Project profile — Health Systems Bond

• Africa, regional (50.00%)
• Asia, regional (50.00%)

• Basic health care:
Basic health care (12220) (20.00%)
Health personnel development (12281) (80.00%)

• Gender equality (significant objective)
• Environmental sustainability (cross-cutting) (not targeted)
• Participatory development and good governance (not targeted)
• Trade development (not targeted)
• Biodiversity (not targeted)
• Climate change mitigation (not targeted)
• Climate Change Adaptation (not targeted)
• Urban issues (not targeted)
• Desertification (not targeted)
• Children's issues (significant objective)
• Youth Issues (significant objective)
• Indigenous Issues (not targeted)
• Disability (not targeted)
• ICT as a tool for development (not targeted)

This project aims to fill critical financing gaps to improve reproductive, maternal, newborn and child health (RMNCH) in high-burden countries by accelerating investments in health systems. The Health Systems Bond is issued by the World Bank and available for purchase by private investors. Capital generated from the proceeds is channeled as loans to countries eligible for funding from the Global Financing Facility (GFF) in support of Every Woman Every Child. DFATD’s contribution helps lower the borrowing costs for GFF countries who wish to access the funds raised by the bonds in the form of performance-based financing. Project activities include: (1) training community health workers; and (2) improving health data systems; and (3) increasing investments in health by improving outreach to private sector. Strengthening health systems is an important part of Canada’s efforts to improve RMNCH as strong systems are central to the delivery of quality essential services for women and children.

The expected intermediate outcomes for this project include: (1) improved health and data systems; (2) improved equitable access to high quality health services for women, children and adolescents; and (3) increased private sector investments in the health.

Results achieved by the Global Financing Facility (GFF) through the support of the Government of Canada and other international donors as of June 2022 include: (1) raised over US$2 billion from private sector investors to finance health and nutrition programming for women and children; (2) two GFF-supported countries, Guatemala and Indonesia, accessed these funds through the GFF to improve health and nutrition programs for women and children; (3) in Indonesia: the financing supported the rollout of a mobile health monitoring app. It also supported training 73,000 health development workers (HDW) to reach women and children in 75,000 villages. The funds facilitated technical assistance to improve the Indonesian government’s capacity to manage its nutrition program. This contributed to an increase of 45% of households receiving the complete package of nutrition interventions in 2021, compared to 25% in 2018. With the support of the GFF, World Bank and other partners, chronic malnutrition decreased from 30.8% in 2018 to 24.4% in 2021; and (4) in Guatemala: funds facilitated the negotiation of a US$9 million conditional grant to reduce World Bank borrowing costs for a nutrition project. The grant depends on the Guatemalan government meeting two health objectives: (a) the government must invest US$18 million into the country’s nutrition program, and (b) the government must increase access to nutrition services amongst pregnant women and children under five. Meeting these objectives will improve nutrition quality and access in Guatemala. GFF financing has supported technical assistance to enhance national health information and social protection systems in Guatemala.

• Proactive disclosure