Effect of donor funding for immunization from Gavi and other development assistance channels on vaccine coverage: Evidence from 120 low and middle income recipient countries

Ikilezi, Gloria; Augusto, Orvalho; Dieleman, Joseph L; Sherr, Kenneth; Lim, Stephen S

doi:10.1016/j.vaccine.2019.10.057

Cited by 51 publications

(31 citation statements)

References 19 publications

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“…Noncommunicable diseases such as cancer, strokes, chronic respiratory infections, hypertension, and diabetes are responsible for more than 32 million deaths per year in LMICs [2]. Global health programmes and partnerships such as the Global Fund and The President's Emergency Plan for AIDS Relief (PEPFAR) have been tremendously successful in mobilising resources and scaling up treatment for communicable diseases [3][4][5][6]. However, these initiatives are unsustainable in the absence of donor support and insufficient for tackling the challenges that come with the triple transition.…”

Section: Introductionmentioning

confidence: 99%

Integrating pharmaceutical systems strengthening in the current global health scenario: three ‘uncomfortable truths’

Hafner

Banda

Köhler

et al. 2020

J of Pharm Policy and Pract

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The response to emergency public health challenges such as HIV, TB, and malaria has been successful in mobilising resources and scaling up treatment for communicable diseases. However, many of the remaining challenges in improving access to and appropriate use of medicines and services require pharmaceutical systems strengthening. Incorporating pharmaceutical systems strengthening into global health programmes requires recognition of a few 'truths'. Systems strengthening is a lengthy and resource-intensive process that requires sustained engagement, which may not align with the short time frame for achieving targets in vertical-oriented programmes. Further, there is a lack of clarity on what key metrics associated with population and patient level outcomes should be tracked for systems strengthening interventions. This can hinder advocacy and communication with decision makers regarding health systems investments. Moving forward, it is important to find ways to balance the inherent tensions between the short-term focus on the efficiency of vertical programmes and broader, longer-term health and development objectives. Global health programme design should also shift away from a narrow view of medicines primarily as an input commodity to a more comprehensive view that recognizes the various structures and processes and their interactions within the broader health system that help ensure access to and appropriate use of medicines and related services.

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Section: Introductionmentioning

confidence: 99%

Integrating pharmaceutical systems strengthening in the current global health scenario: three ‘uncomfortable truths’

Hafner

Banda

Köhler

et al. 2020

J of Pharm Policy and Pract

View full text Add to dashboard Cite

show abstract

“…Since its inception in 2000, Gavi has facilitated the vaccination of 760 million children from 17 infectious diseases through routine immunization programs (41). Support from Gavi has not only increased access to lifesaving and underutilized vaccines, but also improved immunization coverage especially for new vaccines like pentavalent, pneumococcal, measles and rotavirus vaccines in over 120 countries Uganda inclusive (42). In order to qualify for Gavi's support, a country's three year average Gross National Income (GNI) per capita has to be equal to or below the eligibility threshold (43).…”

Section: Discussionmentioning

confidence: 99%

Uganda’s Increasing Dependence On Development Partner’s Support For Immunization – A Five Year Resource Tracking Study (2012 – 2016)

Kamya

Abewe

Waiswa

et al. 2020

Preprint

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Background: In Uganda, there are persistent weaknesses in obtaining accurate, reliable and complete data on local and external investments in immunization to guide planning, financing, and resource mobilization. This study aimed to measure and describe the financial envelope for immunization from 2012 to 2016 and analyze expenditures at sub-national level.Methods: The Systems of Health Accounts (SHA) 2011 methodology was used to quantify and map the resource envelope for immunization. Data was collected at national and sub-national level from public and external sources of immunization through key informant interviews coupled with document reviews. Data were coded using the SHA, categorized and disaggregated to detail the expenditure on immunization activities. Results: Over a five-year period, funding for immunization increased fourfold to US$ 85.6 million in 2016. The Ugandan government was the main contributor (55%) to immunization resources from 2012 to 2014. However, Gavi, the Vaccine Alliance contributed the majority (59%) of the resources to immunization in 2015 and 2016. Majority (66%) of the funds were managed by the National Medical Stores. Over the five-year period, 80% of the funds allocated to immunization activities were spent on facility based routine immunization (expenditure on human resources and outreaches). At sub-national level, districts allocated 15% of their total annual resources to immunization to support supervision to lower health centers (including distribution of vaccines). Health facilities spent 5.5% of their total annual resources on immunization to support outreaches.Conclusion: Development partner support has aided the improvement of vaccine coverage and increased access to vaccines. However, there is an increasing dependence on this support for a critical national program raising sustainability concerns alongside other challenges like being off budget and unpredictable. To ensure financial sustainability, there is need to operationalize the immunization fund, advocate and mobilize additional resources for immunization from the Government of Uganda and the private sector, increase the reliability of resources for immunization as well as leverage on health financing reforms like the National Health Insurance.

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“…The GAVI has been in the funding frontline of the immunization services of many low and middle-income countries 26 , including Mozambique, playing an important role in the reduction of deaths by preventable diseases in young children.…”

Section: Characteristics Of Epi and Immunization Policies In Mozambiquementioning

confidence: 99%

“…Since GAVI support started in the country, the vaccine coverage has increased over time as surveys have demonstrated. Although this support plays an important role, the waiting time associated with financing cycles, from the moment of the support request until its implementation, may lead to changes in EPI priorities and also influence the outcome of immunization coverage 26 .…”

Section: Characteristics Of Epi and Immunization Policies In Mozambiquementioning

confidence: 99%

40 years of immunization in Mozambique: a narrative review of literature, accomplishments, and perspectives

et al. 2020

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In Mozambique, the Expanded Program on Immunization (EPI) was implemented in 1979 with the objective of reducing child mortality and morbidity through the provision of immunization services. This study aims to describe the characteristics of the EPI and review the available information related to immunization service in Mozambique, its accomplishments and perspectives. A narrative review of the literature was carried out and the electronic databases accessed were VHL, Google Scholar, and PubMed between 1979 and 2019, using descriptors related to the theme. A total of 28 articles and other relevant sources have been consulted for the review. The national immunization coverage in Mozambique between 1997 (47%) and 2015 (66%) improved 19 percentual points; also immunization coverage of children under 12 months has increased from 44.3% (1997) to 57% (2015). The 2015 survey showed that out of the 11 provinces, only the southern and Cabo Delgado province could reach the 80% recommended goal at the provincial level. Zambézia, Nampula, and Tete provinces have been reporting low coverage over the years and Cabo Delgado presents coverage oscillation. The BCG, DPT3, Polio 3, and measles have reached 80% of coverage goal from 1997 to 2015. Our analysis have shown important improvements in national immunization, characterized by an overall increase in the national and provincial coverage and a decrease in the number of children that did not receive any vaccine. Despite these improvements, some provinces have lower coverages than expected and it is necessary to understand the determinants of dropout in children to retain them and provide timely and full immunization.

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Effect of donor funding for immunization from Gavi and other development assistance channels on vaccine coverage: Evidence from 120 low and middle income recipient countries

Cited by 51 publications

References 19 publications

Integrating pharmaceutical systems strengthening in the current global health scenario: three ‘uncomfortable truths’

Integrating pharmaceutical systems strengthening in the current global health scenario: three ‘uncomfortable truths’

Uganda’s Increasing Dependence On Development Partner’s Support For Immunization – A Five Year Resource Tracking Study (2012 – 2016)

40 years of immunization in Mozambique: a narrative review of literature, accomplishments, and perspectives

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