Civil Society as the Indispensable Broker for Multi-Sectoral Collaboration to Drive GFF Impact
By Pauline Irungu, Advocacy and Policy Manager, PATH Kenya
When the Global Financing Facility (GFF) was launched in July 2015 at the Financing for Development Conference in Addis Ababa, Kenya was named a frontrunner country for this new platform approach to financing and resource mobilization. For the past decade, reproductive, maternal, newborn, child, and adolescent health (RMNCAH) indicators have been improving in Kenya, yet progress has been slow. The GFF seemed like a natural fit to the evolution of our progress: it was an innovative way to continue to save women’s lives while pregnant and giving birth; to ensure more children survived past the first 28 days of life and reached their fifth birthdays; and to address the specific health needs of adolescents.
As part of the GFF process, the Kenyan government has developed a national RMNCAH Investment Framework that seeks to address key health challenges for women, children, and adolescents. Additionally, the government is working to develop a health financing strategy that will enable this work to succeed by 2030.
Although we’ve seen progress in Kenya during the past three years with the GFF, the reality is that decision-makers are faced with competing priorities daily and must make difficult choices about what to prioritize, where to allocate funding, and how to improve the health of their constituents. Civil society has a fundamental role in supporting our leaders to make these difficult choices and drive ahead with the best intentions for the health and welfare of our communities.
Kenya is a decentralized country; national health policies and plans are operationalized by county governments that face their own unique set of demands and priorities. For this reason, Kenya’s RMNCAH Investment Framework had to be aligned with the devolved health system to enable counties to deliver services their communities need the most. Yet health competes with other development sectors for attention and resources, which has led to the stagnation of national funding allocations, thereby curtailing the improvement of targeted support to counties to respond to their varying needs with respect to service delivery, inter-agency coordination, procurement, and supply chains.
This is where civil society comes in. When it comes to prioritization of national- and county-level demands within the Investment Framework, civil society can help make the linkages between the two levels of government, bringing to light the realities of the poorer, more rural counties and those with the highest burden of mortality, where resources ought to be prioritized. Civil society can help bridge two often desperate worlds, to ensure that the national frameworks and funding opportunities from the GFF focus on the places where need is largest. For example, in 2017, PATH collaborated with the Health NGOs Network (HENNET) and the civil society coordinating team in Kenya to convene a national stakeholder forum that brought together representatives of the council of governors (the unifying forum for county governors), the Ministry of Health, and civil society actors in the absence of a multi-stakeholder platform for the country platform. This forum provided an opportunity to improve coordination across different state and non-state actors toward maximizing the impact of available resources for RMNCAH. It also provided an opportunity to broker linkages between the government and civil society.
Similarly, at all levels of government, leaders balance the push and pull of political priorities against health, economic, and social priorities. As is the case in most countries, even health decisions and drafting the Investment Framework have a political influence, which impacts resources, focus, and how our country moves forward. Too often, politics can undermine otherwise sound health decisions such that resources do not actually reach the populations that need them the most. When politics drives decisions about health, civil society elevates the rallying cry for health priorities over politics. Civil society in Kenya has advocated strongly for the inclusion of essential services such as family planning and support for immunization into county investment priorities supported by resources from the GFF. For example, PATH and UNICEF recently worked with leaders in VIhiga County to develop and approve the first-ever county policy to prioritize investments in RMNCAH indices that will in turn drive smarter resource allocation.
Rightly, the GFF promotes a multi-sectoral approach to priority setting and resource mobilization — recognizing that better health outcomes won’t be achieved by investments in the health sector alone. The biggest gains can be made with the right balance of sectors, inputs, and perspectives. However, a multisectoral approach takes an immense amount of coordination among partners. Coordination — especially in a robust environment such as Kenya’s — is difficult and time consuming. Yet again, our decision-makers are tasked with competing demands of efficiencies and impact while tackling multisectoral coordination to make those things happen. In this context, civil society organizations can play the role of broker among sectors, helping identify gaps and assets among sectors and partners to ensure the right voices are at the table to inform decision making.
The GFF calls on leaders to target GFF resources toward the areas that will most efficiently catalyze impact and save more lives. The task is monumental, and competing priorities abound. Civil society in many countries, including Kenya, is well positioned to be a bridge between these competing demands. Whether it is voicing local needs during a national meeting, or disseminating national decisions to local governors, civil society can be an asset to government communication and decision-making.
Ultimately, in Kenya — as in other countries — civil society can help governments deliver on the GFF Investment Framework. With deep roots at the community level, civil society organizations are often the best at delivering services and reaching the end users prioritized in the Investment Framework. Importantly, civil society plays a nimble role in implementing, results tracking, and ensuring that commitments made, priorities promised, and resources invested are implemented, monitored, and accounted for to save the most lives in the most cost-efficient ways. But just as government agencies can’t function without a budget, neither can civil society organizations.
As development partners meet in Oslo to commit to replenish the GFF, we hope this will include sufficient resources to enable civil society to do its part — while also ensuring we can maintain our independent voices and ability to hold governments and other duty bearers accountable for resources and results. For the GFF to be successful in reaching its goal of ending preventable deaths of women, children, and adolescents, civil society must have the capacity and resources to fully take on our strategic — and indispensable — role.
