What is PHRplus doing in Child Health?
Providing technical assistance to the Global Alliance for Vaccines and Immunizations (GAVI) and the Vaccine Fund (VF) in support of VF activities related to immunization financing
Since 1996-97, the PHR and PHRplus projects have provided support to the GAVI Vaccine Fund on a range of immunization financing issues and the development of tools to guide donors, ministries of health and finance, and National Immunization Program (NIPs) managers in improving financial management and efficiency of immunization programs. The issue of immunization financing in developing countries is critical because, although immunization programs are viewed as some of the most cost efficient health programs, donor funding for these programs has been cut in recent years due to competing priorities, such as HIV/AIDS. Developing country NIPs are under pressure to ensure high levels of immunization coverage with shrinking budgets.
Recognizing these needs, USAID requests the PHRplus project provide to technical assistance and guidance to GAVI in several areas:
- Increased financial and economic data available for planning immunization programs and for cross-country, regional, and global comparisons and analyses.
As a requirement for receiving GAVI funds, qualifying developing countries must develop and submit Financial Sustainability Plans or FSPs, which describe the future projected funding sources of immunization programs over a five-year period. The purpose of these plans is to ensure that country resources are dedicated to ensuring ongoing immunization programs in the long term. To date, the project has provided technical assistance to Ghana, Malawi, Rwanda, Tanzania, Uganda, and Zanzibar on FSP data collection, analysis and technical review of the FSPs. Following on this work, USAID has requested the project to further provide technical support to the Expanded Programme on Immunization (EPI) in Uganda.
- Support to the World Health Organization (WHO) in the development of the Immunizations Financing Database.
The Immunization Financing (IF) Database is intended to provide a source for data and analyses of cost, expenditure, and financing data on national-level immunization programs. The IF Database can be used globally, regionally, and by countries as they plan and budget their immunization programs. Intended users of the database include policymakers, program planners, donors, and other interested parties who can use the information to guide policy and program decisions. PHRplus has provided technical input on the database and related activities by being represented on its oversight and guidance committee since 2001.
- Drawing lessons from the FSPs and subsequent reporting on implementation.
PHRplus has led the VF's efforts in the area of indicator development, monitoring, and evaluation. Project staff presented an overview of the project's work to date at the November 2003 APHA Annual Meeting.
Raising awareness in international forums of the financial implications from switching from oral polio vaccine (OPV) to inactivated polio vaccine (IPV)
As global polio eradication nears completion, the international public health community is becoming increasingly concerned with planning for steps after the world has been certified as polio-free. In light of the challenges posed by stopping polio immunizations, international immunization experts and professionals, as well as host country program managers, need to consider several factors that ultimately impact on routine immunization activities in country programs. The objectives of the PHRplus technical report, OPV vs. IPV: Past and Future Choice of Vaccine in the Global Polio Eradication Program, were to review the historical choices of the polio vaccines at different stages of polio control program; to inform policymakers in choosing appropriate vaccine strategies when poliomyelitis transmission is interrupted worldwide by analyzing the effectiveness and incremental cost of a vaccine switch in developing countries; and to provide suggestions for policymakers on the appropriate use of the results and other considerations in making their decisions of vaccine choice.
PHRplus is continuing to raise these financial issues and contribute evidence-based research to the debate on the trade-off costs of switching from OPV to IPV among national policymakers, country program managers, and international immunization experts.
Providing technical assistance to MHOs on child health and other priority health services
In collaboration with the project’s West and Central Africa program, project staff are providing input into technical assistance to Mutual Health Organizations (MHOs) in Senegal to promote priority health services. MHOs are being implemented in many low-resource countries as alternative financing mechanisms to improve access to health services. MHOs also have the potential to increase the use of priority health services, including maternal and child health services. The findings from the PHRplus MHO study will allow interventions to be designed for use by technical assistance personnel who work with MHOs to help them better ensure access to priority health services.
Other Child Health Related PHRplus Activities and Products