Sailing global health initiative ships into stormy seas: navigating the introduction of the Global Financing Facility in Mozambique.
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| Titel: | Sailing global health initiative ships into stormy seas: navigating the introduction of the Global Financing Facility in Mozambique. |
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| Autoren: | Chivangue A; N'weti, Maputo, Mozambique., Kinney MV; School of Public Health, Faculty of Community and Health Sciences, University of the Western Cape, Cape Town, Bellville, South Africa.; Global Surgery Division, Department of Surgery, University of Cape Town, Observatory, South Africa., Stella D; Cooperation and Development Network, Pavia, Italy., Namburete D; N'weti, Maputo, Mozambique., George AS; School of Public Health, Faculty of Community and Health Sciences, University of the Western Cape, Cape Town, Bellville, South Africa. |
| Quelle: | Global health action [Glob Health Action] 2025 Dec; Vol. 18 (1), pp. 2518651. Date of Electronic Publication: 2025 Jun 26. |
| Publikationsart: | Journal Article |
| Sprache: | English |
| Info zur Zeitschrift: | Publisher: Taylor & Francis Country of Publication: United States NLM ID: 101496665 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1654-9880 (Electronic) Linking ISSN: 16549880 NLM ISO Abbreviation: Glob Health Action Subsets: MEDLINE |
| Imprint Name(s): | Publication: <2016- > : Philadelphia, PA : Taylor & Francis Original Publication: Häggeby : Co-Action Publishing |
| MeSH-Schlagworte: | Global Health*/economics , International Cooperation*, Mozambique ; Humans ; Qualitative Research ; Female ; Interviews as Topic |
| Abstract: | Background: Mozambique joined the Global Financing Facility (GFF), a financing mechanism to accelerate progress for women, children, and adolescents' health, with a history of donor dependence, distrust in public finances, and social inequities. Few independent studies have assessed the GFF. Objectives: To understand how a global mechanism, such as the GFF, was introduced and utilized in Mozambique. Methods: This qualitative study explored the aid coordination dynamics between 2015 and 2020 linked to the development of the Investment Case (IC) and Project Appraisal Document (PAD), key national GFF planning documents, based on data from 25 documents and 14 qualitative interviews thematically analyzed. Results: The GFF was not fully understood by stakeholders and initially gained traction in the name of strengthening the health system, ironically amidst prevailing distrust of government systems. Some viewed the IC as consultatively developed, aiding the Ministry of Health in prioritizing issues and convening donors, while others remained sceptical about its impact. The PAD was viewed as a less consultative process, though it engaged the government and partners in setting disbursement-linked indicators (DLIs) to incentivize health system improvements. However, some stakeholders viewed them as unfeasible, while others were excluded by technical discourse. The perceived transparency issues around DLIs fuelled scepticism. Conclusion: Although the GFF policy processes provided a technically alluring basis for addressing Mozambique's health disparities, respondents revealed nuanced perspectives about how IC and PAD were formulated and followed. Aid coordination reflects various interdependencies, power dynamics, and uncertainties that require active relationship management and long-term institution building. |
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| Contributed Indexing: | Keywords: Global Financing Facility; Global Financing Facility for Women, Children and Adolescents: Examining National Priorities, Processes and Investments; Jennifer Stewart Williams; Mozambique; external financing; health financing; policy analysis Local Abstract: [plain-language-summary] Main findings: The Global Financing Facility policy processes in Mozambique enabled the convening of key stakeholders and a structured framework for addressing health disparities; however, it was shaped by complex contextual factors, stakeholder skepticism, and challenges in aid coordination. Added knowledge: This study examines the development and implementation of national planning documents for the Global Financing Facility, a global health initiative, revealing different viewpoints regarding their consultation process, benefits, impacts, and transparency. Global health impact for policy and action: Effective aid coordination in this context requires the intentional engagement of all stakeholders, including citizens, active relationship management, and long-term institution building. |
| Entry Date(s): | Date Created: 20250626 Date Completed: 20250626 Latest Revision: 20250629 |
| Update Code: | 20250630 |
| PubMed Central ID: | PMC12203692 |
| DOI: | 10.1080/16549716.2025.2518651 |
| PMID: | 40567102 |
| Datenbank: | MEDLINE |
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Nájsť tento článok vo Web of Science | Abstract: | Background: Mozambique joined the Global Financing Facility (GFF), a financing mechanism to accelerate progress for women, children, and adolescents' health, with a history of donor dependence, distrust in public finances, and social inequities. Few independent studies have assessed the GFF.<br />Objectives: To understand how a global mechanism, such as the GFF, was introduced and utilized in Mozambique.<br />Methods: This qualitative study explored the aid coordination dynamics between 2015 and 2020 linked to the development of the Investment Case (IC) and Project Appraisal Document (PAD), key national GFF planning documents, based on data from 25 documents and 14 qualitative interviews thematically analyzed.<br />Results: The GFF was not fully understood by stakeholders and initially gained traction in the name of strengthening the health system, ironically amidst prevailing distrust of government systems. Some viewed the IC as consultatively developed, aiding the Ministry of Health in prioritizing issues and convening donors, while others remained sceptical about its impact. The PAD was viewed as a less consultative process, though it engaged the government and partners in setting disbursement-linked indicators (DLIs) to incentivize health system improvements. However, some stakeholders viewed them as unfeasible, while others were excluded by technical discourse. The perceived transparency issues around DLIs fuelled scepticism.<br />Conclusion: Although the GFF policy processes provided a technically alluring basis for addressing Mozambique's health disparities, respondents revealed nuanced perspectives about how IC and PAD were formulated and followed. Aid coordination reflects various interdependencies, power dynamics, and uncertainties that require active relationship management and long-term institution building. |
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| ISSN: | 1654-9880 |
| DOI: | 10.1080/16549716.2025.2518651 |