Founded in 2002, The Global Fund to Fight Aids, Tuberculosis and Malaria is the largest health financing mechanism in the world. In 2013, SEEK was commissioned by the Global Fund’s Technical Evaluation Reference Board (TERG) to lead a thematic review of the Global Fund’s contributions to Millennium Development Goal (MDG) 4 (reduce child mortality) and MDG 5 (improve maternal health). The thematic review was intended to inform the direction of the Global Fund’s broader strategy.

SEEK adopted a three-pronged approach for the study, using different research methods for each aspect. The evaluation team undertook a quantitative analysis to estimate the amount that the Global Fund’s disbursements have contributed to reaching MDG 4 and 5. This was complemented by a review of available evidence on the ‘return on investments’ of integrated service delivery of disease-specific and maternal and child health interventions, and the degree to which these synergies had been realized by the Global Fund. We also identified success factors for, and barriers to, such investments both at the country level and within the Global Fund.

As part of the assignment, the project team conducted country case studies to provide in-depth exploration of successes and challenges in maximizing child and maternal health outcomes through Global Fund investments, including four in-country studies (Cambodia, Kenya, Lesotho and Rwanda) and four through desk reviews (Ethiopia, Ghana, Nigeria and Zimbabwe).

The review was designed in a highly participatory and collaborative manner. The project team held consultations with the TERG, and facilitated a workshop with key Secretariat members, the World Health Organization, and the United Nations Children’s Fund on findings and recommendations.

Based on the findings of the quantitative analysis, evidence synthesis, and country case studies, SEEK proposed ten recommendations to further strengthen linkages and synergies between Global Fund activities and broader maternal and child health interventions. The findings and recommendations were presented and described in the final report of the evaluation, which was ultimately used to inform a position paper to help shape the broader strategy of the Global Fund.