Who is at the table and who has the power? Case study analysis of decision-making processes for the Global Financing Facility in Tanzania

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dc.contributor.authorKinney, Mary
dc.contributor.authorGeorge, Asha
dc.contributor.authorShamba, Donat
dc.date.accessioned2025-10-27T09:22:20Z
dc.date.available2025-10-27T09:22:20Z
dc.date.issued2025
dc.description.abstractBackground: In 2015, Tanzania joined the Global Financing Facility (GFF), a global health initiative for Reproductive, Maternal, Newborn, Child, and Adolescent Health and Nutrition (RMNCAH-N). Despite its resource mobilization goals, little is known about power dynamics in GFF policy processes. This paper presents the first power analysis of Tanzania’s GFF engagement. Objective: To examine policy processes in developing GFF documents during its first two phases in Tanzania. Methods: An exploratory qualitative case study using document reviews (*n* = 22) and key informant interviews (*n* = 21) conducted in 2022–2023. Data were thematically analyzed and interpreted using Gaventa’s power cube (levels, spaces, and forms of power). Results: Stakeholders praised the GFF’s country-led, evidence-based approach and local autonomy. However, closed-door decision-making in phase one excluded civil society and the private sector. Invisible power imbalances in funding allocations left stillbirths and adolescent health without dedicated budgets, while vulnerable groups (e.g. people with disabilities) were overlooked.
dc.identifier.citationShamba, D., Baraka, J., Kinney, M.V., George, A.S., Msemo, G., Lawn, J.E. and Steege, R., 2025. Who is at the table and who has the power? Case study analysis of decision-making processes for the Global Financing Facility in Tanzania. Global Health Action, 18(1), p.2552531.
dc.identifier.urihttps://doi.org/10.1080/16549716.2025.2552531
dc.identifier.urihttps://hdl.handle.net/10566/21146
dc.language.isoen
dc.publisherTaylor and Francis Ltd.
dc.subjectFinancing Policy
dc.subjectGlobal Health Initiative
dc.subjectNewborn
dc.subjectStillbirths
dc.subjectTanzania
dc.titleWho is at the table and who has the power? Case study analysis of decision-making processes for the Global Financing Facility in Tanzania
dc.typeArticle

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