1ST EDITION

FEBRUARY 2020

SIERRA LEONE

SPOTLIGHT ON
GLOBAL
FINANCING
FACILITY
IN SIERRA LEONE
...to enhance civil society engagement

RMNCAH+N
COALITION
SIERRA LEONE HEALTH ALERT
SIERRA LEONE
 PAGE 2
ACRONYMS

EVD – Ebola Virus Disease

FMoH – Federal Ministry of Health
GFF – Global Financing Facility
IC – Investment Case
MNDSR – Material and Neonatal Deaths
Surveillance and Response
RBF – Results-Based Financing
RMNCAH+N – Reproductive, Maternal, Newborn, Child
and Adolescent Health plus Nutrition
SDG – Sustainable Development Goal
 PAGE 3
ABOUT THE SPOTLIGHT

The GFF Spotlight is an priority interventions,

advocacy and financing model,
accountability tool coordinating structure,
aimed at improving proposed cost of
civil society engagement, implementing the
accountability and strategy over a 5-year
transparency of GFF period, what the GFF
implementation at Partnership committed
country level. It is a to do and key
product of content recommendations for
analysis and review of actions.
RMNCAH+N Strategy
which serves as the The Spotlight would be
Investment Case in used to advocate and
Sierra Leone through sensitize stakeholders
guided analytical including members
questions as of the Health Sector
well as secondary Coordinating
review of information Committee and multi
related to Sierra Leone sectoral coordination
from forum, civil society
https://www.globalfina organizations,
ncingfacility.org/sierra- advocates, professional
leone bodies,
parliamentarians and
The Spotlight provides relevant government
information about; agencies about the GFF
Sierra Leone’s in Sierra Leone.
RMNCAH+N Strategy, its
KEY HEALTH CHALLENGES
PAGE 4
IN SIERRA LEONE?

Sierra Leone has one of the

ABOUT THE RMNCAH+N
highest maternal mortality
STRATEGY
rates globally. The Sierra Leone National
Reproductive, Maternal, Newborn
Teenage pregnancies are and Child and Adolescent Health
Strategy 2017 – 2021 is developed
common and adolescent
by the Ministry of Health and
deaths constitute nearly
Sanitation as a roadmap and serves
25percent of the total as the RMNCAH+N Investment Case
maternal deaths in the to accelerate progress in achieving
country. Sustainable Development Goals and
in response to the problem itemized
More than half of all above.
childhood deaths are Sierra Leone’s RMNCAH+N strategy
preventable with access to provides focused and prioritized set
key interventions. of high impact interventions for
accelerating reduction of maternal,
There are also persistent newborn, child and adolescent
deaths. The strategy is aligned with
deficits in quality of care
national documents such as the
and efficiency of resource
Health Sector Recovery Plan and its
use in the health system. global commitments, including the
SDGs and the New Global Strategy
The 2013 Ebola outbreak for Women’s, Children’s and
further weakened the Adolescents’ Health 2016-2030.
public health system and The RMNCAH+N Strategy has a goal
was associated with a 15-25 of accelerating reduction of
percent drop in RMNCAH+N preventable deaths of women,
service use. children and adolescents and
ensuring their health and well being.
PRIORITIES IDENTIFIED IN THE PAGE 5
INVESTMENT CASE INCLUDE:

Strengthen health systems for Support implementation of a

effective provision of national RMNCAH+N quality
1 RMNCAH+N services, including
by ensuring adequate, skilled
improvement program and
systematic quality improvement
and motivated human
resources for health.
procedures, approaches and
practices, with a special focus
6
on emergency triage
assessment and treatment,
Strengthening leadership and respectful maternity care, and
2 governance at all levels Maternal Perinatal Death
Surveillance Review (MPDSR).

Ensuring availability of essential

RMNCAH+N drugs, supplies Strengthen community systems

3 and equipment; developing

infrastructure; ensuring
for effective delivery of
RMNCAH+N services by
7
availability of a functioning addressing sociocul tural,
emergency referral system. geographical and financial
barriers.

Im p l e m e n t i n g i n t e g ra t e d
Provision of safe blood at all
community case management 8
4 Comprehensive Emergency
Obstetric and Newborn Care
facilities
Strengthen health information
systems, monitoring,

Improve the quality of

evaluation, and research for
9
5 RMNCAH+N services at all
levels of service delivery
effective RMNCAH+N service
delivery, and strengthen civil
registration and vital statistics
systems.
COORDINATING STRUCTURES FOR PAGE 6
THE IMPLEMENTATION

This strategy will promote integrated service delivery approach, multisector response
and engagement with the private sector. For the governance and management, the
strategy will be coordinated from the Ministry of Health and Sanitation via the Health
Sector Coordinating Committee chaired by the Minister of Health and Sanitation. It
has the overall responsibility for ensuring the implementation of the strategy. The
strategy promotes a multisectoral response bringing in other sectors that impact on
RMNCAH+N, as follows;

Health and in particular the RMNCAH+N sub sector will engage in partnership
with key sectors impacting RMNCAH+N including education, food security and
1 agriculture, social protection and economic empowerment, water and
sanitation and the local government. As part of the strategy coordination and
implementation approach, a multisectoral coordination forum at national level
will be established.

Prioritized action plans for RMNCAH+N multisectoral interventions will be

2 developed for joint implementation.

At district levels, the district councils will be tasked to establish or

3 strengthen and use existing multisectoral forums to plan and implement
prioritized multisectoral

FINANCING SIERRA LEONE’S PRIORITY INVESTMENTS

The total cost for implementing this assumptions on donor commitments
RMNCAH+N strategy for the five over the 5 years of the
years is 544.9Million USD. implementation of the strategy, the
country has an estimated resource
The total resource commitments for gap of $228 million USD.
the country for the five years is 535.1
million USD, of which 209.2 Million Partners that contribute to financing
USD were for RMNCAH+N and a Sierra Leone’s priorities as outlined in
further 288.7 Million categorized as the strategy which served as the
cross cutting resources i.e. including investment case include the GFF,
but not limited to RMNCAH+N. Gavi, Global Fund, Partners in Health,
UNICEF, USAID, World Bank, and the
Using the RMNCAH+N specific governments of Germany (KFW),
resource commitments and Italy, Japan (JICA), and United
modelling figures based on Kingdom (DFID).
 PAGE 7
FIGURE 1: ALLOCATION OF FUND ACROSS
INTERVENTION AREAS IN USD MILLIONS FOR 2017-2021

Nutrition
$27.25
5%
Multisector intervention
$38.14
7% Adolescent Health
$5.45
1%
WASH
$27.25
Child Health Services
5%
$185.27
34%
Newborn & reproductive
health Services
$92.63
17%
Immunization
$168.92
31%

FIGURE 2: SHOWS DISTRIBUTION OF COST FOR

2017-2021 IN USD MILLIONS

Total
YEAR 2017 2018 2019 2020 2021 (USD)
AMOUNT 95.7m 106.4m 109.9m 113.8m 119.3m 544.9m
 PAGE 8
THE STRATEGY HAS MADE EMPHASIS ON
DOING THE FOLLOWING;

1
RMNCAH+N health care increase health care
financing coalition to be financing for RMNCAH+N
formed as part of the response.
implementation of this
strategy to advocate to the 3
Government of Sierra
Leone towards increased Mobilise development
resource allocation for partners in alignment with
RMNCAH+N as well as the RMNCAH+N strategy to
improved governance and pre- commit resources.
accountability in the use of Despite the decreasing
the available resources. RMNCAH+N resources from
development partners,
2 donor funding is expected
to continue to be the
Use the ongoing process leading source of funding
for development of the for implementing the
health care financing RMNCAH+N strategy.
strategy to develop
sustainable health care 4
financing options. As part
of the Global Financing To increase the
Facility processes, the predictability of the
Government of Sierra resources, it is
Leone is in the process of recommended that the
developing health care Government uses the
financing strategy. It is strategy to mobilise donors
recommended as part of pre-commit their resources
that process that the in alignment with the
country comes up with strategy.
innovative solutions to
 PAGE 9
HOW THE GFF PARTNERSHIP WORKS IN
SIERRA LEONE

GFF partnership has supported country leadership’s commitment and developed

a strategy to enhance investments and improve reproductive, maternal,
newborn, child, and adolescent health and nutrition (RMNCAH-N) outcomes to
help achieve the Sustainable Development Goals (SDGs).

The GFF partnership focuses on The GFF provides technical

improving coordination and support for monitoring the revenue
alignment between donors, impact of increased tobacco taxes,
ministries, and implementing conducting analysis on potential
partners in the health sector efficiency gains in health financing,
through the development of a and refining results-based
prioritized and realistic financing (RBF).
implementation plan that accounts
foravailable resources and
capacity constraints. RBF will be piloted in two districts
in 2019 and is expected to be
instrumental in providing financing
The GFF works with the
to the front lines for maternal,
government of Sierra Leone to
child, and adolescent health
focus on mobilizing domestic
services. The RBF pilot is also
financial resources for health
expected to help ensure that the
distribution of health services
better reflects the needs in Sierra
Enhancing the efficiency of the
Leone.
health system through strategic
purchasing of services, supporting
appropriate distribution of health
Furthermore, support will be
facilities and staff, and improving
provided to improve decentralized
quality of care.
public financial management by
building the capacity of district
To ensure long-term sustainability health management teams to use
and possible scale-up of key health data for effective decision
interventions, the GFF supports the making.
development of a health financing
Sourced from
strategy to increase efficiency and
https://www.globalfinancingfacility.
domestic resources for the health
org/sierra-leone
sector.
KEY RECOMMENDATIONS
PAGE 10
FOR ACTION

Facilitate meetings and dialogue with relevant senior

government officials, GFFLiaison and focal officers and
development partners to ascertain the contribution of GFF
partnership in improving coordination and alignment as well
as inmobilizing domestic financial resources for health.
1
2 Use the GFF spotlight to educate and sensitize civil society
organizations and relevant stakeholders about GFF
partnership in in Sierra Leone

Use the GFF Spotlight to improve access to information and

promote accountability for the GFF in Sierra Leone 3
Use the GFF spotlight to facilitate meetings to ascertain the
4 level of progress in the implementation of the Sierra Leone
RMNCAH+N strategy (Investment Case).

Use the GFF spotlight to facilitate meetings to review

implementation, key challenges and financial commitment of
partners supporting the government’s targeted interventions
in the Sierra Leone investment case.
5
Use the GFF spotlight to facilitate meetings to ascertain the

6 level of progress made by the Government of Sierra Leone in

developing health care financing strategy.

Facilitate meetings with civil society leaders and young

people to ascertain their level of participation in the Health
Sector Coordinating Committee and multi sectoral
coordination forum.
7
ABOUT THE RMNCAH+N PAGE 11

COALITION IN SIERRA LEONE

The RMNCAH+N Coalition in Sierra Leone is a

platform of civil society organizations including
young people and women groups committed to
promoting civil society participation, engagement,
accountability and transparency in the
implementation of RMNCAH+N including GFF in
Sierra Leone. Its secretariat is hosted by Health

CONTACT US AT

[email protected]

RMNCAH
COALITION
S I E R R A L E O N E HEALTH ALERT
SIERRA LEONE
Designed and produced with technical support from the Africa Health Budget Network as part of its regional mentoring
initiative for Civil Society Organisations in Africa in promoting accountability and transparency for RMNCAH+N
Contact us at [email protected]