Helene Mambu-Ma-Disu is the SIF Senior Program Officer for Madagascar, Rwanda and her home country, DR Congo. All three countries are either post conflict or still in conflict, some are doing much better than the others but all three remain donor dependent.
All three countries joined SIF in 2009 but more work has been done with DR-Congo in sensitizing national stakeholders and major partners on the importance of immunizations and the need for the national government to take ownership of the program by allocating sufficient resources for its activities - including the purchasing of routine vaccines.
Targeted stakeholders have been government institutions: The Ministries of Health, Budget, Finance and Planning and Parliament. This also includes: civil society groups, media and external partners. Information about immunization program performance and challenges has been shared. This has been somewhat hampered by the relative instability of the leaders of the government institutions.
The current economic health of the country does not allow the allocation of sufficient resources for the immunization program, but the 2010 national budget does show that a relative priority has been given to the immunization program within the Ministry of Health. Continuous advocacy is needed so that the allocated resources can be disbursed, and efficiently used in order to improve the program performance to attract more resources.
The law on decentralization was voted and promulgated in 2008. Given the low level of development of the country, this is certainly the way to go. Work is under way so that decentralized entities will include immunization needs in their respective budgets.
The other medium term hope is that that country is scheduled to reach the HIPC completion point in 2010; and health is one of the priority sectors to benefits from the debt relief. Once again, more active advocacy will be needed to make sure that immunization programs receive the needed resources for its activities.
So far Rwanda seems to be doing quite well even though a non negligible portion of the government budget is from a budget support scheme from external donors. Although the program is performing well, SIF advocacy is needed to hopefully help diversify financing sources from within the country. It could provide an example for other countries to learn from the Rwanda's experience. As for Madagascar, there is hope that this country will make a big jump once their political turmoil is under control.