Nepal is pursuing financial sustainability for its immunization services through legislation, expenditure tracking and new financing arrangements. The Sabin Sustainable Immunization Financing (SIF) Program began its efforts in Nepal in December 2008.

National Immunization Program

The Nepali National Immunization Program (NIP) is in the Child Health Division (CHD), Department of Health Services (DOHS), Ministry of Health and Population (MOHP).

Nepal’s Progress to Date

Government Spending on Immunization

Legislation for Sustainability

Vaccination Financing Mechanism

Expenditure Tracking

SIF Program Inputs

Government Spending on Immunization

Over the period 2006-2014, Nepal’s Gross National Income rose from US$350 to US$730 per capita, more than doubling. According to the WHO/UNICEF Joint Reporting Form (JRF), the Nepali government spent $12 on routine immunization per surviving infant in 2006. By 2014, this figure had fallen to $4, a 67% decrease. In addition, the government share of total routine immunization expenditures dropped from 63% to 22% over the period. Since 2010, Nepal has reported inconsistently on JRF financial indicators. The data suggest that Nepal has not progressed towards country ownership of its immunization program. Among SIF countries, Nepal ranked seventeenth in terms of routine immunization spending per surviving infant in 2014.

Nepal’s JRF Financial Feedback Report, 2006-2014.

Legislation for Sustainability

The Constitution of Nepal, enacted on 20 September 2015, stipulates in Article 51(h)(5) that, “[t]he State shall gradually increase necessary investment in the public health sector in order to make citizens healthy,” and in Article 51(h)(8) that “[t]he State shall gradually increase investment in the health sector and make it service-oriented by regulating and managing the investment of the private sector in it.”

In 2010, MPs signed the Kathmandu Declaration, which called for the passage of immunization-related legislation. Nepal’s government and parliament then drafted the immunization bill in 2011-2014. In January 2015, the bill was finalized and tabled in parliament for a vote. The following September, MPs incorporated twelve amendments to the bill and placed it back on the parliamentary docket. On 4 January 2016, the Parliament of Nepal passed the Immunization Act, 2072. The President of Nepal enacted the Act into law on 26 January.

Vaccination Financing Mechanism

Both a public immunization fund — the National Immunization Fund (NIF) — and a public-private immunization fund — the Sustainable Immunization Support Fund (SISF) — are under development. The SISF is currently being seeded by Rotary members and Nepali private stakeholders.

Expenditure Tracking

In June 2015, the NPI team distributed expenditure tracking guidelines to district immunization authorities. In September, the district authorities submitted budget data to the NPI team.

SIF Program Inputs

  • September 2015: Senior Program Officer is featured as guest on live radio broadcast
  • September 2015: Senior Program Officer organizes legislative workshop
  • September 2015: Senior Program Officer organizes media briefing
  • June 2015: Senior Program Officer & CHD co-organize subnational resource tracking workshop
  • June 2015: Senior Program Officer & Radio Nepal co-organize media briefing
  • April 2015: Senior Program Officer & MOHP co-organize parliamentary briefing
  • December 2014: Senior Program Officer, MOHP, and WHO co-organize parliamentary briefing
  • October 2014: Senior Program Officer and Rotary Sbrief President of Nepal
  • September 2014: Senior Program Officer organizes legislative workshop
  • July 2014: Nepalese counterparts join Sri Lankan, Cambodian, Mongolian, Vietnamese, and Indonesian delegates in Sabin-sponsored peer review workshop
  • June 2014: Senior Program Officer organizes two legislative workshops
  • May 2014: Senior Program Officer organizes national briefing
  • February 2014: Senior Program Officer organizes media briefing
  • August 2013: Nepalese counterparts attend Sabin-sponsored colloquium
  • May 2013: Senior Program Officer national briefing
  • May 2013: Senior Program Officer organizes national briefing
  • March 2013: Senior Program Officer organizes financing workshop
  • January 2013: Senior Program Officer organizes financing & legislative workshop
  • October 2012: Nepalese counterparts join Cambodian delegates in peer exchange workshop
  • May 2012: Senior Program Officer, UNICEF, and Nepalese government co-organize two subnational briefings
  • March 2012: Senior Program Officer, UNICEF, and CHD co-organize legislative briefing
  • March 2012: Nepalese counterparts join Sri Lankan and Cambodian delegates in Sabin-sponsored peer exchange workshop
  • March 2011: Nepalese counterparts attend Sabin-sponsored colloquium
  • September 2009-January 2010: Senior Program Officer organizes three parliamentary briefings
  • December 2008: Senior Program Officer and Program Director introduce SIF program to Nepalese government