Mapping financial flows for immunisation in Uganda 2009/10 and 2010/11: New insights for methodologies and policy

Guthrie, Teresa; Zikusooka, Charlotte Muheki; Kwesiga, Brendan; Abewe, Christabel; Lagony, Stephen; Schütte, Carl; Marinda, Edmore; Humphreys, Kerrin; Motlogelwa, Katlego; Nombewu, Zipozihle; Brenzel, Logan; Kinghorn, Anthony

doi:10.1016/j.vaccine.2014.12.053

Cited by 13 publications

(16 citation statements)

References 4 publications

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“…The study presents the trend in the resource envelope for immunization over a five-year period; contribution from Government of Uganda to the overall resource envelope [10]. Additionally, the analysis of country multiyear plans (cMYPs) for 54 national programs also estimated government contribution to account for about 56% and 52% of the total routine program financing and nonvaccine financing respectively [19].…”

Section: Discussionmentioning

confidence: 99%

“…In order to quantify the resource envelope at national level, three data extraction tools (for sources, agents and providers) were developed and used for this study. The tools were adopted from similar exercises in Uganda [10]. At district level, two standardized tools were administered at district and health facility level.…”

Section: Data Collection and Analysismentioning

confidence: 99%

“…However, Uganda has not consistently reported on JRF indicators and therefore exacerbating the need for resource mapping exercises. Uganda was conducted by Guthrie et al for 2009/10 and 2010/11 financial years in which costs and finances for immunization were assessed as part of the country Expanded Program on Immunization Costing (EPIC) study [10]. In this study, the total financing for routine immunization in Uganda increased from $24.2 million to $32.9 million in 2009/10 and 2010/11 respectively with the Uganda government contributing approximately half of all the finances [10].…”

Section: Introductionmentioning

confidence: 99%

“…Uganda was conducted by Guthrie et al for 2009/10 and 2010/11 financial years in which costs and finances for immunization were assessed as part of the country Expanded Program on Immunization Costing (EPIC) study [10]. In this study, the total financing for routine immunization in Uganda increased from $24.2 million to $32.9 million in 2009/10 and 2010/11 respectively with the Uganda government contributing approximately half of all the finances [10]. Since this resource tracking exercise, there have been few efforts to track financial flows specific to immunization especially in light of the newly introduced vaccines.…”

Section: Introductionmentioning

confidence: 99%

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Uganda’s Increasing Dependence On Development Partner Support For Immunization – A Five Year Resource Tracking Study (2012 – 2016)

Kamya

Abewe

Waiswa

et al. 2020

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Background There are persistent weaknesses in obtaining accurate reliable and complete data on local and external investments in immunization and yet these are critical to estimate costs, resource needs and gaps so as to aid country financing, planning and resource mobilization. This study aimed to measure and describe the financial envelope for immunization activities and conduct an expenditure analysis at district level. Methods The Systems of Health Accounts (SHA) 2011 methodology was used to quantify and map out the resource envelope for immunization. Data were collected at national and district levels from public and external sources of immunization through key informant interviews coupled with document reviews. Data were coded (SHA), categorized and disaggregated to allow for greater detail on the types of immunization activities. Financing methodology used was largely drawn from Guthrie et al, 2015. Results Over a five-year period, funding for immunization has increased fourfold from US$20.4 million in 2012 to US$ 85.6 million in 2016. The increase in the resource envelope is attributed to the lift of the ban of Gavi funding to Uganda as well as new vaccine introduction. Gavi, the Vaccine Alliance became the biggest contributor (59%) in 2015 and 2016 with 66% of the funds managed by National Medical Stores. Eighty percent of the resources are spent on facility-based routine immunization which includes expenditure on human resources and immunization outreaches. At district level, the overall proportion of total funding to immunization was 15% of their Primary Health Care (PHC) Grant. The bulk (82%) of the PHC funds were spent on supervision to lower health centers (transport and distribution of vaccines) while majority (51%) development partner funds were spent on routine immunization activities (vaccine collection and per-diems/allowances to support outreaches). Conclusion The increasing dependence on development partner support raises issues around sustainability alongside other challenges like misalignment and displacement This warrants an increase in financial commitment to immunization by Government of Uganda, prioritization of resources for immunization at district level, and also operationalization of the existing financial sustainability plan for immunization.

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Section: Discussionmentioning

confidence: 99%

Section: Data Collection and Analysismentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Uganda’s Increasing Dependence On Development Partner Support For Immunization – A Five Year Resource Tracking Study (2012 – 2016)

Kamya

Abewe

Waiswa

et al. 2020

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“…We also costed the internal staff meetings that were held to organize district response activities at the beginning of the outbreak. The unit cost used for a fully immunized child was estimated at $33.7 for 1 dose of measles vaccine [15].…”

Section: Costs At District Levelmentioning

confidence: 99%

Costs of Responding to a Measles Outbreak: Buvuma Islands, Lake Victoria, Uganda, February-May 2017

Nguna¹,

Jk²,

Birungi³

et al. 2019

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Background Despite the strong prevention efforts by the Uganda Ministry of Health (MOH), measles outbreaks continue to occur. The MOH responded to a measles outbreak in the hard to reach areas of Buvuma Islands, identifying 54 case-patients, 4 of whom developed complications and were hospitalized. We estimated the provider cost of responding to this outbreak, cost of prevention, and the cost the government would have saved with effective prevention. Methods We took the Government perspective into consideration. Using an itemized form, we systematically collected data on quantities and unit costs of all the resource inputs for both direct and indirect costs at national, district, and facility levels. Medical cost referred to hospital and clinic costs for medications, supplies, utilities, transport, and personnel; non-medical costs included those associated with person-hours spent on the outbreak investigation and control effort. Results The overall cost of investigating and controlling this outbreak was $16,259.50 (including $5,526.30) of medical costs, $10,733.20 of non-medical costs) and the cost per capita of number of children 6mon-5years was $117.80 (16,259.5/138 (number of children 6mon-5years. This is the target for measles intensified immunization following an outbreak). Conclusion and Recommendations The total cost incurred in this outbreak is four fold the amount needed to vaccinate all children in Buvuma which would have averted the outbreak. We recommend strengthening vaccination services in all corners of the country, especially hard-to-reach areas, to enable the government forego the extra cost and morbidity associated with outbreak control.

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Costs of routine immunization and the introduction of new and underutilized vaccines in Ghana

Gargasson

Nyonator

Adibo³

et al. 2015

Vaccine

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Mapping financial flows for immunisation in Uganda 2009/10 and 2010/11: New insights for methodologies and policy

Cited by 13 publications

References 4 publications

Uganda’s Increasing Dependence On Development Partner Support For Immunization – A Five Year Resource Tracking Study (2012 – 2016)

Uganda’s Increasing Dependence On Development Partner Support For Immunization – A Five Year Resource Tracking Study (2012 – 2016)

Costs of Responding to a Measles Outbreak: Buvuma Islands, Lake Victoria, Uganda, February-May 2017

Costs of routine immunization and the introduction of new and underutilized vaccines in Ghana

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