Investing in Sustainable Immunization Financing by Improving Data
This post is part of our World Immunization Week blog series. Stay tuned for more blogs highlighting the benefits of immunization and the work Sabin is doing to support immunization programs worldwide.
When it comes to children’s health around the world, vaccination has proven to be a wise investment – a point illuminated by many this World Immunization Week. But unfortunately, the costs of introducing new vaccines and expanding current immunization programs are rising, putting a strain on national health programs in many developing countries. For this reason, Sabin’s Sustainable Immunization Financing (SIF) program has been hard at work supporting these countries in their efforts to sustainably finance and run their own immunization programs. One aspect of that advocacy work is analyzing and providing feedback on their budgets and reported expenditures and investments. Unless this financial information is accurate, progress toward sustainable immunization financing and country ownership cannot be properly measured.
Within the span of three weeks, SIF, along with staff from the WHO and UNICEF, attended the three annual sub-regional EPI manager meetings for Central African Countries, West African Countries and East and Southern African Countries. While each meeting was unique, the collaborators discovered worrying trends in all three regions: countries are not reporting their expenditures on immunization as frequently as in previous years, and the data they are reporting are inconsistent. See chart below:
At each meeting, the collaborators provided national immunization (EPI) managers with detailed feedback on their recent financial reports. Each manager was given a report card showing the actual values reported for four financial indicators during 2006-2012. (Report cards are published on Sabin’s website. Click here to see an example of the report cards shown at the EPI meetings.) The data come from the WHO/UNICEF Joint Reporting Form for Immunization– a standard questionnaire on all aspects of immunization program performance filled out annually by the countries.
After receiving this feedback, the EPI managers discussed reasons for their infrequent and inconsistent reporting. Additionally, the managers noted that, despite the problems they are facing, they believe their governments are actually spending more than they are reporting.
At the West African Countries meeting, one of SIF’s senior program officer’s called attention to the troublesome fact that fewer than half of the West African countries (8 out of 17) reported any government expenditures at all in 2011 and 2012. And the problem appears to be worsening.
Similarly, at the East and Southern Africa meeting, it was noted that between 2011 and 2012, there was a 36% decrease in reported government routine immunization expenditures. The analysis also showed that countries reporting inconsistently or not at all tend to be those with the lowest expenditures – so higher investing countries, in other words, are better reporters.
Moving forward, EPI managers at the Central African countries meeting discussed possible solutions to their financial reporting problems. Harmonizing the various tools and reporting formats currently in use was one idea. More importantly, the managers agreed to use their financial data to argue for increases in their immunization budgets.
The bottom line is more frequent and consistent data are needed to make progress towards national and global immunization goals – those outlined in the Global Vaccine Action Plan. This World Immunization Week, we’re calling attention to just one of the obstacles the immunization community needs to overcome to save more lives and promote the development of healthier, more productive families, communities and societies.