- National Immunization Policy approved and being transformed into immunization law
- Public immunization financing mechanism incorporated into National Immunization Policy
- National authorities advocating to provincial officials to mobilize local resources for immunization
- Resource tracking operational at the sub-national level
National Immunization Program (NIP)
The Department of Health Services and the Provincial Health Sector, Ministry of Health, provide preventive, curative and rehabilitative health care services. The National Immunization Program (NIP) has been in operation since 1978. The Ministry’s Epidemiology Unit, within the Family Health Bureau, directs the NIP.
Government Spending on Immunization
Over the period 2006-2013, Sri Lanka’s Gross National Income increased from US$1,350 to US$3,170 per capita, a 135 percent increase. According to WHO/UNICEF Joint Reporting Form (JRF), the Sri Lankan government spent $24 on routine immunization per surviving infant in 2006. By 2013, this figure had risen to $35, reflecting a 46 percent increase. In addition, the government reported that its share of total routine immunization expenditures rose from 77 percent to 100 percent over 2010-2013. However, the percent of government contributions for vaccines simultaneously decreased, from 68 percent to 41 percent over 2006-13. Caveats: Reporting for JRF Indicator 6500 is incomplete and there are inconsistencies across the other JRF financial indicators. The data nevertheless suggest that Sri Lanka has progressed towards country ownership of its immunization program.
Vaccination Financing Mechanism
A National Immunization Policy was approved in April 2014. Chapter 5 of the policy guarantees that the government will provide sufficient funding for the timely procurement and supply of quality vaccines and logistical support. It further stipulates that the government will establish a separate line item for the NIP within the Ministry of Health budget, and that all provincial authorities must ensure the timely availability of adequate funds and other resources. Chapter 5 establishes a mechanism to monitor the financial sustainability of the NIP.
Tracking Expenditure Flows
The Sri Lankan Epidemiology Unit completed a costing study in Kalutara district in September 2014, which allowed the Unit to estimate how much is being spent per child under five years at the subnational level (excluding vaccine costs). The Epidemiology Unit plans to refine this figure with an additional four-district study in early 2015.
Legislation for Sustainability
In March 2013, the MOH Epidemiology Unit established a Working Subcommittee to draft the country’s National Immunization Policy. The Subcommittee completed the draft Policy and disseminated it for public input in February 2014, completing the vetting process. By March, the Subcommittee had inserted all relevant public input into the draft Policy.
Approved in April 2014, the National Immunization Policy is being transformed into an immunization law.
Domestic Advocacy Network
In August 2011, government authorities from five of the country’s nine provinces signed the Colombo Resolution, by which they pledged to advocate for sustainable immunization financing in their respective provinces.
In June 2013, authorities from Central, Sabaragamuwa, Southern, Uva and Western provinces signed the Colombo Commitment, further elaborating the Colombo Resolution. The officials pledged to allocate adequate local resources to their respective provincial immunization programs.
Major SIF Program Efforts
- July 2014: Senior Program Officers from Nepal and Mongolia co-organize Asia Peer Review Workshop on Sustainable Immunization Financing. Peer exchangers from Nepal, Sri Lanka, Cambodia, Mongolia, Indonesia and Vietnam participate.
- June 2013: Senior Program Officer and Epidemiology Unit co-organize a multi-provincial briefing.
- June 2013: Senior Program Officer organizes multi-institutional briefing on National Immunization Policy.
- May 2013: Senior Program Officer participates in consultative workshop on National Immunization Policy. In attendance are non-governmental health experts and MOH officials.
- April 2013: Senior Program Officer participates in two consultative workshops on National Immunization Policy. In attendance are non-governmental health experts and MOH officials.
- February 2013: Senior Program Officer organizes multi-provincial briefing between five provinces.
- July 2012: Sri Lankan peer exchangers participate in the Fourth Asian Sub-Regional Symposium and Second Sub-national Parliamentary Briefing in Cambodia.
- March 2012: Senior Program Officer and Program Director organize peer exchange titled, Symposium for Parliamentarians and Elected Members of Local Government Bodies on Sustainable Immunization Financing.
- August 2011: Senior Program Officer and MOH co-organize Symposium for Elected Members of Local Government Bodies on Sustainable Immunization Financing.
- June 2011: Senior Program Officer participates in a parliamentary briefing.
- October 2010: Two MPs and two government officials from Sri Lanka attend the SIF/Cambodia-organized Third Sub-Regional Symposium for Parliamentarians on Sustainable Immunization Financing in Cambodia.
- July 2010: Senior Program Officer, MOH, and parliament co-organize the Second Sub-Regional Symposium for Parliamentarians on Sustainable Immunization Financing in Sri Lanka.
- June 2010: One MP and four government officials from Sri Lanka attend the SIF-organized Countdown to 2015 and Sustainable Immunization Financing: Role of Civil Society Organizations in Nepal.
- April 2010: Senior Program Officer and the Cambodian National Assembly co-organize Maternal and Child Health and Sustainable Immunization Financing in Cambodia, in which the Epidemiology Unit Chief and Public Health Deputy Director General of the MOH participated.
- February 2010: Six Sri Lankan peer exchangers participate in a Sub-Regional Parliamentary Symposium on Sustainable Immunization Financing co-organized by Senior Program Officer and UNICEF.
- December 2008: Senior Program Officer and Program Director conduct introductory briefings with MOH counterparts.