Abstract
BackgroundIn Uganda, there are persistent weaknesses in obtaining accurate, reliable and complete data on local and external investments in immunization to guide planning, financing, and resource mobilization. This study aimed to measure and describe the financial envelope for immunization from 2012 to 2016 and analyze expenditures at sub-national level.MethodsThe Systems of Health Accounts (SHA) 2011 methodology was used to quantify and map the resource envelope for immunization. Data was collected at national and sub-national levels from public and external sources of immunization. Data were coded, categorized and disaggregated by expenditure on immunization activities using the SHA 2011.ResultsOver the five-year period, funding for immunization increased fourfold from US$20.4 million in 2012 to US$ 85.6 million in 2016. The Ugandan government was the main contributor (55%) to immunization resources from 2012 to 2014 however, Gavi, the Vaccine Alliance contributed the majority (59%) of the resources to immunization in 2015 and 2016. Majority (66%) of the funds were managed by the National Medical Stores. Over the five-year period, 80% of the funds allocated to immunization activities were spent on facility based routine immunization (expenditure on human resources and outreaches). At sub-national level, districts allocated 15% of their total annual resources to immunization to support supervision of lower health facilities and distribution of vaccines. Health facilities spent 5.5% of their total annual resources on immunization to support outreaches.ConclusionDevelopment partner support has aided the improvement of vaccine coverage and increased access to vaccines however, there is an increasing dependence on this support for a critical national program raising sustainability concerns alongside other challenges like being off-budget and unpredictable. To ensure financial sustainability, there is need to operationalize the immunization fund, advocate and mobilize additional resources for immunization from the Government of Uganda and the private sector, increase the reliability of resources for immunization as well as leverage on health financing reforms like the National Health Insurance.
Highlights
In Uganda, there are persistent weaknesses in obtaining accurate, reliable and complete data on local and external investments in immunization to guide planning, financing, and resource mobilization
The “rest of the world” scheme is funded by development partners including United Nations agencies, bilateral agencies, and international Non-Government Organizations (NGOs)
Development partners manage the bulk of their funds, with a few exceptions (e.g. World Health Organization and Gavi) whose bulk of the funds are managed by Uganda National Expanded Program on Immunization (UNEPI) and National Medical Stores (NMS)
Summary
In Uganda, there are persistent weaknesses in obtaining accurate, reliable and complete data on local and external investments in immunization to guide planning, financing, and resource mobilization. In line with the Sustainable Development Goal 3.2 that seeks to end preventable deaths of newborns and children under 5 years of age [3], the Uganda National Expanded Program on Immunization (UNEPI) has increased access to immunization services nationally through the introduction of new vaccines and improvement in vaccine coverage with support of its partners [4,5,6]. The Global Vaccine Action Plan highlights the need to increase the total amount of funding for immunization from countries and development partners even though financing for immunization is primarily the responsibility of governments [7]. In addition to the NHA, WHO/UNICEF jointly capture various domains on performance, planning, financing and quality indicators from member states through the Joint Reporting Form (JRF) so as to track implementation of the Global Vaccine Action Plan (GVAP) [11]. Uganda has not consistently reported on JRF indicators and exacerbating the need for resource mapping exercises
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
