Empowering civil society and communities to have a say on public spending on health

Civil society organisations (CSOs) play a critical role in building a strong, equity-focused and people-led movement for universal health coverage (UHC). Although civil society engagement in health financing advocacy and accountability has increased over the years, civil society and communities still lack opportunities to participate in government-led planning, progress reviews or implementation towards universal health coverage. At the same time, the COVID-19 pandemic has exacerbated global- and country-level challenges, diverting resources from key health programmes, jeopardising hard-won gains in specific communicable diseases and basic health services outcomes, and straining already fragile health systems. It has therefore become more important than ever that civil society organisations rooted in local communities get involved in the planning process and influence national spending priorities for health services to respond to people’s needs.

To address these challenges and strengthen understanding and knowledge of key health financing concepts, The Global Financing Facility (GFF), The Global Fund, The Partnership for Maternal, Newborn & Child Health (PMNCH), Gavi, and UHC2030 are working together with regional partners Impact Santé Afrique and WACI Health to develop and deliver the Joint Learning Agenda on Health Financing and Universal Health Coverage.

What is it?

Created for CSOs by CSOs, the Joint Learning Agenda on Health Financing and Universal Health Coverage is a two-year capacity-building programme on UHC budget advocacy and accountability. This unique partnership leverages collaboration between different global health initiatives, such as the SDG3 Global Action Plan, and collaboration on the UHC agenda and the COVID-19 response, and provides a coordinated, aligned and long-term support to CSO engagement.

Where is it carried out?

The programme is being implemented in 20 participating countries: Burkina Faso, Cameroon, Côte d’Ivoire, Chad, Benin, Togo, Democratic Republic of Congo, Ethiopia, Ghana, Kenya, Madagascar, Malawi, Mozambique, Liberia, Niger, Nigeria, Senegal, Sierra Leone, Tanzania, and Uganda.

Why is it necessary?

By empowering local champions and stakeholders, the Joint Learning Agenda on Health Financing and Universal Health Coverage promotes multi-stakeholder collaboration that will hold governments and donors accountable for the allocation and equitable use of funding for health.

Launched in November 2020, the Phase 1 – Learning, entailed regional online training of trainers and in-country practical and action-oriented trainings. These in-country trainings equipped CSOs to:

• Identify inefficiencies in budget allocations to health programmes and provide recommendations for optimal allocation
• Understand national budgeting processes and opportunities to influence health budget allocation
• Monitor the use of health budgets and provide recommendations for improvement
• Produce and present evidence-based policy notes, newspaper/journal articles, etc.
• Identify and collaborate with key partners/influencers
• Identify heath financing priorities and prepare an advocacy and accountability plan in favour of these priorities

The Phase 2 – Support is now providing the necessary capacity-building, technical assistance, mentoring and grants to help CSOs put the knowledge into practice and implement national advocacy and accountability plans focusing on country specific health financing priorities.

The collaboration through this Joint Learning Agenda has proven instrumental in not just increasing understanding of health financing issues as well as access to relevant information, but also to promote alignment of training activities with country programmes and reforms, by bringing together civil society partners on the ground in the health sector and beyond and connecting them with relevant decision-makers in the Ministry of Health and parliamentarians.

CSOs play an essential role in driving progress towards strong health systems that leave no one behind. The Joint Learning Agenda on Health Financing and Universal Health Coverage supports this role by providing the necessary tools and assistance to ensure CSOs can effectively and meaningfully engage in health financing advocacy and accountability. It benefits from financial support from the Global Financing Facility, the Global Fund and Gavi, as well as from technical support from UHC2030 and PMNCH.