Uganda’s Dependence On Development Partner Support.: A Five Year Resource Tracking Study (2012-2016)
Presenter: Carol Kamya
Co-authors: Abewe Christabel, Waiswa Peter, Asiimwe Gilbert, Namugaya Faith, Opio Charles, Lagony Stephen, Muheki Charlotte.
Poster file: [download]
Background: Uganda prioritized immunization as a means to achieving SDG goal 3 in a bid to end preventable deaths of children and newborns. There have been few resource tracking efforts for routine immunization funding and expenditure. Given that several new vaccines have been introduced or are planned for introduction in Uganda, it is important to understand the trends in immunization financing. This study aimed to track and estimate the resource envelope for immunization resources in Uganda from 2012 to 2016. Methods: The Systems of Health Accounts (SHA) 2011 methodology was used to quantify and map out the resource envelope for immunization. Data were collected from government and external funders for immunization through key informant interviews using structured data collection guides coupled with document reviews. Data were coded using the SHA (2011) codes and categorized as either; financing sources, financing agents, service providers, and, health care functions. The SHA codes were further disaggregated to allow for greater detail on the types of immunization activities. Results: Over a five-year period, there was a reasonably significant increase in the resource envelope (averagely 49% increment) with the biggest increment in funding observed between 2015 and 2016. The Government of Uganda was the greatest contributor towards immunization activities from 2012 to 2014 (during the temporary Gavi funding freeze in Uganda). Gavi, the Vaccine Alliance, became the biggest contributor in 2015 and 2016 (once the funding ban was lifted). We found that National Medical Stores is currently managing most of the immunization funds with an allocation of 66% of the total funds in 2016. Further, we found that 80% of the funds were spent on facility based routine immunization specifically on human resources and outreaches. Furthermore, government health facilities provided majority of the immunization services over the five year period. (70%) Conclusion: An external partner, Gavi, is currently the major contributor to vaccines and the delivery of immunization services in Uganda. This raises sustainability concerns as well all the other challenges that come with over dependency on external funding to support a critical and essential national program such as immunization. Uganda, like other low-income countries, urgently needs to develop a sustainable system for funding immunization services.