EPIC Studies: Governments Finance, On Average, More Than 50 Percent Of Immunization Expenses, 2010–11

Abstract

Governments in resource-poor settings have traditionally relied on external donor support for immunization. Under the Global Vaccine Action Plan, adopted in 2014, countries have committed to mobilizing additional domestic resources for immunization. Data gaps make it difficult to map how well countries have done in spending government resources on immunization to demonstrate greater ownership of programs. This article presents findings of an innovative approach for financial mapping of routine immunization applied in Benin, Ghana, Honduras, Moldova, Uganda, and Zambia. This approach uses modified System of Health Accounts coding to evaluate data collected from national and subnational levels and from donor agencies. We found that government sources accounted for 27-95 percent of routine immunization financing in 2011, with countries that have higher gross national product per capita better able to finance requirements. Most financing is channeled through government agencies and used at the primary care level. Sustainable immunization programs will depend upon whether governments have the fiscal space to allocate additional resources. Ongoing robust analysis of routine immunization should be instituted within the context of total health expenditure tracking.

Funding gap for immunization across 94 low- and middle-income countries

“…As for sources of financing, the majority of available financing (58%) was projected to come from country governments. This finding is similar to that found in a recent multi-country study of routine immunization financing (EPIC) and analysis of cMYP data [1], [41], [42]. While this supports the GVAP principles to promote country ownership in national immunization programs, additional government funds may be necessary both to reduce the funding gap and reliance on support from Gavi and other development partners [43].…”

“…While governments share in the financing of vaccination programs [1], achieving ambitious GVAP targets will require additional financial commitment. One of the primary challenges in garnering these commitments lies in the difficulty of estimating the resources required for NIPs.…”

Improved calibration estimators for the total cost of health programs and application to immunization in Brazil

“…As a result, program managers do not have the key information to improve efficiency or to advocate for adequate budget support. This is even more important when considering newly available technologies that are incorporated into public health programs, such as the introduction of new vaccines which are significantly more costly that the traditional childhood vaccines [1–4].…”

“…In the past several years, selected studies have been conducted to assess the costs of immunization programs. In particular, various low and middle income countries conducted immunization costing studies since 2010, with the support from the Expanded Program on Immunization Costing and Financing (EPIC) project [1]. Detailed costing information on routine child immunization from Benin, Ghana, Honduras, Moldova, Uganda and Zambia [2, 3, 5–8].…”