1. Budget and resource tracking
Dr. Michael McQuestion
Ms. Diana Kizza Mugenzi
Dr. Cliff Kamara
Ms. Dana Silver
Sustainable Immunization Financing Program
Anglophone African Peer review workshop
Abuja, Nigeria
19-21 April 2016

2. Overview “To pay for something is to own it”
Most countries are actually paying most of their immunization program costs but are not properly capturing and reporting those expenditures
The countries are closer to the country ownership goal than they know

3. What the world sees now
Government R.I. expenditures per surviving infant (US$) Anglophone African SIF countries
Country
2010
2011
2012
2013
2014
Kenya 4 3
Liberia 2
Nigeria 7
Sierra Leone 6
Uganda 10
Africa mean 5
Weighted mean 15 12 8
Sources: WHO/UNICEF Indicator 6730; UN Population Division
Note: mid-year exchange rates used

4. PEFA standards
1. Credibility of the budget - The budget is realistic and is implemented as intended
2. Comprehensiveness and transparency - The budget and the fiscal risk oversight are comprehensive, and fiscal and budget information is accessible to the public.
3. Policy-based budgeting - The budget is prepared with due regard to government policy.

5. PEFA standards
4. Predictability and control in budget execution - The budget is implemented in an orderly and predictable manner and there are arrangements for the exercise of control and stewardship in the use of public funds.
5. Accounting, recording and reporting – Adequate records and information are produced, maintained and disseminated to meet decision-making control, management and reporting purposes.
6. External scrutiny and audit - Arrangements for scrutiny of public finances and follow up by executive are operating

6. Budgets As their budgets grow, immunization managers are obliged to:
demonstrate transparency and accountability (budget efficiency)
link outputs and impacts to investments (“value for money”)
create new budgets based on actual expenditures (empirical budgeting)

7. Resource tracking
Across the SIF countries, national counterparts are approaching these budget challenges in different ways
They are innovating, developing new budgeting and resource tracking practices
SIF Program provides a generic tool- budget flow analysis flowsheet

8. Sabin SIF Budget flow analysis tool
The Sabin-developed tool for simple central-level resource tracking
partial but quickly identifies bottlenecks
based on PEFA
provides strong basis for advocacy
begins with cMYP, ends with JRF 6730
The EPI team does the work themselves
Only about half of SIF countries this transparent

9. Best Practice: DRC Sabin SIF Budget flow analysis tool

10. Sabin SIF Budget flow analysis tool

11. Sabin SIF Budget flow analysis tool

12. Resource tracking examples
In three SIF countries, immunization managers secured the budget they sought simply by presenting EPI expenditure data over the previous several years as part of their “investment case”
Demonstrated budget credibility, sound budget management

13. Resource tracking examples
In two SIF countries, national immunization teams provided feedback on immunization expenditures to provincial officials, the public
Immediate improvement in provincial expenditure reporting

14. Resource tracking examples
In one SIF country, the immunization team presented the completed SIF budget flow analysis to parliamentarians, who then showed it to the prime minister, who then instructed the minister of finance to fully disburse the immunization budget
“information is power”

15. Advocacy Case studies
The art of advocacy is knowing how to formulate messages that fit into each particular institution’s logic and deliver them effectively
Some examples:
EPI manager makes investment case to MPs
Finance officer convinces health director to cross analyze data, report expenditure per fully immunized child

16. Advocacy Case studies Advocacy examples, continued
Rotary and Lions clubs convince Government of Nepal to create an immunization trust fund
MPs from National Assembly convince provincial MPs to join national MP immunization network
EPI team analyzes provincial immunization expenditures, demonstrates program efficiency, avoids mandated budget cut

17. Thank you!