1. Sabin peer review workshop on sustainable immunization financing Abuja, Nigeria 19-21 April 2016 Country: Liberia Case: New Financing Practices Presented By: Hon. William V. Dakel Representative House of Parliament/RL

2. Presentation Structure 1.NEW PRACTICE(S)  Description  Problems Addressed  Importance of the problem  Duration  Institutions/Organizations involved  Activities/Interventions inputs  Key individuals/units involved  Contributions to the process  Frequency of activities  Champions  Challenges and difficulties encountered 2. SIGNIFICANCE 3. COMMENTS

3. THE NEW PRACTICE - 1 DESCRIPTION OF NEW PRACTICE The Ministry of Health along with its developmental partners enhanced the capacity of the Health Financing Unit to perform the below task: o Donor Mapping; o Resource tracking of all funding into the sector; o Costing study; and o Alternative financing for health (e.g. Levying of syntax on commodities such tobacco, alcohol, etc) PROBLEMS ADDRESSED BY NEW PRACTICE o Little or no information on the actual expenditure on routine immunization o Multiple donors supporting minute component of the health sector o Limited funding for health

4. THE NEW PRACTICE - 2 IDENTIFICATION OF POROBLEM The aforementioned problems were identified through a structured study on: o Resource tracking and o Determining actual expenditure on health inclusive of routine immunization. IMPORTANCE OF PROBLEM o The current problems identified is very important as the cost of immunization is increasing as new vaccines and technologies are being introduce. Therefore, the need for building a strong investment case for increase budgetary support for immunization a cost effective public health intervention cannot be over emphasized. DURATION OF NEW PRACTICE 2013 – TO DATE.

5. THE NEW PRACTICE - 3 INSTITUTIONS AND ORGANIZATIONS INVOLVED Research Unit, Health Financing Unit, Office of Financial Management, County Health Teams, USAID and WHO ROLE OF EACH ORGANIZATION/ INSTITUTION All organization participated in a well-coordinated manner with Research and Health Financing being the leads. ACTIVITIES/ INTERVENTIONS/ INPUTS o Establishment of a Technical Working Group (TWG, Chaired: Research; Co-chaired Health Financing) o Development and finalization of ToR o Adapted study protocol o Recruited and trained assessors and supervisors o Monitoring and Supervision o Report writing

6. THE NEW PRACTICE - 4 o KEY INDIVIDUALS/ UNITS INVOLVED  Research Unit  Health Financing Unit  Office of Financial Management (OFM) Unit o CONTRIBUTIONS TO THE PROCESS Research Unit -40% Health Financing Unit -35% Office of Financial Management - 25% FREQUENCY OF ACTIVITIES Periodically taking phase wide approach

7. START OF NEW PRACTICE - 1 CHAMPIONS o Hon. Hans Barchue – Immunization Champion, Deputy Speaker, House of Parliament o Hon. Sen. Dr. Peter S. Coleman – Immunization Champion, Liberian Senate, House of Parliament o Hon. Johnson T. Chea – Immunization Champion, House of Representative o Hon. William V. Dakel – Immunization Champion, House of Representative o Atty. Mardina Wesseh – Immunization Champion These champions supported the study on health expenditure tracking and the need to increase immunization budgetary support through innovative means.

8. START OF NEW PRACTICE - 2 CHALLENGES AND DIFFICULTIES ENCOUNTERED Low budgetary support for routine immunization and delay in accessing GoL funding- These champions ensured that:  Sustained advocacy on immunization financing was championed which led to the creation of immunization budget line and increased budgetary support (e.g. US$ 50,000.00 – US$ 500,000.00)  Facilitated the timely disbursement of EPI co- financing contribution

9. SIGNIFICANCE SCALE UP AND SPREAD The new practice has not been taken up by other organizations/institutions so far The practice could be adopted in other countries EFFECTIVENESS The new practice moved the country closer to the sustainable immunization financing goal: Wider acceptance of the investment case, increased budgetary support (e.g. US$ 50,000.00 – US$ 500,000.00) The practice is considered sustainable, with the process showing increased government commitment.

10. “ We are all friends aim at one objective which is to ensure that the children survive”