Financing Immunisation Programmes

Ensuring the financial sustainability of immunisation programmes requires securing new domestic resources for immunisation and strengthening the planning, budgeting, and financial management capacity of immunisation programmes. Network countries are exploring a variety of strategies to increase the financial resources they have available for immunisation and strengthen financial management for immunisation, including developing advocacy strategies to highlight the value of immunisation investments to lawmakers and other financial decision-makers, engaging private sector resources for immunisation, developing electronic funds management systems that link spending to results, and changing the way immunisation programmes are planned and budgeted. At the same time, many countries are undergoing wider health financing reform, and immunisation programmes are adapting to systemic changes such as the expansion of social health insurance or fiscal decentralization.

The Linked Immunisation Action Network focuses on the following core immunisation financing functions:

Working within the macro-fiscal context to ensure sustainable immunisation financing: Understanding, engaging with, and planning within larger economic and fiscal trends affecting immunisation resources, including health reform initiatives such as the introduction or expansion of national social health insurance.
Maintaining political will and commitment: Successfully advocating for domestic resources for immunisation to Parliament and other decision-makers in the context of limited fiscal space for health.
Strengthening public financial management and immunisation budgeting: Conducting adequate long-term planning, and budgeting of immunisation programmes while providing enough transparency and flexibility to allow immunisation programmes to make strategic spending decisions in pursuit of health priorities.
Immunisation expenditure tracking: Understanding how effectively immunisation budgets are executed and how immunisation funds are spent to aid planning of immunisation policy and services as well as to improve transparency and accountability.
Evaluating cost and cost-effectiveness of immunisation programmes: Evaluating the long-term cost and cost-effectiveness of routine immunisation and new vaccine introduction to make informed decisions about which vaccines and immunisation activities are right for the country.

Explore the Data

Explore the dashboard below to see how Network countries compare to each other in terms of economic performance and health financing. Hover over an indicator for additional information. (Weak internet connection? Download the dashboard as a PDF here.)

Managing the Gavi transition

Gavi’s vision for a successful transition is one in which countries have successfully expanded their national immunisation programmes with vaccines of public health importance and sustain these vaccines post-transition with high and equitable coverage of target populations, while having robust systems and decision-making processes in place to support the introduction of future vaccines. Explore our Country dashboards to get a detailed breakdown of key transition indicators across the dimensions of coverage, equity, systems, economic performance, and health and immunisation financing.

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Strengthening immunisation programme performance

Ensuring the sustainability of immunisation programmes requires maintaining or strengthening core immunisation programme functions. These include collecting, analyzing, and using program, coverage, and surveillance data to make decisions; establishing and regularly consulting advisory bodies to improve governance and decision-making; ensuring an adequate pipeline of skilled immunisation professionals at all levels of the health system; and advocating for immunisation in the context of larger health program changes, such as primary healthcare reform. Explore our Immunisation Performance, Service Delivery, and Supply Data dashboard to see how Network countries compare to each other in terms of immunisation performance, service delivery, and supply.

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Affordable and Sustainable Vaccines

Ensuring the sustainability of immunisation programmes requires ensuring a vaccine supply that is adequate, safe, reliable, and affordable.

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Partners Working in this Area

Working within the macro-fiscal context to ensure sustainable immunisation financing

Ensuring a sustainable immunisation system requires understanding the broader government and health financing context and analyzing fiscal space for health. Many Network countries are introducing, reforming, or expanding national social health insurance schemes, and have identified understanding how immunisation services fit into these schemes as a high-priority topic.

Click the button below to find key training resources for Ministry of Health or Finance staff looking to learn more about immunisation financing. You can also find information about the macroeconomic context, the financial risks countries face, and guidance for countries exploring various immunisation financing structures, including social health insurance.

Maintaining political will and commitment

With an estimated $16 return on every $1 investment, immunisation is one of the best health investments in terms of value for money. For ministries of health to successfully implement immunisation policy, they must advocate for sufficient immunisation resources and effective laws, policies, and processes to Parliament and other government agencies, such as the Ministry of Finance or subnational governments. Political commitment is critical in planning for future introductions of new vaccines, which require substantial costs up-front; ensuring that funds from the national budget are released on time to avoid gaps in coverage; allocating sufficient budget for operational costs critical for service delivery; and establishing legislation, regulations, and procedures that allow for the efficient procurement of safe vaccines and the implementation of the immunisation programme.
Network country representatives have expressed an urgent need for data and materials to make a strong case for increased government spending on vaccines, operations, and service delivery for routine immunisation to maintain or expand existing coverage.

Click the button below to access materials demonstrating the value of immunisation that can be adapted depending on country goals and target audience along with other key resources.

Strengthening PFM and immunisation budgeting

Budget structure, planning, and execution plays an important role in determining the efficiency, quality, and cost-effectiveness of health service delivery. Conducting adequate long-term planning and budgeting of immunisation programmes in collaboration with immunisation programme staff is a critical step toward ensuring that immunisation programmes have the resources they need to achieve coverage goals. Additionally, some Network countries are undergoing larger governance and institutional reforms that affect public financial management in the health sector. For example, some are shifting to new budget structures, such as output-based or program-based budgets, and payment mechanisms that incentivize high service quality and preventative services as they transition off donor funds. Others are undergoing fiscal decentralization and looking at ways to strengthen planning, budgeting, transparency, and accountability at the subnational level.

Click the button below to find a collection of key resources and tools for immunisation budgeting and public financial management.

Immunisation expenditure tracking

Understanding how effectively immunisation budgets are executed and how immunisation funds are spent is a crucial component of immunisation public financial management and accountability. It also plays a key role in planning immunisation policy and services. Many Network countries are in the process of developing electronic funds management systems and linking these to immunisation performance indicators. Some Network countries that are undergoing fiscal decentralization are exploring how to use these systems to ensure transparency and accountability at the subnational level.

The Linked Immunisation Action Network collaborated with Abt Associates, which assists countries to use System of Health Accounts (SHA) data to inform immunisation policy and plan immunisation programmes, to facilitate learning between countries on this topic. To learn more, you can view the recording of the joint webinar on this topic, or access other key resources by clicking the button below.

Evaluating cost and cost-effectiveness of immunisation programmes

Countries need to make informed decisions about the long-term cost and cost-effectiveness of routine immunisation programmes and the introduction of new vaccines as they become available. We have collected resources to help immunisation programme planners and National Immunisation Technical Advisory Group (NITAG) members use evidence-based decision making to select the vaccines and immunisation activities that are right for their countries.

Click on the button below to find the Immunisation Costing Action Network (ICAN)’s Immunisation Delivery Cost Catalogue, which provides unit costs of vaccine delivery given different delivery strategies, guidance or standards for costing study design, including information from Harvard’s EPIC studies, and other key resources from our partners.