Nepal is pursuing financial sustainability for its immunization services through legislation, expenditure tracking and new financing arrangements. Sabin’s Sustainable Immunization Financing (SIF) Program worked with officials in Nepal from 2008 to 2017.
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).
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 percent decrease. In addition, the government share of total routine immunization expenditures dropped from 63 percent to 22 percent 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 8th in terms of routine immunization spending per surviving infant in 2016.
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 drafted the immunization bill in 2011-2014.
The bill was passed in January 2016. The President enacted the bill 22 days later.
In February 2016, four committees were assigned to develop regulations and oversee the implementation of the immunization law.
Both a public immunization fund — the National Immunization Fund — and a public-private immunization fund — the Sustainable Immunization Support Fund — are under development.
National Immunization Fund: An earmarked tax is proposed. Any unused health budget funds will be rolled into the fund at the end of each fiscal year.
Sustainable Immunization Support Fund: Being capitalized by Rotary and Lions club members, other private domestic stakeholders. Donors to the private fund will be given tax credits.
SIF provides a tool for analyzing how efficiently recent immunization budgets have been executed. In 2014, the NIP team used this tool to analyze the performance of the Program’s 2011-2013 budgets.
In June 2015, the NIP team distributed expenditure tracking guidelines to district immunization authorities.
In September 2015, the district authorities submitted budget data to the NIP team.
- July 2014, May 2016: Nepalese counterparts join Sri Lankan, Cambodian, Mongolian, Vietnamese, and Indonesian delegates in Sabin-sponsored peer review workshops
- March 2013, January, March 2016: Parliamentary Coalition for Immunization, Ministry of Finance Revenue Management Division, Rotary leaders discuss immunization financing strategies
- March 2012, January 2013, June 2014, September 2015: Resident Senior Program Officer organizes legislative workshops
- February, June 2014, June 2015: Resident Sabin Senior Program Officer and Child Health Division, Ministry of Health and Population, organize subnational resource tracking workshop
- September 2009, January 2010, May 2014, September 2014, December 2014, April 2015: Resident Sabin Senior Program Officer, Ministry of Health and Population organize parliamentary briefings
- February 2014, September 2015: Senior Program Officer organizes media briefings
- October 2012: Nepalese counterparts join Cambodian peers in peer exchange workshop
- May 2012: Senior Program Officer, UNICEF, and Nepalese government co-organize two subnational briefings
- March 2012: Nepalese counterparts join Sri Lankan and Cambodian delegates in Sabin-sponsored peer exchange workshop
- December 2008: Resident Sabin Senior Program Officer and SIF Program Director introduce SIF program to Nepalese government
Last Updated July 12, 2016