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Budget line items for immunization in 33 African countries.

Ulla K Griffiths1, Jennifer Asman2, Alex Adjagba1,3

  • 1Health Section, UNICEF, 3 UN Plaza, New York, NY 10017, USA.

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Budgeting for immunization services in Sub-Saharan Africa shows significant variation. Many countries struggle with budget execution and data discrepancies, impacting financial sustainability and health program planning.

Keywords:
Budgetexpenditureimmunizationpublic financial managementvaccine

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Area of Science:

  • Public Health
  • Health Economics
  • Health Systems Research

Background:

  • Financial sustainability of health programs is crucial for effective service delivery.
  • Ministry of Health (MOH) budget line items are often considered a primary indicator of financial commitment.
  • Immunization programs serve as a critical reference for evaluating health budgeting practices.

Purpose of the Study:

  • To analyze the number and types of budget line items for immunization services across Sub-Saharan African countries.
  • To compare budgeted amounts with actual budget execution for immunization.
  • To assess the alignment between budgeted immunization funds and reported expenditures to international organizations.

Main Methods:

  • Cross-country comparative analysis of Ministry of Health budgets from 33 Sub-Saharan African countries for 2016/2017.
  • Data collection focused on immunization budget line items, budget execution rates, and reported expenditures (WHO/UNICEF).
  • Analysis of budget execution data was limited due to data availability in only eight countries.

Main Results:

  • The number of immunization budget line items varied widely (median of eight, range 0-42).
  • Significant discrepancies (over 50%) between budgeted and reported expenditures were observed in 66% of countries.
  • Immunization budgets per child in the birth cohort ranged from US$1.37 to US$67.51, averaging US$10.05.

Conclusions:

  • Obtaining comprehensive MOH budget and execution data was challenging, hindering assessment of budget credibility.
  • Discrepancies suggest issues with reporting, donor fund integration, data extraction, and public financial management capacity.
  • Improving financial transparency and management capacity is essential for the sustainability of immunization programs.