The COVID-19 emergency has prompted a shift in global health priorities worldwide, putting the health and well-being of mothers, children, and adolescents at risk. Without a comprehensive emergency response , the Global Financing Facility (GFF) estimates that due to disruptions caused by the COVID-19 pandemic, as many as 26 million women could lose access to contraception, leading to nearly 8 million unintended pregnancies. This, along with other negative effects on maternal, child, and adolescent health, are caused by a blend of closures of health clinics, scaling-down of reproductive health services, medical supply shortage, communities avoiding health clinics due to fear of infection, lockdowns and movement restrictions, and health workers being diverted from maternity to COVID-19 units. It is vital that the World Bank, which implements GFF grants and is providing COVID-19 health response support to countries, consider essential maternal, child, and adolescent health and nutrition services as a central part of effective COVID-19 response and recovery efforts.
The Global Financing Facility was established to tackle some of the world’s greatest health and nutrition needs by working towards preventing maternal, newborn, and child deaths by 2030. It aims to improve the lives of women, children, and adolescents around the world and help them build a more sustainable future. The Multi-Stakeholder Country Platforms (MCPs) are designed to provide civil society organizations (CSOs) with the opportunity to input into key components of World Bank projects, such as project design and implementation, as well as identify and communicate to GFF Focal Points, about gaps in service delivery or adverse effects of the project. The GFF MCPs play a significant role in pushing for an inclusive, comprehensive response to essential maternal, child, and adolescent health and nutrition programming during the COVID-19 pandemic. As the entity coordinating the GFF MCPs, the GFF should:
1. Prioritize meaningful stakeholder engagement. As CSOs advocate for maternal, child, and adolescent health policies at the national and international level, the GFF should incorporate their input and feedback through the MCPs into its policies and operations. The World Bank and Governments should prioritize consulting with the MCPs as a first line of engagement with CSOs in the design and implementation of Bank-funded health projects. In some countries, CSOs have developed engagement plans with the government and development partners to analyze the sustainability of their interventions and policies. In numerous countries, however, the existence of MCPs has not directly translated into CSO participation throughout the project lifecycle. CSOs have pushed for involvement during the development of the investment case, but the cooperation seems to lessen as projects move into implementation. MCPs engagement in countries such as the Ivory Coast offers examples of success because they have effectively participated in advocacy, accountability, and monitoring activities, elevating the voices of marginalized groups and providing technical assistance. The GFF should consider the lessons learned and encourage this type of meaningful engagement with marginalized groups in other countries.
2. Enable the participation of marginalized groups in Multi-Stakeholder Country Platforms and amplify their voices. Local CSOs play a crucial role in representing marginalized communities, especially as the COVID-19 pandemic has pushed marginalized groups further into poverty, and travel restrictions have made in-person consultations more difficult. The GFF should establish relevant measures to engage with marginalized groups by providing a platform for engagement that is gender-sensitive, culturally and linguistically appropriate, and accessible for persons with disabilities. In some countries, LGBTQI groups might require a safe space for engagement, therefore the GFF should explicitly share non-discriminatory policies in the use of the MCPs. Additionally, the GFF should create alternative methods for participation and dissemination of information for people with lower levels of literacy, such as the use of easy to read documents.
3. Develop stronger relationships at the national level through the Multi-Stakeholder Country Platform. The GFF should take steps to strengthen the relationship of the GFF Focal Points and GFF Liaison Officers, staff based in-country that are responsible for interacting with stakeholders in target countries. The GFF Focal Points should build on the disruption caused by the COVID-19 pandemic on communities, which has exacerbated food insecurity, financial instability, and discrimination, by tapping into the potential of MCPs and leveraging the full range of CSOs experiences and knowledge. The GFF can further its commitment to countries by facilitating timely and consistent communication between GFF Focal Points, Liaison Officers, and CSOs, investing in capacity building and strengthening for local CSOs as well as by providing training on the role of the World Bank and how to engage. Some local CSOs in GFF target countries have expressed that having a stronger relationship with GFF Focal Points, Liaison Officers and World Bank Team Task Leader would more easily enable them to provide feedback during consultations and enhance the project as a whole. Investing in this in-country relationship can help build trust between stakeholders, establish a mutually beneficial relationship, and generate stronger coordination and cooperation in other health projects outside of the GFF.
BIC is currently monitoring three GFF projects in Uganda, Cambodia, and Rwanda that will provide lessons learned and valuable insights on how to increase CSO engagement on the Multi-Stakeholder Country Platforms and utilize it to safeguard the access to essential services for women, children, and adolescents in GFF target countries. The GFF has the potential to mitigate the impact of the COVID-19 crisis on marginalized groups, but it must take steps now to strengthen an inclusive, effective response.
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