Country Overview

  • Resource tracking is operational.
  • The draft immunization law is being conceptualized.
  • The domestic advocacy network has been established and has an official structure and Terms of Reference.

Expanded Program on Immunization (EPI)
The Sierra Leonean EPI is in the Medical Services Directorate, Primary Health Care Division, Ministry of Health and Sanitation (MOHS).

Government Spending on Immunization
Over the period 2006-2013, Sierra Leone’s Gross National Income increased from US$330 to US$680 per capita, doubling in eight years. According to the WHO/UNICEF Joint Reporting Form (JRF), the Sierra Leonean government spent less than $1 on routine immunization per surviving infant in 2007. By 2013, this figure had risen to $2, reflecting increased government contributions. In addition, the government share of total routine immunization expenditures rose from 0 percent to 9 percent from 2011-2013. Caveats: Reporting for JRF Indicator 6500 is incomplete and there are inconsistencies across the other JRF financial indicators. The data do suggest that Sierra Leone has progressed towards country ownership of its immunization program.

Sierra Leone's 2006-2013 Reported Government Expenditures on Routine Immunization updated 09/2014

Tracking Expenditure Flows
By June 2012, the expenditure tracking tool developed by the EPI team was finalized.

During the period August 2013 to January 2014, Deputy Secretaries from the Ministry of Finance and Economic Development (MOFED) and other government officials used the SIF Budget Process Tool to illustrate the country’s top-down flow of immunization spending. The EPI accountant contributed to these advances by procuring 2013 budget figures and 2010-2013 aggregate district-level health expenditures.

Presently, MOFED working to procure the Chart of Accounts (CoA) within the tumult of the Ebola outbreak. The CoA is a financial coding tool used in part for immunization expenditure tracking.

Legislation for Sustainability
Chapter II, Section 8 (Social objectives), Provision 3 of the 1991 Sierra Leonean Constitution states that the government will ensure that all citizens have easy access to adequate medical and health facilities.

As of November 2013, the Law Officer’s Department (LOD), MOHS and SIF are collaborating to produce a Cabinet Paper as a precursor to a draft law. The LOD is to spearhead the law drafting process immediately thereafter.

Domestic Advocacy Network
In August 2013, MOHS, MOFED, and parliament jointly finalized the Terms of Reference, composition, and steering committee for Sierra Leone’s Multi-Institutional Network on Immunization. By January 2014, the Network was established.

Global Vaccine Action Plan (GVAP) Implementation
In June 2014, Sierra Leonean officials finalized a timeline to streamline relevant principles from GVAP into the country’s Multi-Year Plan (cMYP).

Major SIF Program Efforts

  • October & November 2014: Senior Program Officer participates in two meetings of National Ebola Emergency Task Force and continues to emphasize the need to preserve immunization financing in the face of Ebola.
  • June 2014: Senior Program Officer facilitates the streamlining of GVAP principles into Sierra Leone’s cMYP at WHO-sponsored event. Small working groups composed of government peers conduct the streamlining.
  • March 2014: Senior Program Officer shares the SIF program experience at the Sierra Leone Health and Biomedical Research Association (HBIOMED) 6th Annual Research Symposium: Health of the Sierra Leonean Child.
  • November 2013: Senior Program Officer holds peer exchange between Sierra Leone and Liberia where each country shares its best practices in aggregating the information for the SIF Budget Process Tool.
  • June 2012: Liberian Deputy EPI manager and Health and Social Welfare House Standing Committee Co-Chair both attend SIF-organized Parliamentary peer exchange on legislative strategies.
  • February 2012: Senior Program Officer participates in UN/WHO/IST Measles Partnership Advocacy Mission on Measles SIA.
  • November 2011: Senior Program Officer holds two subregional SIF briefings, one in Makeni (for the districts of the Northern Province, Western Area, and Kono district), and one in Bo (for the districts of the Southern and Eastern provinces, excluding Kono).
  • July 2011: Senior Program Officer briefs District Council Health Committee members on SIF issues.
  • August 2010: Senior Program Officer sponsors Sierra Leonean MOFED representative and Liberian peer exchanger at budgeting process study tour in Uganda.
  • March 2010: Parliamentary Health Committee Chairlady and MOFED representative attend SIF peer exchange in Liberia.
  • December 2009: Senior Program Officer sponsors Liberian EPI manager at study tour in Sierra Leone.
  • November 2009: Senior Program Officer holds multi-institutional briefing with MPs, Paramount Chiefs, MOHS and MOFED
  • October 2009: Senior Program Officer holds second parliamentary briefing.
  • August 2009: Senior Program Officer holds first parliamentary briefing.
  • March 2009: Senior Program Officer addresses Rotary Club of Greater Freetown.
  • October 2008: Senior Program Officer and Program Director conduct introductory SIF briefings with MOHS officials and EPI manager.