Global Financing Facility policy documents for 11 African countries, especially regarding pregnancy and childbirth, though less for stillbirth, or postnatal care, or small and sick newborn care.Added knowledge: This study is the first independent content analysis of Global Financing Facility investment cases and related project appraisal documents, revealing mostly consistent content for maternal and newborn health across documents and overall correlation between national mortality burden and investments committed.Global health impact for policy and action: The Global Financing Facility have demonstrated promising initial investments for maternal and newborn health, although there are also missed opportunities for strengthening, especially for some neonatal high-impact packages and counting impact on stillbirths.

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Conflict of interest statement

No potential conflict of interest was reported by the author(s).

Figures

Figure 1.
Figure 1.
Framework for content analysis components: Mindset, Measures and Money.
Figure 2.
Figure 2.
MNH policy content analysis across the continuum of care: mindset, measures and money (a) pregnancy and/or childbirth care (b) postnatal and small and sick newborn. Themes included care packages along the continuum of care. Blue colour was used for pregnancy and childbirth and purple colours was used for postnatal and small and sick newborn care.
Figure 3.
Figure 3.
Mentions of the three outcomes (maternal, stillbirths and newborns) in GFF country planning documents.
Figure 4.
Figure 4.
Comparison of GFF related investments to national maternal and neonatal deaths, plus stillbirths.
See this image and copyright information in PMC

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