Sabin SIF country fact sheets VII.2016

Armenia
July 2016
The Republic of Armenia is pursuing a financially sustainable public immunization program through
legislation and enhanced budget oversight. Sabin’s Sustainable Immunization Financing (SIF) Program
began its efforts in Armenia in March 2015.
Immunization Program Structure
The Armenian Expanded Program on Immunization (EPI) is managed through two Ministry of Health
entities: the State Hygiene and Anti-epidemic Inspection (SHAEI) and the National Center for Disease
Control.
Armenia’s Progress to Date
Government Spending on Immunization
Legislation for Sustainability
Expenditure Tracking
SIF Program Inputs
Over the period 2006-2014, Armenia’s Gross National Income increased 91 percent from US$1,990 to
$3,810 per capita. According to the WHO/UNICEF Joint Reporting Form (JRF), the Armenian government
spent $2 on routine immunization per surviving infant in 2006. By 2014, government contributions had
increased forty-fold, to $84. The government share of total routine immunization expenditures rose from 50
percent to 99 percent over the period. Though JRF financial indicators have been reported inconsistently
since 2010, the data nevertheless suggest that Armenia has progressed towards country ownership of its
immunization program. Among SIF countries, Armenia ranked first in terms of routine immunization
spending per surviving infant in 2014.
ARMENIA’S JRF FINANCING FEEDBACK REPORT, 2006-2014.
Armenia’s constitution provides protections for health and health care, but there is no specific
immunization law.
Chapter 2, Article 33.2, of Armenia’s Constitution (1995) states, “Everyone shall have the right to live in
an environment favorable to his/her health and well-being and shall be obliged to protect and improve it in
person or jointly with others.”
Chapter 2, Article 48, of Armenia’s Constitution (1995) states that a basic task of the state is “to
implement health care programs for the population and contribute to the effective and affordable medical
service for the population.”
In Armenia, immunization is regulated by ministerial decrees on sanitary norms and rules. For each
vaccine, including new vaccines, there is a separate ministerial decree that sets instructions and
conditions for implementation.

The Ministry of Health (MOH) is formulating a Public Health Law which is slated to provide for public
immunization financing.
SIF provides a tool for analyzing how efficiently recent immunization budgets have been
executed. Armenian counterparts analyzed national immunization program budget flows for 2012-
2013 and 2014-2015 using the SIF Budget Process tool.
SIF Program Inputs
 March 2016: Sabin Senior Program Officer meets with MOH Finance Unit Director to analyze
proposed and approved budget, EPI Manager and team to complete the SIF budget flow analysis
for 2014-2015
 October 2015: SIF Director, Sabin Senior Program Officer and national immunization manager
meet with members of the Parliamentary Health Committee
 March 2015: Sabin Senior Program Officer meets with representatives from EPI, National Center
for Disease Control & Prevention, and Head of MOH Financing-Economic Unit to analyze the
immunization budget flow and to document the immunization budget process
Financial Indicators, WHO/UNICEF - Joint Reporting Form (JRF)
The amount a country spends on its routine immunization program is a direct measure of country
ownership and an indicator of the financial sustainability of the program. Each year, countries report these
expenditures through the WHO/UNICEF Joint Reporting Form (JRF).
Variables 2006 2007 2008 2009 2010 2011 2012 2013 2014
Total Government Expenditure on Health in US$ per capita 44 65 69 59 60 66 63 66 N/A
Government Expenditure on RI Vaccines - US$ (JRF 6510) 90,000 157,353 N/A 420,000 630,000 N/A 1,029,000 N/A 1,067,452
US$ per Surviving Infant 2.02 3.63 N/A 9.50 14.18 N/A 23.54 N/A 25.19
All Source Expenditures on Vaccines - US$ (JRF 6520) N/A N/A N/A N/A N/A N/A 1,583,000 N/A 2,692,500
US$ per Surviving Infant N/A N/A N/A N/A N/A N/A 36.21 N/A 63.54
Reported % of Total Expenditure on Vaccines Financed by Government
(JRF 6530) 30 33 N/A 60 N/A N/A 65 N/A 60
Government Expenditure on Routine Immunization - US$ (JRF 6540) 75,000 N/A N/A 450,000 630,000 N/A 1,029,000 N/A 3,548,305
US$ per Surviving Infant 1.69 N/A N/A 10.18 14.18 N/A 23.54 N/A 83.74
All Source Expenditures on Routine Immunization - US$ (JRF 6550) N/A N/A N/A N/A 960,000 N/A 1,583,000 N/A 3,572,814
US$ per Surviving Infant N/A N/A N/A N/A 21.60 N/A 36.21 N/A 84.32
Reported % of Total Expenditure on Routine Immunization Financed by
Government (JRF 6560) 50 N/A N/A 63 66 75 65 N/A 99
Data Accuracy Indicators Met* 0/1 N/A N/A N/A 3/3 N/A 5/6 N/A 5/6
*Data Accuracy Indicators represent number of logical tests satisfied divided by number of tests run
ARMENIA
Reported JRF Financial Indicators 6510-6560
JRF Financial Indicator Reporting Consistency

Cambodia
July 2016
Cambodia is pursuing financial sustainability for its immunization services primarily through
legislation. The Sabin Sustainable Immunization Financing (SIF) Program began its efforts in
Cambodia in December 2008.
Cambodia’s national immunization program (NIP) is located in the Health Directorate, Ministry of
Health (MOH).
Cambodia’s Progress to Date
SIF Program Inputs
Over the period 2006-2014, Cambodia’s Gross National Income rose from US$510 to $1010 per
capita, a 98 percent increase. According to the WHO/UNICEF Joint Reporting Form (JRF), the
Cambodian government spent $2 on routine immunization per surviving infant in 2008. By 2014,
this figure had risen to $26, increasing thirteen-fold. From 2006-2014, the government share of
total routine immunization expenditures increased from 17 percent to 55 percent. Though JRF
financial reporting has been inconsistent since 2010, the data nevertheless suggest that
Cambodia has progressed towards country ownership of its immunization program. Among SIF
countries, Cambodia ranked fourth in terms of routine immunization spending per surviving infant
in 2014.
CAMBODIA’S JRF FINANCIAL FEEDBACK REPORT, 2006-2014.
Chapter VI, Article 72 of Cambodia’s 1993 constitution states: “The health of the people is to be
guaranteed. The State gives full consideration to disease prevention and medical treatment. Poor
citizens receive free medical consultation in public hospitals, infirmaries, and maternities.”
The MOH established a Legal Drafting Committee in February 2012. The Committee met with
MPs as well as representatives from the NIP, MOH, and Ministry of Economy and Finance in
October 2012 and March 2013.
In September 2014, at the request of the National Assembly, the MOH shifted from drafting a law
to drafting a ministerial sub-decree on immunization.
executed. In March 2012, Sabin Senior Program Officer and MOH counterparts used the SIF tool
to analyze 2010-12 NIP budgets. Reporting errors were detected and rectified.
SIF Program Inputs
 March 2011, July 2012, July 2014, May 2016: Cambodian counterparts join Nepali, Sri
Lankan, Mongolian, Indonesian, and Vietnamese delegates in peer review workshops

 January 2015: SIF sponsored a visit by a Nepali peer working on that country’s
immunization bill to the Cambodian MOH to discuss the new sub-decree.
 October 2014: Sabin Senior Program Officer, SIF Program Director and MOH
counterparts organize GVAP briefing
 May 2013: Sabin Senior Program Officer organizes national legislative workshop
 October 2012: Cambodian counterparts join Nepalese peers in financing & legislative
peer exchange
 February, April, October 2010, April 2012: Sabin Senior Program Officer and SIF
Program Director organize parliamentary briefings
 February 2011: Sabin Senior Program Officer, government and National Assembly
counterparts organize Cambodia's first provincial-level briefing on immunization
financing
 December 2008: Sabin Senior Program Officer and SIF Program Director introduce SIF
program to Cambodian government
Variables 2006 2007 2008 2009 2010 2011 2012 2013 2014
Total Government Expenditure on Health in US$ per capita 1,3
5 7 8 9 10 11 14 16 N/A
Government Expenditure on RI Vaccines - US$ (JRF 6510) 0 298,095 824,844 767,338 1,130,366 1,068,217 1,174,231 1,997,291 2,246,340
US$ per Surviving Infant 2
0 0.91 2.46 2.24 3.24 2.92 3.32 5.64 6.34
All Source Expenditures on Vaccines - US$ (JRF 6520) N/A N/A N/A N/A 2,808,589 4,695,909 4,789,135 5,228,651 4,976,806
US$ per Surviving Infant N/A N/A N/A N/A 8.05 12.83 13.55 14.76 14.04
Reported % of Total Expenditure on Vaccines Financed by Government (JRF
6530) 0 17 41 22 40 23 25 38 45
Government Expenditure on Routine Immunization - US$ (JRF 6540) 1,390,700 1,584,800 2,231,044 1,161,164 277,814 305,596 1,131,083 2,275,105 9,163,487
US$ per Surviving Infant 4.31 4.86 6.67 3.39 0.80 0.84 3.20 6.42 25.85
All Source Expenditures on Routine Immunization - US$ (JRF 6550) N/A N/A N/A N/A 473,544 2,422,036 2,020,796 8,958,495 16,768,710
Government (JRF 6560) 17 33 46 N/A 59 13 56 25 55
Data Accuracy Indicators Met* 1/1 1/1 1/1 1/1 4/6 4/6 4/6 6/6 6/6
Sources: 1 World Bank; 2 UN Population Division; 3 WHO - National Health Accounts
CAMBODIA

Cameroon
July 2016
Cameroon is pursuing financial sustainability for its routine immunization services through new financing
arrangements, budget advocacy and resource tracking. The Sabin Sustainable Immunization Financing (SIF)
Program began its efforts in Cameroon in October 2008.
Cameroon’s Expanded Program on Immunization (EPI) is a division within the Ministry of Health (MOH).
Cameroon’s Progress to Date
Budget Advocacy
SIF Program Inputs
Over the period 2006-2014, Cameroon’s Gross National Income rose from US$960 to $1,350 per capita, a 41
percent increase. According to the WHO/UNICEF Joint Reporting Form (JRF), the Cameroonian government
spent $6 on routine immunization per surviving infant in 2006. By 2014, this figure had increased 17 percent, to
$7. During the same period, the government share of total routine immunization expenditures dropped from 57
percent to 21 percent. Since 2010, Cameroon has reported complete and consistent JRF financial data. The data
show that Cameroon has progressed towards country ownership of its immunization program. Among SIF
countries, Cameroon ranked 15th
in terms of routine immunization spending per surviving infant in 2014.
CAMEROON’S JRF FINANCIAL FEEDBACK REPORT, 2006-2014.
The Constitution of Cameroon, Part X (Articles 55–62), states that 10 semi-autonomous regions, ruled by
regional councils, have responsibility for “economic, social, health, educational, cultural and sports development.”
In July 2011, a committee designated by the Minister of Health (MOH) and Parliament prepared a draft bill
establishing a national immunization fund. In November, the council of ministers directed that the bill be revised
to set aside funds for all communicable disease control programs, including immunization.
In 2013, an MOH-led working committee began drafting regulations for the proposed Health Support Fund, which
would be included in a larger proposed Health Law.
In November 2014, the scope of the proposed fund was reduced to cover just vaccines and antiretroviral drugs.
The Inter-Ministerial Committee approved the completed Health Law containing the HIV section in March 2015.
In October 2015, the draft bill was expanded to include a National Public Health Agency. After the draft bill was
finalized and approved by the Ministry of Finance Health Budget Director in November 2015, the bill was then
submitted to the MOH Cabinet Legal Department for review.
In April 2016, the draft bill was revised to remove a proposed tax earmark and substitute a voluntary government
financing mechanism.
Budget Advocacy
In September 2015, the EPI team used budget data to successfully advocate for an approved FY2016
immunization budget increase.

In February 2016, a Cameroonian MP attended and signed a Parliamentary Statement in Support of the
Ministerial Conference on Immunization in Africa.
SIF provides a tool for analyzing how efficiently recent immunization budgets have been executed. In September
2015, an EPI team completed annual SIF budget flow analyses for 2010-15.
SIF Program Inputs
 September 2010, November 2012, December 2014, June 2016: Cameroonian counterparts join DRC,
Congo, Malgache, Malian, and Senegalese peers in Sabin-sponsored peer review workshops
 May 2012, November 2014, October, November 2015, April 2016: Resident Sabin Senior Program
Officer co-organizes national legislative and financing workshops
 June 2015: Cameroonian counterparts join Malian and Senegalese peers for Sabin-sponsored
resource tracking workshop in Dakar, Senegal
 September 2014: Resident Sabin Senior Program Officer, EPI team, and NGO Immunization Platform
integrate SIF budget flow analysis, cMYP costing tools
 August 2014: Resident Sabin Senior Program Officer, WHO, and UNICEF counterparts organize
advocacy technique workshop for MPs, Association of Women Mayors
 August, December 2009, June, July 2011: Resident Sabin Senior Program Officer organizes
parliamentary briefings
 October 2008: Resident Sabin Senior Program Officer and SIF Program Director introduce SIF
program to government and parliament
Variables 2006 2007 2008 2009 2010 2011 2012 2013 2014
10 11 12 15 17 22 20 23 N/A
Government Expenditure on RI Vaccines - US$ (JRF 6510) 1,173,490 1,436,151 2,494,510 2,102,420 2,257,870 1,963,100 2,591,200 2,852,100 3,272,320
1.77 2.14 3.65 3.02 3.19 2.72 3.54 3.84 4.33
6530) 20 40 51 34 96 9 13 12 15
Government Expenditure on Routine Immunization - US$ (JRF 6540) 3,755,260 10,716,876 13,220,441 2,684,790 4,859,660 6,378,620 2,702,320 4,326,220 5,081,960
All Source Expenditures on Routine Immunization - US$ (JRF 6550) N/A N/A N/A N/A 27,759,700 26,463,700 20,205,900 27,819,600 23,978,700
Government (JRF 6560) 57 36 44 13 18 24 13 16 N/A
CAMEROON

Congo
July 2016
The Republic of Congo is pursuing financial sustainability for its immunization services primarily through budget
advocacy. The Sabin Sustainable Immunization Financing (SIF) Program began its efforts in Congo in February
2012.
Congo’s Expanded Program on Immunization (EPI) is located in the Family Health Department, Ministry of
Health.
Congo’s Progress to Date
Vaccination Financing Mechanism
Budget Advocacy
SIF Program Inputs
Over the period 2006-2014, the country’s Gross National Income rose from US$1,210 to $2,680 per capita, a
121 percent increase. According to the WHO/UNICEF Joint Reporting Form (JRF), the Congolese government
spent $3 on routine immunization per surviving infant in 2006. By 2014, this figure had increased more than five-
fold to $17. In addition, the government share of total routine immunization expenditures increased from 26
percent to 40 percent over the period. Since 2010, Congo has reported consistently on JRF financial indicators.
The data suggest that Congo has progressed towards country ownership of its immunization program. Among
SIF countries, Congo ranked sixth in terms of routine immunization spending per surviving infant in 2014.
CONGO'S JRF FINANCIAL FEEDBACK REPORT, 2006-2014.
In October 2014, the MOH began developing guidelines for a “Special Appropriation Account,” which will be used
for vaccine procurement and will be subsidized by an airline tax.
SIF provides a tool for analyzing how efficiently recent immunization budgets have been executed. In 2013, the
EPI team analyzed its 2011-12 budgets using the SIF Budget Flow Analysis tool.
Ministerial and parliamentary officials participated in a sub-regional peer review workshop in December 2014 and
received recommendations on their resource tracking approach from peers. In February 2016, the EPI Manager
began engaging departmental health directors in resource tracking activities.
Title I, Article 34 of the 1992 Constitution states: “The State is the guarantor of public health. Every citizen has
the right to a standard of living adequate for the health and well-being of himself and his family, including food,
clothing, housing, medical care and necessary social services. The right to create private social and health
institutions is guaranteed. Social and health institutions are subject to approval by the State and governed by
law.”
The government of Congo began drafting a new immunization bill in June 2012. In February 2013, the draft bill
was amended.

In February 2016, a Congolese MP signed the Parliamentary Statement in Support of the Ministerial Conference
on Immunization in Africa.
Budget Advocacy
In August 2015, the National Assembly Health Committee (NAHC) Chairman began organizing a Parliamentary
Coalition for Immunization. Among its purposes is to advocate for appropriate immunization budgets.
In February 2016, the EPI Manager and NAHC Committee Chairperson briefed departmental health directors on
resource mobilization.
In February 2016, a Congolais MP attended and signed a Parliamentary Statement in Support of the Ministerial
Conference on Immunization in Africa.
SIF Program Inputs
 August 2015: Sabin Executive Vice President, SIF Program Director and Sabin Senior Program Officer
attend briefing of the National Assembly Health Committee
 June 2015: National Assembly Health Committee Chairman joins DRC Advocacy Coalition mission to
Katanga province
 November 2012: Congolese counterparts join DRC, Malgache, Cameroonian, Malian, and Senegalese
delegates in legislative peer review workshop
 February 2012: Sabin Senior Program Officer conducts introductory briefings with the MOH and EPI
The amount a country spends on its routine immunization program is a direct measure of country ownership
and an indicator of the financial sustainability of the program. Each year, countries report these expenditures
through the WHO/UNICEF Joint Reporting Form (JRF).
Variables 2006 2007 2008 2009 2010 2011 2012 2013 2014
32 35 38 27 40 68 99 101 N/A
Government Expenditure on RI Vaccines - US$ (JRF 6510) 500,000 140,000 360,000 360,000 295,130 159,901 397,915 635,680 1,604,940
4.05 1.10 2.73 2.65 2.11 1.11 2.70 4.23 10.47
6530) 75 100 100 100 N/A 9 11 15 34
Government Expenditure on Routine Immunization - US$ (JRF 6540) 420,000 672,990 541,520 483,556 87,647 768,239 810,078 883,891 1,342,690
All Source Expenditures on Routine Immunization - US$ (JRF 6550) N/A N/A N/A N/A 441,772 2,602,375 5,083,170 6,951,420 6,571,120
CONGO

Democratic Republic of Congo
July 2016
The Democratic Republic of the Congo is pursuing financial sustainability for its immunization services through
legislation, budget advocacy, and expenditure tracking. The Sabin Sustainable Immunization Financing (SIF)
Program began its efforts in DRC in June 2009.
DRC’s Expanded Program on Immunization (EPI) is located in the Disease Control Directorate, Ministry of Public
Health (MOPH).
DRC’s Progress to Date
Budget Advocacy
SIF Program Inputs
Over the period 2006-2014, the country’s Gross National Income rose from US$230 to $410 per capita, almost
doubling. According to the WHO/UNICEF Joint Reporting Form (JRF), the government spent $1 on routine
immunization per surviving infant in 2006. In 2014, the government spent the same amount. The government
share of total routine immunization expenditures dropped from 9 percent to 5 percent over the period. Since
2010, DRC has reported consistently on JRF financial indicators. The data suggest that DRC has not progressed
towards country ownership of its immunization program. Among SIF countries, DRC ranked 20th
in terms of
routine immunization spending per surviving infant in 2014.
THE DEMOCRATIC REPUBLIC OF CONGO'S FINANCIAL FEEDBACK REPORT, 2006-2014.
SIF provides a tool for analyzing how efficiently recent immunization budgets have been executed. In 2014, EPI
team completes annual SIF Budget Flow Analyses for 2010-14 using the SIF Budget Process Tool.
The EPI team captures subnational expenditures using a tool called Formulaire 6, which distinguishes public
from external partner contributions. In October 2015, the team analyzed the Formulaire 6 data from four districts.
Budget Advocacy
In May 2012, the National Assembly established the Parliamentary Support Network for Immunization. The
network includes around fifty Members of Parliament, ministry officials, EPI staff, other health professionals and
partners. Network members have visited eleven provinces to advocate for increased immunization budgets.
Increases have been reported in eight.
The DRC’s national parliamentary network served as a model for a similar Africa-wide effort. In February 2016,
an MP from DRC attended and signed a Parliamentary Statement in Support of the Ministerial Conference on
Immunization in Africa. The statement calls on all 47 African countries to form a Regional parliamentary
immunization support network.
Section VII, Article 204 of the Constitution empowers provinces to organize basic health services, including
immunization campaigns.
The government began drafting an immunization bill in 2012. In June 2014, work shifted from a stand-alone bill
to an immunization-related health bill. In September 2015, the committee completed the immunization-related

section of a legal proposal to draft the health bill. In March 2016, a companion national immunization policy paper
was finalized and presented with the draft bill to the National Assembly for review.
SIF Program Inputs
 March 2016: Resident Sabin Senior Program Officer co-organizes legislative consultation on immunization-
related health bill
 October 2015: Resident Sabin Senior Program Officer organizes expenditure tracking workshop
 August 2015: Resident Sabin Senior Program Officer and SIF Program Director brief the Senate Vice
Chairman and National Assembly President on immunization financing issues
 October 2013- December 2014: Resident Sabin Senior Program Officer and MP network members visit
Maniema, Orientale, Kasai-Occidental and Kasai-Oriental, Bas-Congo and Katanga provinces
 July 2013: Sabin Senior Program Officer co-facilitates provincial financial management workshop
 June 2013: Resident Sabin Senior Program Officer organizes a legislative workshop
 June 2012: DRC counterparts review Madagascar’s draft immunization law in Sabin-organized study tour
 July 2010: Resident Sabin Senior Program Officer and SIF Program Director brief authorities in Katanga and
Bas-Congo provinces
 June 2010: Resident Sabin Senior Program Officer and WHO co-organize MP briefing
 September 2009: Resident Sabin Senior Program Officer organizes first MP briefing
 June 2009: Resident Sabin Senior Program Officer and SIF Program Director introduce SIF program to DRC
government
Variables 2006 2007 2008 2009 2010 2011 2012 2013 2014
2 3 7 7 7 8 8 8 N/A
Government Expenditure on RI Vaccines - US$ (JRF 6510) 0 0 0 892,653 0 0 4,466,399 3,727,193 2,628,012
0.00 0.00 0.00 0.36 0.00 0.00 1.67 1.36 0.94
6530) 0 0 0 2 0 0 11 7 4
Government Expenditure on Routine Immunization - US$ (JRF 6540) 3,206,520 N/A 0 1,870,993 90,640 1,828,000 4,469,057 4,999,802 3,845,799
US$ per Surviving Infant 1.39 N/A 0.00 0.76 0.04 0.70 1.68 1.83 1.37
All Source Expenditures on Routine Immunization - US$ (JRF 6550) N/A N/A N/A N/A 3,774,268 5,897,937 58,202,534 75,077,165 79,543,362
Government (JRF 6560) 9 N/A 3 2 2 31 8 7 N/A
DRC

Georgia
July 2016
Georgia is reviewing existing legislation and tracking expenditures to secure sustainable financing for its
national immunization program. Sabin’s Sustainable Immunization Financing (SIF) Program began its
efforts in Georgia in July 2014.
Georgia’s National Immunization Program (NIP) is located in the National Center for Disease Control and
Public Health (NCDC), Ministry of Health.
Georgia’s Progress to Date
Budget Advocacy
SIF Program Inputs
Over the period 2006-2014, Georgia’s Gross National Income rose from US$1,680 to $3,720 per capita, a
121 percent increase. According to the WHO/UNICEF Joint Reporting Form (JRF), the Georgian
government spent $13 on routine immunization per surviving infant in 2006. By 2014, this figure had risen
to $61, more than a four-fold increase. In addition, the government share of total routine immunization
expenditures increased from 58 percent to 77 percent over the period. Since 2010, Georgia has reported
consistently on JRF financial indicators. The data suggest that Georgia is progressing towards country
ownership of its immunization program. Among SIF countries, Georgia ranked second in terms of routine
immunization spending per surviving infant in 2014.
GEORGIA’S JRF FINANCIAL FEEDBACK REPORT, 2006-2014.
The Georgian Law on Public Health mandates that the Government organize and supervise the supply,
storage, transportation, of all necessary vaccines as defined by the National Immunization Calendar. The
Law also creates healthcare provider accountability for vaccine provision by requiring that they provide
timely and comprehensive information about vaccination and submit documentation of preventative
vaccination refusals. Moving forward, the Parliamentary Health Care Committee Chairman and Deputy
Chairman have committed to building consensus to legislate obligatory immunizations.
Vaccine Financing Mechanism
Until 2010, vaccines were procured through UNICEF Supply Division. Now, Georgia oversees the purchase
of vaccines and injection supplies through a state procurement mechanism.
Budget Advocacy
In response to a proposed cut in the immunization budget in 2015, the resident Sabin Senior Program
Officer organized a national briefing. The Minister of Finance restored the budget after Members of
Parliament highlighted the country’s impending GAVI graduation and the proportionate impacts on child
health that would accompany an EPI budget cut.

SIF provides a tool for analyzing how efficiently recent immunization budgets have been executed. Using
the SIF Budget Process Tool, the NCDC team completed an analysis of the 2014 immunization budget.
The NCDC is adapting the SIF Budget Process tool to better suit local needs.
In 2016, the NCDC Deputy Director initiated work on new Results-Based Financing approach which will
analyze data from district and facility immunization managers.
SIF Program Inputs
 April 2016: Resident Sabin Senior Program Officer briefs Health Care Committee Chairman and
Deputy Chairman
 November 2015: Resident Sabin Senior Program Officer organizes national briefing
 April 2015: Resident Sabin Senior Program Officer and MOH counterparts map immunization-
related legislation
 July 2014: Resident Sabin Senior Program Officer introduces SIF program to Georgian government
Variables 2006 2007 2008 2009 2010 2011 2012 2013 2014
Government Expenditure on RI Vaccines - US$ (JRF 6510) 342000 375000 545455 951800 2059783 780300 905544 2274878 1599639
All Source Expenditures on Vaccines - US$ (JRF 6520) N/A N/A N/A N/A 2594257 1003320 1574943 3691853 2509139
6530) 71 43 63 88 79 78 57 62 64
Government Expenditure on Routine Immunization - US$ (JRF 6540) 712000 918000 1015758 1144580 2104293 4520000 1066354 2319163 3465081
All Source Expenditures on Routine Immunization - US$ (JRF 6550) N/A N/A N/A N/A 3292572 4520000 2821297 4745229 4501581
Government (JRF 6560) 58 67 68 97 64 100 38 49 77
GEORGIA

Indonesia
July 2016
Indonesia is pursuing financial sustainability for its immunization services through legislation and
expenditure tracking. The Sabin Sustainable Immunization Financing (SIF) Program began its
efforts in Indonesia in July 2013.
Indonesia’s National Immunization Program (NIP) is located in the Immunization and Quarantine
Directorate, Division of Communicable Disease Control and Environmental Health, Ministry of
Health (MOH).
Indonesia’s Progress to Date
SIF Program Inputs
Over the period 2006-2014, Indonesia’s Gross National Income rose from US$1,390 to $3,650
per capita, a 163 percent increase. According to the WHO/UNICEF Joint Reporting Form (JRF),
the Indonesian government spent $8 on routine immunization per surviving infant in 2006. By
2014, this figure had risen to $9, a 13 percent increase. While increasing in absolute terms, the
government share of total routine immunization expenditures dropped from 95 percent to 64
percent over the period. Since 2010, Indonesia has reported inconsistently on JRF financial
indicators. The data suggest that Indonesia has progressed towards country ownership of its
immunization program. Among SIF countries, Indonesia ranked 10th
in terms of routine
INDONESIA'S JRF FINANCIAL FEEDBACK REPORT, 2006-2014.
The Indonesian Health Law was passed in 2009.
In November 2014, the MOH and Ministry of Planning (MOP) began reviewing all immunization-
related legislation.
executed. MoH counterparts used the SIF budget flow analysis tool to analyze 2011-2014
immunization budgets.
SIF Program Inputs
 July 2014: Indonesian counterparts join Cambodian, Mongolian, Nepali and Sri Lankan
peers in a Sabin-sponsored peer review workshop
 November 2013: Indonesian counterparts join Vietnamese and Mongolian peers in Sabin-
sponsored peer review workshop

 July 2013: Sabin Senior Program Officer and SIF Program Director introduce SIF program
to Indonesian government
Variables 2006 2007 2008 2009 2010 2011 2012 2013 2014
Government Expenditure on RI Vaccines - US$ (JRF 6510) 36,376,527 34,022,328 32,768,672 36,382,034 44,189,088 61,795,661 60,251,472 50,804,809 37,565,525
All Source Expenditures on Vaccines - US$ (JRF 6520) N/A N/A N/A N/A N/A 61,795,661 N/A 59,942,908 48,313,540
US$ per Surviving Infant N/A N/A N/A N/A N/A 13.60 N/A 12.06 9.52
6530) 87 92 100 100 N/A 100 100 85 78
Government Expenditure on Routine Immunization - US$ (JRF 6540) 34,516,798 119,597,657 32,910,671 44,550,470 8,634,252 68,509,010 N/A 18,127,289 47,323,717
US$ per Surviving Infant 7.78 26.85 7.36 9.88 1.89 15.08 N/A 3.65 9.32
All Source Expenditures on Routine Immunization - US$ (JRF 6550) N/A N/A N/A N/A 10,418,766 69,083,024 N/A 30,080,098 73,482,802
US$ per Surviving Infant N/A N/A N/A N/A 2.28 15.21 N/A 6.05 14.48
Government (JRF 6560) 95 86 100 80 83 99 N/A 60 64
Data Accuracy Indicators Met* 0/1 1/1 1/1 1/1 2/3 6/6 N/A 4/6 6/6
Sources: 1 World Bank; 2 UN Population Division; 3 WHO/UNICEF Joint Reporting Form (JRF); 4 WHO - National Health Accounts
INDONESIA

Kenya
July 2016
Kenya is pursuing financial sustainability for its immunization services primarily through a new
financing arrangement. The Sabin Sustainable Immunization Financing (SIF) Program began its
efforts in Kenya in October 2008.
Kenya’s Expanded Program on Immunization (EPI) is in the Immunization Division, Department
of Family Health, Ministry of Public Health and Sanitation (MOPHS).
Kenya’s Progress to Date
SIF Program Inputs
Over the period 2006-2014, Kenya’s Gross National Income rose from US$600 to $1,290 per
capita, a 115 percent increase. According to the WHO/UNICEF Joint Reporting Form (JRF), the
Kenyan government spent $4 on routine immunization per surviving infant in 2006. Government
contributions fluctuated over the period but remained at $4 per surviving infant in 2014. The
government share of total routine immunization expenditures rose from 10 percent to 14 percent
over this period. Since 2010, Kenya has reported inconsistently on JRF financial indicators. The
data suggest that Kenya has progressed towards country ownership of its immunization program.
Among SIF countries, Kenya ranked 18th in terms of routine immunization spending per surviving
infant in 2014.
KENYA’S JRF FINANCIAL FEEDBACK REPORT, 2006-2014.
In 2010, the Health Sector Services Fund began disbursing funds, including those for
immunization, directly to county-level facilities, dispensaries, and health centers. Provincial and
district health management teams provide oversight and district-level accountants report how the
funds are used.
Faced with devolution, federal and county-level EPI authorities met to agree on financing
responsibilities between the national and subnational levels in September 2015.
In 2011, parliament began drafting a bill covering vaccines and vaccination activities. In January
2012, the MOPHS began mapping of all immunization-related legislation in Kenya.

By October 2014, two draft immunization-related bills existed: a vaccine procurement bill, which
introduces a vaccine procurement trust fund, and the general health bill, which includes a section
on vaccinations.
Recent SIF Program Inputs
 October 2015, April 2016: Kenyan counterparts join Nigerian, Kenyan, Sierra Leonean,
and Liberian peers in Sabin-sponsored peer review workshops
 September 2015: Sabin Senior Program Officer organizes county-level briefings in
Naivasha and Nairobi
 September 2010, March 2011, February 2012, September 2014: Sabin Senior Program
Officer organizes national briefings
 June 2012: Sabin Senior Program Officer and parliament organize legislative workshop
 October 2008: Sabin Senior Program Officer and SIF Program Director introduce SIF
program to Kenyan government
Variables 2006 2007 2008 2009 2010 2011 2012 2013 2014
Government Expenditure on RI Vaccines - US$ (JRF 6510) 956,742 4,273,440 N/A N/A 3,500,750 4,500,250 N/A 4,277,138 5,133,400
US$ per Surviving Infant 0.75 3.32 N/A N/A 2.57 3.25 N/A 3.01 3.57
All Source Expenditures on Vaccines - US$ (JRF 6520) N/A N/A N/A N/A 7250750 7850700 N/A 27,727,538 34,220,900
(JRF 6530) 80 N/A 100 N/A 48 57 N/A 15 15
Government Expenditure on Routine Immunization - US$ (JRF 6540) 5,417,050 10,436,900 7,063,500 N/A 6,263,408 6,463,301 N/A 5,739,293 5,311,200
US$ per Surviving Infant 4.27 8.12 5.38 N/A 4.59 4.67 N/A 4.04 3.69
All Source Expenditures on Routine Immunization - US$ (JRF 6550) N/A N/A N/A N/A 7,363,408 7,373,400 N/A 39,255,293 38,417,200
Government (JRF 6560) 10 10 90 10 85 88 N/A 15
Indicator
Removed
Data Accuracy Indicators Met* 1/1 1/1 N/A N/A N/A 5/6 N/A 6/6 5/5
KENYA
Reported JRF Financial Indicators 6510-6560 [2]

Liberia
July 2016
Liberia is pursuing financial sustainability for its immunization services through legislation and expenditure
tracking. The Sabin Sustainable Immunization Financing (SIF) Program began its efforts in Liberia in
November 2008.
Liberia’s Expanded Program on Immunization (EPI) is located in the Preventative Services Division, Health
Services Department, Ministry of Health & Social Welfare (MOHSW).
Liberia’s Progress to Date
Budget Advocacy
SIF Program Inputs
Over the period 2006-2014, Liberia’s Gross National Income rose from US$130 to $370 per capita, a 185
percent increase. According to the WHO/UNICEF Joint Reporting Form (JRF), the Liberian government
spent $1 on routine immunization per surviving infant in 2006. By 2014, this figure had doubled to $2. In
addition, the government share of total routine immunization expenditures rose from 3 percent to 6 percent
over this period. Since 2010, Liberia has reported inconsistently on JRF financial indicators. The data
nonetheless suggest that Liberia has progressed towards country ownership of its immunization program.
Among SIF countries, Liberia ranked 19th in terms of routine immunization spending per surviving infant in
2014.
LIBERIA’S JRF FINANCIAL FEEDBACK REPORT, 2006-2014.
Budget Advocacy
In June 2012, Liberian parliamentarians visited Uganda to study its Parliamentary Network for
Immunization. The same MPs formed the Liberian Parliamentary Network for Immunization in March 2013.
The Network participates directly in annual national budget negotiations.
In September 2015, Network members briefed House and Senate Health Committee members on
immunization during the FY2016 budgetary preparations.
Chapter II, Article 8 of the 1984 Liberian Constitution states that guaranteeing a healthy citizenry is one of
the essential government policy goals. Many current childhood immunization policies stem from the 1956
Public Health Law, which offers several relevant provisions but no immunization financing clauses.
The Parliamentary Network for Immunization and the MOHSW began preparing a draft immunization bill in
March 2013. The following June, the draft bill was submitted to the Senate. In July and October 2013, a
few amendments were made following a public vetting process. The Senate approved the bill for passage
in May 2014. The bill awaits consideration by the House of Representatives.

SIF Program Inputs
 October 2015, April 2016: Liberian counterparts join Nigerian, Sierra Leonean, Kenyan, and
Ugandan peers in Sabin-sponsored peer review workshops
 August 2015: Liberian counterparts join Nigerian and Sierra Leonean peers in Sabin-sponsored
peer exchange workshop
 November 2013, May 2015: Liberian counterparts join Sierra Leonean peers in Sabin-sponsored
 March 2013: Sabin Senior Program Officer organizes MP briefing
 June 2012: Liberian MP and MOHSW counterpart survey Ugandan MP network and immunization
bill in Sabin-sponsored peer exchange to Uganda
 August 2010: Liberian Ministry of Finance officer visits Uganda in Sabin-sponsored study tour
 July 2009: Sabin Senior Program Officer and EPI counterparts co-organize briefing in Margibi
county
 November 2008: Sabin Senior Program Officer and SIF Program Director introduce SIF program
to Liberian government
and an indicator of the financial sustainability of the program. Each year, countries report these
Variables 2006 2007 2008 2009 2010 2011 2012 2013 2014
Government Expenditure on RI Vaccines - US$ (JRF 6510) 0 6,026 177,125 N/A 121,980 155,623 158,236 120,132 232,500
US$ per Surviving Infant 0 0.05 1.39 N/A 0.91 1.15 1.14 0.86 1.65
All Source Expenditures on Vaccines - US$ (JRF 6520) N/A N/A N/A N/A 2132880 171432 1,881,164 2,564,374 4,329,252
(JRF 6530) 0 1 4 N/A 6 91 8 5 5
Government Expenditure on Routine Immunization - US$ (JRF 6540) 100,000 66,000 217,125 N/A N/A N/A N/A 406,012 265,591
US$ per Surviving Infant 0.83 0.54 1.71 N/A N/A N/A N/A 2.90 1.88
All Source Expenditures on Routine Immunization - US$ (JRF 6550) N/A N/A N/A N/A N/A N/A N/A 1,425,430 4,520,173
US$ per Surviving Infant N/A N/A N/A N/A N/A N/A N/A 10.19 32.03
Government (JRF 6560) 3 3 2 N/A N/A N/A N/A 28
Indicator
Removed
Data Accuracy Indicators Met* 2/2 2/2 2/2 N/A 1/1 3/3 1/1 5/6 5/5
LIBERIA

Madagascar
July 2016
Madagascar is pursuing financial sustainability for its immunization services primarily through legislation.
The Sabin Sustainable Immunization Financing (SIF) Program began its efforts in Madagascar in December
2009.
Madagascar’s Expanded Program on Immunization (EPI) is located in the Immunization Department,
Maternal and Child Health Directorate, General Secretariat, Ministry of Health & Family Planning (MOHFP).
Madagascar’s Progress to Date
Budget Advocacy
SIF Program Inputs
Over the period 2006-2013, Madagascar’s Gross National Income rose from US$280 to $440 per capita, a
57 percent increase. According to the WHO/UNICEF Joint Reporting Form (JRF), the Malgache
government spent $1 on routine immunization per surviving infant in 2006. By 2013, this figure had risen to
$3, a 300 percent increase. While increasing in absolute terms, the government share of total routine
immunization expenditures dropped from 13 percent to 6 percent over the period. Since 2010, Madagascar
has reported inconsistently on JRF financial indicators. The data nonetheless suggest that Madagascar
has progressed towards country ownership of its immunization program.
MADAGASCAR’S JRF FINANCIAL FEEDBACK REPORT, 2006-2014.
Immunization is a mandatory expense for the Ministry of Finance and Budget. The government uses a
Monthly Activity Report (rapport mensuel d’activité, RMA) to track expenditures from the health district level.
Section II (Economic, Social and Cultural Rights and Duties), Article 19 of the 1992 Constitution of
Madagascar states: “The State shall recognize every individual’s right to protection of his health, starting
from conception.” Decree 2003‐1162 (Organisant la Médecine d’Entreprise), Article 13, Chapter II, states
that corporate medical providers must offer preventive care to workers and their families.
In February 2012, an immunization law drafting committee was established. The committee finalized a draft
immunization bill thereafter. Peers from other Francophone African SIF countries proposed amendments
to the draft bill in November 2012. The committee incorporated these amendments.
In June 2015, Members of Parliament (MPs) and government officials worked on the bill.
Budget Advocacy
In February 2016, two Malgache MPs attended and signed a Parliamentary Statement in Support of the

SIF Program Inputs
 September 2010, November 2012, December 2014, June 2016: Cameroonian counterparts join
DRC, Congo, Malgache, Malian, and Senegalese peers in Sabin-sponsored peer review
workshops
 August 2015: Sabin Senior Program officer convenes NAHC Chairman, Senatorial Secretary’s
Cabinet Chief, and seven Committee Members to track progress towards establishment of an
advocacy committee
 June 2015: Sabin Senior Program Officer co-organizes third legislative workshop
 June 2012: Malgache counterparts share draft immunization bill with DRC officials in Sabin-
sponsored study tour
 November 2011: Sabin Senior Program Officer organizes national advocacy and legislative
workshop
 June 2011: Sabin Senior Program Officer and SIF Program Director organize MP briefing
 February 2011: Sabin Senior Program Officer organizes MP briefing
 December 2009: Sabin Senior Program Officer and SIF Program Director introduce SIF program
to Malgache government
Variables 2006 2007 2008 2009 2010 2011 2012 2013 2014
8 10 10 9 11 10 8 12 N/A
Government Expenditure on RI Vaccines - US$ (JRF 6510) 655,000 770,132 783,133 752,471 381,163 874,747 614,218 1,907,315 337,615
1.03 1.18 1.18 1.11 0.55 1.24 0.85 2.58 0.45
6530) 18.00 26.00 10.00 9.00 5.00 21.00 4.00 6.00 2.00
Government Expenditure on Routine Immunization - US$ (JRF 6540) 677,525 1,190,459 1,340,822 2,912,052 413,955 911,352 1,296,420 2,126,347 N/A
US$ per Surviving Infant 1.06 1.82 2.02 4.30 0.60 1.29 1.79 2.88 N/A
All Source Expenditures on Routine Immunization - US$ (JRF 6550) N/A N/A N/A N/A 8,534,024 3,936,215 19,518,800 37,136,162 N/A
US$ per Surviving Infant N/A N/A N/A N/A 12.34 5.57 27.02 50.23 N/A
Data Accuracy Indicators Met* 1/1 1/1/ 1/1 1/1 6/6 5/6 6/6 6/6 4/4
MADAGASCAR

Mali
July 2016
Mali is pursuing financial sustainability for its immunization services through budget advocacy and expenditure
tracking. The Sabin Sustainable Immunization Financing (SIF) Program began its efforts in Mali in December
2008.
Mali’s Expanded Program on Immunization (EPI) is located in the Immunization Section, Disease Control &
Prevention Division, National Health Directorate, Ministry of Health (MOH).
Mali’s Progress to Date
Expenditure tracking
Budget Advocacy
SIF Program Inputs
Over the period 2006-2014, Mali’s Gross National Income rose from US$470 to $720 per capita, a 53 percent
increase. According to the WHO/UNICEF Joint Reporting Form (JRF), the Malian government spent less than
$1 on routine immunization per surviving infant in 2006. In 2013, this figure rose to $8, an eight-fold increase. In
addition, the government share of total routine immunization expenditures rose from 7 percent to 17 percent over
the period. Since 2010, Mali has reported inconsistently on JRF financial indicators. The data suggest that Mali
has progressed towards country ownership of its immunization program. Among SIF countries, Mali ranked 12th
MALI’S JRF FINANCIAL FEEDBACK REPORT, 2006-2014.
Chapter III, Article 17 of Mali’s Constitution (1992) recognizes the citizens’ right to health.
In August 2012, government and parliament finalized a draft immunization bill. Amendments were incorporated
the following November. The draft bill was sent to the Health Minister in July 2014.
EPI team utilized this tool to analyze the program’s 2010-2012 budget performance.
Budget Advocacy
The National Assembly established a Parliamentary Network for Immunization in January 2013.In August 2015,
sixty MPs belonged to the Network.
In July 2015, the EPI Manager analyzed budget execution, presented corrected expenditure figures to the Inter-
Agency Coordinating Committee and used the information to secure a budget increase for FY2016.
In February 2016, a Malian MP attended and signed a Parliamentary Statement in Support of the Ministerial
Conference on Immunization in Africa.

SIF Program Inputs
 March 2016: Senior Program Officer, EPI Manager, Ministry of Health Budget Office Director, and parliament
co-organize Action Plan meeting
 September 2015: Senior Program Officer briefs EPI Manager
 June 2015: Malian EPI officials join Senegalese and Cameroonian peers in Sabin-sponsored resource
tracking peer exchange
 August, December 2009, October 2011, January, February 2013, November 2014: Sabin Senior Program
Officer organizes MP briefing
 December 2013: Sabin Senior Program Officer and WHO counterparts co-organize cMYP workshop
 May 2012: Sabin Senior Program Officers from Cameroon and DRC, WHO, UNICEF, and AMP co-organize
cMYP workshop
 December 2009: Malian counterparts join Senegalese legislators in MP briefing
 December 2008: Sabin Senior Program Officer, SIF Program Director introduce SIF program to Malian
government
Variables 2006 2007 2008 2009 2010 2011 2012 2013 2014
16 19 21 21 19 23 16 21 N/A
Government Expenditure on RI Vaccines - US$ (JRF 6510) 212,496 1,609,060 2,356,940 3,155,950 5,577,700 N/A 2,051,456 2,717,494 4,816,882
0.39 2.91 4.11 5.33 9.16 N/A 3.23 4.20 7.31
All Source Expenditures on Vaccines - US$ (JRF 6520) N/A N/A N/A N/A 27,557,500 N/A 16,676,881 19,875,721 19,811,382
US$ per Surviving Infant N/A N/A N/A N/A 45.28 N/A 26.24 30.71 30.07
6530) 77 100 20 100 20 N/A 12 14 24
Government Expenditure on Routine Immunization - US$ (JRF 6540) 127,498 1,793,510 1,177,220 61,228 6,066,690 N/A 2,193,072 13,145 5,482,191
US$ per Surviving Infant 0.24 3.24 2.05 0.10 9.97 N/A 3.45 0.02 8.32
All Source Expenditures on Routine Immunization - US$ (JRF 6550) N/A N/A N/A N/A 28,046,500 N/A 30,669,803 26,070,948 33,078,851
Government (JRF 6560) 57 36 44 13 18 N/A 13 16 N/A
Data Accuracy Indicators Met* 0/1 1/1 0/1 0/1 6/6 N/A 6/6 5/6 5/5
MALI

Mongolia
July 2016
Mongolia is pursuing financial sustainability for its immunization services primarily through expenditure
tracking. The Sabin Sustainable Immunization Financing (SIF) Program began its efforts in Mongolia in
June 2012.
Mongolia’s National Immunization Program (NIP) is located in the National Center for Communicable
Disease Control, Ministry of Health (MOH).
Mongolia’s Progress to Date
Over the period 2006-2014, Mongolia’s Gross National Income rose from US$1,120 to $4,320 per capita,
a 286 percent increase. According to the WHO/UNICEF Joint Reporting Form (JRF), the Mongolian
government spent less than $1 on routine immunization per surviving infant in 2006. The government
reported spending the same amount in 2014. The government share of total routine immunization
expenditures dropped from 29 percent to 0 percent over the period. Since 2010, Mongolia has reported
inconsistently on JRF financial indicators. The data suggest that Mongolia has not progressed towards
country ownership of its immunization program. Among SIF countries, Mongolia ranked 21st in terms of
routine immunization spending per surviving infant in 2014.
MONGOLIA’S JRF FEEDBACK REPORT ON FINANCIAL INDICATORS, 2006-2014.
The Constitution of Mongolia (1992) guarantees certain rights and freedoms, including “the right to the
protection of health and health care. The procedure and conditions of free medical aid shall be defined by
law.” In Mongolia, legislation has to determine from time to time what health services should be free and to
whom.
Mongolia’s Government passed the Law on Immunization in April 2000. The law regulates activities for the
“prevention of the Mongolia population from and immunization against infectious diseases.” An
Immunization Fund was later established under this law to mobilize and manage funds for immunization
from various sources. The Immunization Law was amended in 2010.
Adopted in March 2001, Government Resolution 67 approved regulations establishing the Immunization
Fund and its operations. The Fund was established as an independent legal entity governed by a Fund
Council. The Immunization Fund finances routine, non-routine and emergency vaccines and organizes the
transportation of routine and non-routine vaccines to local centers.
In May and November 2014, Mongolia’s Tax Department (Ministry of Finance), National Department of
Communicable Diseases (NCCD) and two parliamentarians visited two aimags (provinces), Hovd and
Umnogobi, to brief local authorities on federal immunization and health expenditures and to propose local
expenditure tracking.

In May and September 2015, NCCD, MOF and parliamentarian counterparts carried out similar resource
tracking activities in two additional aimags, Huvsgul and Hentii.
In February 2016, NCCD, MOF and a parliamentarian joined local officials in Hentii to examine sub-aimag
(soum) health expenditure flows.
SIF Program Inputs
 July 2014, May 2016: Mongolian counterparts join Nepalese, Sri Lankan, Cambodian, Indonesian
and Vietnamese peers in Sabin-sponsored peer review workshops
 May and November 2014, May and September 2015: Sabin Senior Program Officer joins Sabin-
sponsored subnational resource tracking workshops
 February 2016: Resident Sabin Senior Program Officer convenes Mongolian counterparts to
review, plan subnational immunization resource tracking activities
 January 2013, November 2015: Resident Sabin Senior Program Officer organizes parliamentary
briefings
 October 2014: Mongolian counterparts host Ugandan and Vietnamese peers in Sabin-sponsored
peer exchange
 November 2013: Mongolian counterparts join Mongolian and Indonesian delegates in Sabin-
sponsored peer exchange workshop
 June 2012: Resident Sabin Senior Program Officer and SIF Program Director introduce SIF
program to Mongolian government
Variables 2006 2007 2008 2009 2010 2011 2012 2013 2014
41.7 55.2 84.0 66.8 89.1 120.2 145.7 147 N/A
Government Expenditure on RI Vaccines - US$ (JRF 6510) 4,500 510,169 1,271,186 1,082,488 1,307,970 1,474,722 1,344,102 2,373,153 4
0.10 10.24 23.90 19.10 21.83 22.80 20.55 35.14 0.00
All Source Expenditures on Vaccines - US$ (JRF 6520) N/A N/A N/A N/A 1,634,840 2,138,556 1,802,974 2,815,597 5
6530) N/A 19 61 64 80 69 75 84 88
Government Expenditure on Routine Immunization - US$ (JRF 6540) 1,640 190,000 183,613 528,649 10,277 1,539,363 1,357,274 2,668,095 4
All Source Expenditures on Routine Immunization - US$ (JRF 6550) N/A N/A N/A N/A 43,455 2,242,682 1,829,472 2,821,634 6
Government (JRF 6560) 29 19 22 46 24 69 74 95 74
MONGOLIA

Nepal
July 2016
Nepal is pursuing financial sustainability for its immunization services through legislation, expenditure tracking
and new financing arrangements. The Sabin Sustainable Immunization Financing (SIF) Program began its
efforts in Nepal in December 2008.
National Immunization Program
The Nepali National Immunization Program (NIP) is in the Child Health Division (CHD), Department of Health
Services (DOHS), Ministry of Health and Population (MOHP).
Nepal’s Progress to Date
SIF Program Inputs
Over the period 2006-2014, Nepal’s Gross National Income rose from US$350 to US$730 per capita, more than
doubling. According to the WHO/UNICEF Joint Reporting Form (JRF), the Nepali government spent $12 on
routine immunization per surviving infant in 2006. By 2014, this figure had fallen to $4, a 67 percent decrease. In
addition, the government share of total routine immunization expenditures dropped from 63 percent to 22 percent
over the period. Since 2010, Nepal has reported inconsistently on JRF financial indicators. The data suggest that
Nepal has not progressed towards country ownership of its immunization program. Among SIF countries, Nepal
ranked 17th
NEPAL’S JRF FINANCIAL FEEDBACK REPORT, 2006-2014.
The Constitution of Nepal, enacted on 20 September 2015, stipulates in Article 51(h)(5) that, “[t]he State shall
gradually increase necessary investment in the public health sector in order to make citizens healthy,” and in
Article 51(h)(8) that “[t]he State shall gradually increase investment in the health sector and make it service-
oriented by regulating and managing the investment of the private sector in it.”
In 2010, MPs signed the Kathmandu Declaration, which called for the passage of immunization-related
legislation.
Nepal’s government and parliament drafted the immunization bill in 2011-2014. The bill was passed in January
2016. The President enacted the bill 22 days later
In February 2016, four committees were assigned to develop regulations and oversee the implementation of
the immunization law
Both a public immunization fund — the National Immunization Fund — and a public-private immunization fund
— the Sustainable Immunization Support Fund — are under development.
National Immunization Fund: An earmarked tax is proposed. Any unused health budget funds will be rolled into
the fund at the end of each fiscal year.
Sustainable Immunization Support Fund: Being capitalized by Rotary and Lions club members, other private
domestic stakeholders. Donors to the private fund will be given tax credits.

Tracking Expenditure Flows
NIP team used this tool to analyze the performance of the Program’s 2011-2013 budgets.
In June 2015, the NIP team distributed expenditure tracking guidelines to district immunization authorities.
In September 2015, the district authorities submitted budget data to the NIP team.
SIF Program Inputs
 July 2014, May 2016: Nepalese counterparts join Sri Lankan, Cambodian, Mongolian, Vietnamese,
and Indonesian delegates in Sabin-sponsored peer review workshops
 March 2013, January, March 2016: Parliamentary Coalition for Immunization, Ministry of Finance
Revenue Management Division, Rotary leaders discuss immunization financing strategies
 March 2012, January 2013, June 2014, September 2015: Resident Senior Program Officer organizes
legislative workshops
 February, June 2014, June 2015: Resident Sabin Senior Program Officer and Child Health Division,
Ministry of Health and Population, organize subnational resource tracking workshop
 September 2009, January 2010, May 2014, September 2014, December 2014, April 2015: Resident
Sabin Senior Program Officer, Ministry of Health and Population organize parliamentary briefings
 February 2014, September 2015: Senior Program Officer organizes media briefings
 October 2012: Nepalese counterparts join Cambodian peers in peer exchange workshop
 May 2012: Senior Program Officer, UNICEF, and Nepalese government co-organize two subnational
briefings
 March 2012: Nepalese counterparts join Sri Lankan and Cambodian delegates in Sabin-sponsored
 December 2008: Resident Sabin Senior Program Officer and SIF Program Director introduce SIF
program to Nepalese government
Variables 2006 2007 2008 2009 2010 2011 2012 2013 2014
6.9 8.3 10.6 11.5 14.8 18.8 14.2 17.0 N/A
Government Expenditure on RI Vaccines - US$ (JRF 6510) 798,025 1,794,132 3,129,007 1,946,871 3,918,544 1,781,114 1,963,750 2,170,476 1,904,662
1.21 2.74 4.85 3.07 6.31 2.93 3.36 3.82 3.43
6530) 18 29 43 16 39 20 45 36 29
Government Expenditure on Routine Immunization - US$ (JRF 6540) 8,537,030 2,094,322 4,576,317 2,044,094 1,040,993 3,053,760 19,944,517 4,518,679 2,175,804
All Source Expenditures on Routine Immunization - US$ (JRF 6550) N/A N/A N/A N/A 12,801,592 14018614.3 23689422.2 9,754,334 9,735,011
Government (JRF 6560) 63 25 30 15 8 22 84 46 22
NEPAL

Nigeria
July 2016
Nigeria is pursuing financial sustainability for its immunization services through a new financing
arrangement, budget advocacy and legislation. The Sabin Sustainable Immunization Financing (SIF)
Program began its efforts in Nigeria in February 2009.
The National Program on Immunization (NPI) is located in the National Primary Health Care Development
Agency (NPHCDA), a parastatal institution under the Federal Ministry of Health.
Nigeria’s Progress to Date
Budget Advocacy
SIF Program Inputs
Over the period 2006-2014, Nigeria’s Gross National Income rose from US$840 to $2,970 per capita, a 254
percent increase. According to the WHO/UNICEF Joint Reporting Form (JRF), the Nigerian government
spent $17 on routine immunization per surviving infant in 2006. By 2014, this figure had fallen to $8, a 53
percent decrease. In addition, the government share of total routine immunization expenditures dropped
from 87 percent to 24 percent over the same period. Since 2010, Nigeria has reported inconsistently on
JRF financial indicators. The data suggest that Nigeria has not progressed towards country ownership of
its immunization program. Among SIF countries, Nigeria ranked 13th in terms of routine immunization
NIGERIA’S JRF FINANCIAL FEEDBACK REPORT, 2006-2014.
A Public Health Fund was established by the National Health Law in February 2014. The Fund is to be
financed by contributions from federal and state revenues.
In 2015, the Nigerian National Immunization Financing Task Force (NIFT) was established. One of the
NIFT’s main directives is to establish an external public-private partnership Immunization Financing Trust
Fund (IFTF) to complement the Public Health Fund.
Chapter I, Part 1, Article 17 of Nigeria’s 1999 Constitution states: “The State shall direct its policy towards
ensuring that there are adequate medical and health facilities for all persons.”
Parliament began drafting the National Health Bill in 2004. In 2013, the Senate Health Committee inserted
a provision guaranteeing public vaccine financing. The Bill was passed by Congress in February 2014 and
approved by the President in December 2014.

Budget Advocacy
In 2015, NIFT began sensitizing domestic stakeholders and channeling advocacy messages on sustainable
immunization financing through local and social media.
SIF Program Inputs
 October 2015, April 2016: Nigerian counterparts join Kenyan, Ugandan, Liberian, and Sierra
Leonean peers in Sabin-sponsored peer review workshops
 December 2015: Sabin Senior Program Officer invited to attend National Roundtable on Local
Vaccine Production and the National Immunization Financing Trust Fund
 August 2015: Nigerian counterparts join Sierra Leonean and Liberian peers in Sabin-sponsored
 October 2010: Sabin Senior Program Officer and SIF Program Director organize parliamentary
briefing
 February 2009: Sabin Senior Program Officer and SIF Program Director introduce SIF program to
Nigerian government
Variables 2006 2007 2008 2009 2010 2011 2012 2013 2014
Total Government Expenditure on Health in US$ per capita 20.1 26.8 32.5 23.2 21 28.9 28.2 26.2 N/A
Government Expenditure on RI Vaccines - US$ (JRF 6510) 26,133,100 N/A 21,000,000 11,920,800 14,400,000 N/A N/A 40,629,508 37,227,051
US$ per Surviving Infant 4.98 N/A 3.84 2.13 2.51 N/A N/A 6.59 5.91
All Source Expenditures on Vaccines - US$ (JRF 6520) N/A N/A N/A N/A 20290900 N/A N/A 73,764,508 90,962,051
US$ per Surviving Infant N/A N/A N/A N/A 3.54 N/A N/A 11.97 14.44
(JRF 6530) 100 N/A 90 74 71 N/A N/A 55 41
Government Expenditure on Routine Immunization - US$ (JRF 6540) 89,599,000 N/A N/A N/A 23,825,400 N/A N/A N/A 49,205,698
US$ per Surviving Infant 17.07 N/A N/A N/A 4.15 N/A N/A N/A 7.81
All Source Expenditures on Routine Immunization - US$ (JRF 6550) N/A N/A N/A N/A 26,836,300 N/A N/A N/A 204,675,066
US$ per Surviving Infant N/A N/A N/A N/A 4.68 N/A N/A N/A 32.50
Government (JRF 6560) 87 N/A 70 N/A 89 N/A N/A N/A
Indicator
Removed
Data Accuracy Indicators Met* 1/1 N/A N/A N/A 5/5 N/A N/A 4/4 5/5
NIGERIA

Senegal
July 2016
Senegal is pursuing financial sustainability for its immunization services primarily through budget advocacy.
The Sabin Sustainable Immunization Financing (SIF) Program began its efforts in Senegal in December
2008.
Senegal’s Expanded Program on Immunization (EPI) is located in the Medical Prevention Department of
the Ministry of Health and Prevention (MOHP).
Senegal’s Progress to Date
Budget Advocacy
SIF Program Inputs
Over the period 2006-2014, Senegal’s Gross National Income rose from US$800 to $1,050 per capita, a
31 percent increase. According to the WHO/UNICEF Joint Reporting Form (JRF), the Senegalese
government spent $4 on routine immunization per surviving infant in 2006. Senegal spent the same amount
in 2014. The government share of total routine immunization expenditures dropped from 58 percent to 8
percent over the period. Since 2010, Senegal has reported inconsistently on JRF financial indicators. The
data suggest that Senegal has not progressed towards country ownership of its immunization program.
Among SIF countries, Senegal ranked 16th in terms of routine immunization spending per surviving infant
in 2014.
SENEGAL’S JRF FINANCIAL FEEDBACK REPORT, 2006-2014.
An MoH steering committee began developing a private immunization trust fund in April 2011.
Chapter I, Article 7 of the Senegalese Constitution (2001) guarantees citizens the right to health,
and. Article 17 guarantees that the state will provide health services to families.
In November 2012, a drafting committee began drafting a national immunization bill. The bill was later
amended to incorporate suggestions from a Sabin-sponsored peer exchange workshop.
In October 2015, the immunization law project was inserted as an activity in the country’s comprehensive
multi-year plan (cMYP).
In January 2016, The Ministries of Health and Finance began reviewing the draft bill.
In February 2016, MPs and MOH counterparts agree to insert the draft immunization law into a draft
universal health care law.
Budget Advocacy
In January 2015, a Parliamentary Coalition for Immunization was established.

In July 2015, the EPI team and Parliamentary Coalition for Immunization convinced the Finance Minister to
increase the 2016 immunization budget by 83 percent.
In February 2016, a Senegalese MP attended and signed a Parliamentary Statement in Support of the
SIF Program Inputs
 September 2010, November 2012, December 2014, June 2016: Cameroonian counterparts join
DRC, Congo, Malgache, Malian, and Senegalese peers in Sabin-sponsored peer review
workshops
 August, December 2009, September 2010, June, July 2013, November 2014, January, November
2015, February, April 2016: Sabin Senior Program Officer organizes parliamentary briefings
 October 2015: Sabin Senior Program Officer co-organizes GVAP/cMYP workshop
 June 2015: Malian and Cameroonian counterparts join Senegalese peers in Dakar for a Sabin-
sponsored resource tracking peer exchange
 May 2012, November 2013: Sabin Senior Program Officer, MOH partner agency counterparts co-
organize immunization financing workshop
 December 2008: Sabin Senior Program Officer, SIF Program Director introduce SIF program to
Senegalese government
Variables 2006 2007 2008 2009 2010 2011 2012 2013 2014
25 22 28 25 24 25 22 24 N/A
Government Expenditure on RI Vaccines - US$ (JRF 6510) N/A 1,709,620 2,001,270 1,736,050 1,639,610 1,856,220 1,018,136 2,012,336 2,272,920
N/A 4.11 4.69 3.95 3.61 3.97 2.08 3.96 4.32
6530) 37 31 100 17 100 32 27 27 8
Government Expenditure on Routine Immunization - US$ (JRF 6540) 1,561,120 5,430,560 1,700,000 51,061 1,639,610 N/A 7,980,174 881,332 2,272,920
US$ per Surviving Infant 3.80 13.05 3.98 0.12 3.61 N/A 16.30 1.73 4.32
All Source Expenditures on Routine Immunization - US$ (JRF 6550) N/A N/A N/A N/A 1,639,610 N/A 26,466,465 5,925,873 27,587,200
SENEGAL

Sierra Leone
2016
Sierra Leone is pursuing financial sustainability for its immunization services through legislation and
expenditure tracking. The Sabin Sustainable Immunization Financing (SIF) Program began its efforts in
Sierra Leone in October 2008.
Sierra Leone’s Expanded Program on Immunization (EPI) is located in the Medical Services Directorate,
Primary Health Care Division, Ministry of Health and Sanitation (MOHS).
Sierra Leone’s Progress to Date
Budget Advocacy
SIF Program Inputs
Over the period 2006-2014, Sierra Leone’s Gross National Income rose from US$330 to $720 per capita,
more than doubling. According to the WHO/UNICEF Joint Reporting Form (JRF), the Sierra Leonean
government spent less than $1 on routine immunization per surviving infant in 2007. By 2014, this figure
had risen to $7. In addition, the government share of total routine immunization expenditures rose from 0
percent to 22 percent over the period. Since 2010, Sierra Leone has reported inconsistently on JRF financial
indicators. The data suggest that Sierra Leone has progressed towards country ownership of its
immunization program. Among SIF countries, Sierra Leone ranked 14th in terms of routine immunization
SIERRA LEONE'S JRF FINANCIAL FEEDBACK REPORT, 2006-2014.
In June 2012, the EPI team developed a subnational expenditure tracking tool for routine immunization.
The EPI team performed partial budget flow analyses for 2010-13 using the SIF budget flow analysis tool.
District-level disbursements were included in the analyses.
Chapter II, Section 8 (Social objectives), Provision 3 of the 1991 Sierra Leonean Constitution states that
the government will ensure that all citizens have easy access to adequate medical and health facilities.
An MOHS team began drafting a cabinet paper in October 2015. The paper is to facilitate preparation and
submission of a private member’s immunization bill to Parliament.
Budget Advocacy
In January 2014, a Multi-Institutional Network on Immunization was established. Members include
representatives from MOHS, Ministry of Finance and Economic Development (MOFED), and parliament.
In July 2015, the Parliamentary Health Committee Chairman visited Bombali district to assess immunization
resource mobilization and execution.

SIF Program Inputs
 October 2015, April 2016: Sierra Leonean counterparts join Kenyan, Ugandan, Nigerian, and
Liberian peers in Sabin-sponsored peer review workshops
 August 2015: Sierra Leonean counterparts join Nigerian and Liberian peers in Sabin-sponsored
 March 2010, November 2013, May 2015: Sierra Leonean counterparts join Liberian peers in Sabin-
sponsored peer exchange workshops
 August, October, November 2009, June 2012: Resident Sabin Senior Program Officer organizes
parliamentary briefing
 November 2011: Sierra Leonean officials visit Makeni and Bo municipalities under Sabin
sponsorship
 August 2010: MOFED official surveys Ugandan budgetary strategies in Sabin-sponsored study tour
 December 2009: Liberian EPI Manager visits Sierra Leonean counterparts in Sabin-sponsored
peer exchange
 October 2008: Resident Sabin Senior Program Officer and SIF Program Director introduce SIF
program to Sierra Leonean government
Variables 2006 2007 2008 2009 2010 2011 2012 2013 2014
Government Expenditure on RI Vaccines - US$ (JRF 6510) 0 0 56,000 55,000 N/A 89,500 N/A 322,000 360,000
US$ per Surviving Infant 0 0 0.29 0.28 N/A 0.44 N/A 1.60 1.78
All Source Expenditures on Vaccines - US$ (JRF 6520) N/A N/A N/A N/A N/A 3610500 N/A 4,985,272 5,070,999
(JRF 6530) N/A 0 2 N/A N/A 2 N/A 6 7
Government Expenditure on Routine Immunization - US$ (JRF 6540) N/A 0 908,941 N/A N/A 7,837 N/A 459,907 1,395,039
US$ per Surviving Infant N/A 0 4.66 N/A N/A 0.04 N/A 2.28 6.90
All Source Expenditures on Routine Immunization - US$ (JRF 6550) N/A N/A N/A N/A N/A 3,618,337 N/A 5,283,362 6,466,038
Government (JRF 6560) N/A N/A N/A N/A N/A 0 N/A 9
Indicator
Removed
Data Accuracy Indicators Met* 1/1 1/1 1/1 N/A N/A 5/6 N/A 6/6 5/5
SIERRA LEONE

Sri Lanka
July 2016
Sri Lanka is pursuing financial sustainability for its immunization services through expenditure
tracking. The Sabin Sustainable Immunization Financing (SIF) Program began its efforts in Sri
Lanka in December 2008.
Sri Lanka’s immunization services are managed by the Epidemiology Unit, located in the Family
Health Bureau, Ministry of Health (MOH).
Sri Lanka’s Progress to Date
SIF Program Inputs
Over the period 2006-2014, Sri Lanka’s Gross National Income rose from US$1,350 to US$3,400
per capita, a 152 percent increase. According to WHO/UNICEF Joint Reporting Form (JRF), the
Sri Lankan government spent $25 on routine immunization per surviving infant in 2006. By 2014,
this figure had dropped to $19, a 24 percent decrease. While decreasing in absolute terms, the
government reported that its share of total routine immunization expenditures rose from 77
percent to 93 percent over the period. Since 2010, Sri Lanka has reported inconsistently on JRF
financial indicators. The data nevertheless suggest that Sri Lanka has progressed towards
country ownership of its immunization program. Among SIF countries, Sri Lanka ranked fifth in
terms of routine immunization spending per surviving infant in 2014.
SRI LANKA'S JRF FINANCIAL FEEDBACK REPORT, 2006-2014.
A National Immunization Policy was approved by the Ministry of Health in April 2014. Chapter 5
of the policy guarantees that the government will provide sufficient funding for the timely
procurement and supply of quality vaccines and logistical support. It further stipulates that the
government will establish a separate line item for the National Immunization Program (NIP) within
the Ministry of Health budget, and that all provincial authorities must ensure the timely availability
of adequate funds and other resources. Chapter 5 also establishes a mechanism to monitor the
financial sustainability of the NIP.

The Epidemiology (EPI) Unit examined immunization costs in Kalutara district in September
2014. The immunization costing study was expanded to include seven out of the nation’s twenty
five districts, and revealed that the estimated cost to immunize one child under five years is
about $13.
SIF Program Efforts
 July 2014, May 2016: Sri Lankan counterparts join Nepalese, Cambodian, Mongolian,
Vietnamese, and Indonesian delegates in Sabin-sponsored peer review workshops
 June 2013: Sabin Senior Program Officer organizes national briefing
 February 2013: Sabin Senior Program Officer, Ministry of Health counterparts organize
subnational briefing, propose immunization co-financing
 February 2012: Ministry of Health begins series of SIF-assisted district-level costing
studies
 February, July 2010, August 2011, March 2012: Sabin Senior Program Officer, Ministry of
Health, partner agency counterparts organize parliamentary briefings
 December 2008: Sabin Senior Program Officer and SIF Program Director introduce SIF
program to Sri Lankan government
The amount a country spends on its routine immunization program is a direct measure of
country ownership and an indicator of the financial sustainability of the program. Each year,
countries report these expenditures through the WHO/UNICEF Joint Reporting Form (JRF).
Variables 2006 2007 2008 2009 2010 2011 2012 2013 2014
27 28 31 31 37 39 34 45 N/A
Government Expenditure on RI Vaccines - US$ (JRF 6510) 1,810,416 1,553,225 40,000 2,000,000 218,013,000 2,040,225 N/A 1,961,203 4,514,300
4.94 4.28 0.11 5.53 608.82 5.77 N/A 5.84 13.77
All Source Expenditures on Vaccines - US$ (JRF 6520) N/A N/A N/A N/A 8,050,000 5,264,025 N/A 4,772,203 4,812,650
6530) 68 31 90 100 57 39 N/A 41 94
Government Expenditure on Routine Immunization - US$ (JRF 6540) 9,040,711 9,764,756 N/A 4,000,000 12,384,000 N/A N/A 13,913,997 6,139,013
US$ per Surviving Infant 24.68 26.93 N/A 11.06 34.58 N/A N/A 41.41 18.73
All Source Expenditures on Routine Immunization - US$ (JRF 6550) N/A N/A N/A N/A 16,139,721 N/A N/A 13,953,000 6,595,363
US$ per Surviving Infant N/A N/A N/A N/A 45.07 N/A N/A 41.52 20.12
Government (JRF 6560) 90 67 95 95 77 97 N/A 100 93
Data Accuracy Indicators Met* 1/1 1/1 N/A 1/1 4/6 2/2 N/A 6/6 6/6
SRI LANKA

Uganda
July 2016
Uganda is pursuing financial sustainability for its immunization services through legislation and expenditure
tracking. The Sabin Sustainable Immunization Financing (SIF) Program began its efforts in Uganda in
September 2008.
The Ugandan National Expanded Program on Immunization (UNEPI) is located in the Directorate of Clinical
and Community Services, Department of National Communicable Disease Control, Ministry of Health
(MOH).
Uganda’s Progress to Date
Budget Advocacy
SIF Program Inputs
Over the period 2006-2014, Uganda’s Gross National Income per capita doubled from US$340 to $680.
According to the WHO/UNICEF Joint Reporting Form (JRF), the Ugandan government spent $3 on routine
immunization per surviving infant in 2006. In 2014, government contributions rose to $11 per surviving
infant, more than tripling. In addition, the government share of total routine immunization expenditures rose
from 13 percent to 49 percent over the period. Since 2010, Uganda has reported inconsistently on JRF
financial indicators. The data suggest that Uganda has not progressed towards country ownership of its
immunization program. Among SIF countries, Uganda ranked eighth in terms of routine immunization
UGANDA'S JRF FINANCIAL FEEDBACK REPORT, 2006-2014.
An earmarked immunization fund is provided for in Uganda’s 2016 National Immunization Act.
The Constitution of Uganda lacks a substantive provision on the right to health; the right is mentioned under
the directive principles of government policy. Parliament has the mandate to make laws to operationalize
that constitutional right.
A desk review of immunization-related by-laws was completed in 2010. Work on an immunization bill began
in September 2011. In October 2014, Sabin arranged a study tour for a team of MPs and government
officials to Mongolia where a law and immunization fund already exist. In March 2015, the Ugandan
counterparts incorporated provisions for an immunization fund into the draft bill. The bill was sent to the
Health Committee in November, 2015, where it was approved and sent up for a full parliamentary vote. The
bill was passed the following month. The President signed the National Immunization Act into law on 10
March 2016. Regulations for implementing the law are under preparation.
Budget Advocacy
A Parliamentary Network on Immunization was established in February 2012.

SIF Program Inputs
 June 2012, October 2015, April 2016: Ugandan counterparts join Kenyan, Nigerian, Sierra
Leonean, and Liberian peers in Sabin-sponsored peer review workshops
 March 2015: Resident Sabin Senior Program Officer organizes legislative workshop
 September 2009, September, November 2014: Resident Sabin Senior Program Officer organizes
parliamentary briefings
 October 2014: Ugandan counterparts study Mongolia’s immunization law and fund in Sabin-
sponsored study tour
 February 2010, April 2012, April 2013, March 2014: Resident Sabin Senior Program Officer,
Ugandan Local Government Association, other counterparts organize national briefings
 November 2011, January 2012: Resident Sabin Senior Program Officer and ULGA co-organize
subnational briefings
 September/October 2008: Resident Sabin Senior Program Officer introduces SIF program to
Ugandan government
Variables 2006 2007 2008 2009 2010 2011 2012 2013 2014
Government Expenditure on RI Vaccines - US$ (JRF 6510) 2,000,000 2,906,977 4,413,620 2,021,228 1,639,048 2,860,099 N/A 3,006,424 4,337,739
US$ per Surviving Infant 1.66 2.36 3.49 1.55 1.23 2.09 N/A 2.10 2.96
All Source Expenditures on Vaccines - US$ (JRF 6520) N/A N/A N/A N/A 4575450 15096699 N/A 18,949,424 29,851,928
(JRF 6530) 8 15 N/A 13 36 19 N/A 16 15
Government Expenditure on Routine Immunization - US$ (JRF 6540) 3,500,000 2,965,117 939,470 3,605,904 N/A 2,031,691,005 N/A 4,987,097 16,150,943
US$ per Surviving Infant 2.90 2.41 0.74 2.77 N/A 1485.03 N/A 3.49 11.03
All Source Expenditures on Routine Immunization - US$ (JRF 6550) N/A N/A N/A N/A N/A 2,032,617,887 N/A 20,939,393 33,056,604
Government (JRF 6560) 13 15 60 21 21 100 N/A 24
Indicator
Removed
Data Accuracy Indicators Met* 1/1 1/1 0/1 1/1 N/A 6/6 N/A 6/6 5/5
UGANDA

Uzbekistan
July 2016
Uzbekistan is pursuing financial sustainability for its immunization services primarily through
legislation. The Sabin Sustainable Immunization Financing (SIF) Program began its efforts in
Uzbekistan in September 2015.
Uzbekistan’s National Immunization Program (NIP) is located in the Department of Sanitary and
Epidemiological Surveillance, Ministry of Health.
Uzbekistan’s Progress to Date
Resource Tracking
SIF Program Inputs
Over the period 2006-2014, Uzbekistan’s Gross National Income increased from US$600 to
$2,090 per capita, a 248 percent increase. According to the WHO/UNICEF Joint Reporting Form
(JRF), the Uzbekistani government spent $2 on routine immunization per surviving infant in 2006.
By 2014, this figure had risen to $13, more than a six-fold increase. In addition, the government
share of total routine immunization expenditures rose from 64 percent to 72 percent over the
period. Since 2010, Uzbekistan has reported inconsistently on JRF financial indicators. The data
nevertheless suggest that Uzbekistan has progressed towards country ownership of its
immunization program. Among SIF countries, Uzbekistan ranked seventh in terms of routine
UZBEKISTAN’S JRF FINANCIAL FEEDBACK REPORT, 2006-2014.
Uzbekistan enacted its Law on the Sanitary & Epidemiological Welfare of the Population in August
2015. The law defines the responsibilities of immunization authorities within government and is
intended to promote greater accountability.
The NIP and Ministry of Health Economics & Funding Forecasting Directorate are analyzing
immunization-related legislation.
Resource Tracking
executed. In April 2016, the NIP team completed the SIF budget flow analysis for 2010-15. The
analysis revealed the approved budget for immunizations sextupled from 2010 to 2016.

Sabin SIF country fact sheets VII.2016

Sabin SIF country fact sheets VII.2016

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Sabin SIF country fact sheets VII.2016