Any better? A follow-up content analysis of adolescent sexual and reproductive health inclusion in Global Financing Facility country planning documents

Figures & data

Figure 1. Mindset, measurement, money (M³) grading for inclusion of adolescent health in GFF planning documents.

Table 1. Adolescent health and demographic indicators, ordered by national under-18 birth rate.

Country Groups: (% births by women <18 yrs.)	% Births by age 18 2015–2020	Countries	% Demand for FP satisfied by modern methods: 15–19 yrs.	Child marriage: % Married by 15 years	% Secondary school completion: Females	% Secondary school completion: Males	% Population that are adolescent: 10–19 yrs.
Group 1 [<10%]	1	Tajikistan	18	0	63	80	19
	5	Vietnam	60	1	61	50	14
	6	Rwanda	84	0	16	19	22
	7	Indonesia	82	2	37	40	17
	7	Cambodia	46	2	20	20	19
Group 2 [10–25%]	14	Haiti	31	2	16	17	21
	16	Senegal	25	9	10	11	23
	20	Afghanistan	21	4	14	32	25
	25	Cote d Ívoire	18	7	15	17	23
Group 3 [>25%]	28	Burkina Faso	51	10	2	6	24
	31	Malawi	62	9	13	15	25
	31	Sierra Leone	32	13	18	27	23
	36	Madagascar	51	13	15	16	23
	37	Mali	31	16	12	23	25
	39	Guinea	33	17	13	22	24
	43	CAR	14	26	6	8	26

Data source: United Nations Children’s Fund Global databases https://data.unicef.org/resources/sowc-2021-dashboard-and-tables/ (Accessed 28 August 2023).

Figure 2. Extent to which adolescent health is included in Country ICs and PADs.Supplementary file 3: Summary analysis for Figure 2

Text box 1 Inclusion of adolescent health in Senegal’s documents.

1) Mindset: There is a high degree of consistency in the extent to which adolescent health is mentioned in the content of both the PAD and IC. Adolescent health falls under RMNCAH-H, and AYRH (Adolescent and Youth Reproductive Health). Senegal’s PAD describes its country context as politically stable, with a favourable economic outlook although youth experience higher levels of unemployment than other demographic groups, as well as educational and health care inequities. Early pregnancies and marriages are major concerns, particularly for rural adolescent girls from poor households, and with a low level of education. Both documents contain separate sections and project components dedicated to adolescent health, and adolescent rights are included. Annex 3 of the PAD is entitled ‘Special Focus on Adolescent Health in Senegal’, and describes the importance of investing in this demographic, the challenges it faces (mostly linked to SRH) and the need for empowering girls by reducing the rate of fertility and child marriage and improving educational attainment. Boys are discussed due to their key role in female empowerment. Cash transfers are proposed as a measure to incentivise girls’ continued education and vocational training, with the intention that empowerment and employment opportunities will reduce adolescent vulnerability and early pregnancy.

2) Measurement: While the IC does not include adolescent-specific indicators, the PAD Indicators are linked to outcomes which quantify benefits of the pilot cash transfer system for adolescents: Utilisation rate of modern contraceptive methods by adolescent girls in a relationship, aged 15–19; number of adolescent girls who benefited from cash transfers; adolescent girls’ pregnancy rate among the beneficiaries of cash transfer initiatives.

3) Money: The IC does not contain adolescent-specific financing, unlike the PAD. The PAD states that USD25 million of a total project budget of USD150 million is allocated to a project component promoting adolescent health and women’s empowerment.

Data availability statement

The datasets used and/or analysed in this study are available from the corresponding author on reasonable request. This paper is part of the Global Health Action Special Series, “Global Financing Facility for Women, Children and Adolescents: Examining National Priorities, Processes and Investments”, available in Volume 17-01.