The Global Financing Facility (GFF) is a big deal in the world of global health. It was set up in 2015 to get more money flowing into health and nutrition for mothers, babies, kids, and teens. But how well is it really doing?  It is hard to say.  The GFF has been around for a while, but not many people have taken a close look at how it works and what it achieves.

The GFF has been busy. Between 2015 and 2022, it helped bring in 14. 5 billion dollars for health projects in 26 countries. The GFF itself chipped in about 4% of that amount. Most of the money went into making healthcare services better, improving how things are run, and paying for results. Countries that needed it most got more help for moms and babies, and for teens. But how much attention was paid to community health and quality?  That is a good question.

The GFF has some interesting documents called Investment Cases (ICs) and Project Appraisal Documents (PADs). These papers show what the GFF is all about in 28 countries. The ICs are pretty broad and include lots of voices. The PADs are more specific and focus on getting things done. Local situations matter a lot in how these policies play out. The GFF helps countries figure out what's important and learn from it. But turning those priorities into actual actions with money behind them? That's the tricky part.

Power plays a big role in all this. Who has the power can affect how much countries own their plans, how well donors work together, and how much money is raised. The GFF is a big chance to improve health for those who need it most. There's been progress in being open and using data, but there are still problems with being accountable, balancing power, and getting everyone involved. More research is needed to see if the GFF really makes a difference in getting more money for health.

In four countries—Burkina Faso, Mozambique, Tanzania, and Uganda—local contexts shaped how policies were made. The GFF supported these countries in setting priorities and learning. However, turning these priorities into funded actions was challenging. Power dynamics influenced how much countries owned their plans, how well donors coordinated, and how much money was raised. The GFF is a big chance to improve health for those who need it most. There's been progress in being open and using data, but there are still problems with being accountable, balancing power, and getting everyone involved. More research is needed to see if the GFF really makes a difference in getting more money for health.

MULTI COUNTRY HEALTH INITIATIVES

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