Contents

1. Strengthening Global Fund Proposals in relation Equityand Maternal Newborn and Child Health ( MNCH)IFRC: Round 11 Regional OrientationDr. Tonya Nyagiro, Global Fund Senior Adviser GenderOctober 4, 2011

2. Contents • Equity and Gender • MNCH across the Three Diseases • Elements for Strong Proposals and Considerations • Resources and technical support • Summary

3. Promoting equity through R11 financing New R11 guidance for CCMs and PRs to assess and promote equity at proposal development and grant renewal: • Equity is a core principle of GF financing and a focus of the new five-Year strategy • TRP gives due consideration to inclusion/omission of interventions for groups most in need • From R11, equity will be assessed as part of grant performance at Periodic Review --> R11 proposals must set the baseline to monitor progress • GF Secretariat has developed new guidance for R11 to support CCMs to: --> Make better use of available data to assess gaps and barriers --> Include appropriate interventions in R11 proposal interventions and budgets --> Monitor progress and use R11 financing to fill data gaps

4. Gender, MARPS and Vulnerability key drivers of HIV infection - biological vulnerability, social marginalization and vulnerability, economic, educational, legal and political discrimination norms around masculinity and femininity barriers to their access to prevention, treatment, care and agency vulnerability to malaria (pregnant women) and tuberculosis (migrant workers, miners, hostel dwellers and prisoners)

5. Global Fund Strategies

6. MNCH Background Decision Point GF/B21/DP20 (May 2010): • The Board supports the efforts of countries to integrate MCH within their HIV/AIDS, TB and malaria programmes, and strongly encourages CCMs to look at opportunities to scale up an integrated health response that includes MCH in their applications for HIV/AIDS, TB, malaria and HSS • The Board encourages countries and partners, as a matter of urgency, to work together in the context of opportunities presented through grant reprogramming, Round 10, and changes to the Global Fund grant architecture to urgently scale up investments in MCH in the context of the Global Fund's core mandate.

7. MNCH across the 3 Diseases

8. Elements for preparing strong proposals for MNCH: TRP Considerations • Consideration for pilot programmes that include operational research in areas associated in MNCH • Demonstrated technical strength in MNCH and other interventions in the proposals • Financial strength- realistic costing, budget consistencies • Implementation capacity in MNCH efficiently and effectively including capacity and human resources • How the current request complements previous proposals

9. Opportunities for incorporating MNCH into Global Fund Proposals (1) Identify Quick Wins • Countries should be encouraged to keep MNCH activities simple with a clear potential for synergies, in programmatic and financial terms • Comprehensive PMTCT • Prioritization based on impact, available resources, and local priorities • Health System Strengthening & Community system strengthening Maximize synergies and linkages to disease-specific and HSS initiatives • There is no special pool of funding for MNCH, but there are flexibilities • R11 can address missed opportunities in areas of MNCH, but activities must be presented in the context of the Global Fund mandate • Maximize synergies and linkages of MNCH to disease specific/HSS initiatives – How can HIV/malaria/TB/HSS interventions be leveraged to improve MNCH? • R11 is not an opportunity for funding entire MNCH programs

10. Opportunities for incorporating MNCH into Global Fund Proposals (2) Additionality • Additionality of GF funding is key – requests to the GF should not displace/replace/overlap with funding or interventions from other sources  (and in particular traditional sources of funding for MNCH); Situational and Gap Analysis • Define priorities; align with existing national plans • Provide analysis of MNCH gaps in relation to the achievement of HIV, TB, and malaria outcomes • Financial gap analyses should be presented Participation • Throughout proposal development, participation of people with MNCH and health system expertise is key;

11. Investment in Health Systems Strengthening: Ethiopia Ethiopia:USD 330.5 million Over 30,000 Health Extension Workers trained and deployed between 2004 - 2009.

12. MNCH resources to support R11

13. Summary • Equity is an important consideration for Round 11 • There are multiple opportunities for integration and linkages for MNCH interventions in ATM and HSS service settings and vice versa. • There is room for operational research and piloting • The choice and delivery of interventions depends on the country context (epidemiological profile of diseases; relative burden of maternal and child morbidity and mortality and situational and gap analyses).