“The first step is therefore to include immunisation financing as part of the Medium-Term Development Plan (MTDP) of district assemblies. It is refreshing to note that the current MTDP (2022-2025) captures immunisation.”

This was in a release by SEND GHANA in partnership with Hope for Future Generations and Socio-Serv Ghana, copied to the Ghana News Agency, in an analysis of immunisation budget execution in selected Metropolitan, Municipal and District Assemblies (MMDAs), Ghana after undertaking a monitoring of immunisation budget execution in some districts for the period 2018 to 2021.

The release recommended an improved collaboration between District Assemblies and District Health Management Team (DHMT) to plan, document, and properly allocate internally generated funds, DACF and funds from donors.

“This will instill trust, and open avenues for regularized funding, in the same vein, there needs to be more resources allocated to certain immunization related activities including capacity building training, conferences, logistics and stationery.”

It also called for the expansion of district response initiative for malaria at the district level to include immunisation activities, while Assembly be encouraged to align immunisation activities to strengthen Community-Based Health Planning and Services (CHPS).

It saaid decentralisation of Health would get the Assembly to pay more attention to health like others including education and Agriculture, while calling for advocacy by Civil Society Organisations and other key stakeholders on the inclusion of immunisation financing to core districts indicators from the National Development Planning Commission.

It revealed that inadequate and late releases of funds impeded the implementation of routine immunisation adding that the untimely releases of funds made it difficult to embark on outreach services to meet timelines and targets given that immunisation services were timebound.

Some of the findings showed that DHMTs and Assemblies underscored the importance of immunisation in the districts hence implement the plans and carry out assessments annually to measure the performance of the districts on some health indicators including immunisation.

“Additionally, the DHMTs present on quarterly basis, reports to the MMDAs to track the performance of the districts regarding immunisation and other health interventions.”

It said the five Assemblies stated that they were unable to finance immunisation due to financial constraints and other competing priorities and added that the MMDAs said much of the expenditure on health was spent on infrastructural development.

The release said budget performance over the years had been of concern due to weak execution rate and analysis of the 2020 and 2021 annual budget performance indicated an execution gap of 7.6 and 6.9 percent respectively of the health budget.

“From information provided by the districts on immunisation budgets, four districts did not allocate funds for immunisation related activities though it was budgeted for,” the release added.

It added that disbursement of funds for immunisation activities according to the districts, was not timely which attributed to the delay in the release of funds from the national level to the district, thus, affecting the level of support the district assemblies provided to the DHMTs.

The districts were Ho, Shai Osudoku, Asuogyman, Tatale/Sanguli and Kasena Nankana Municipal and District Assemblies in the Northern, Eastern, Volta and Greater Accra regions.

“These districts were purposively selected to build on previous work on immunisation by SEND GHANA and HFFG (the immunisation advocacy initiative, 2019 to 2021). Funding and technical support for this exercise came from the International Budget Partnership (IBP) and UNICEF.”

Exploring budgetary allocations, disbursements, and utilisation for immunisation related activities at the selected districts for the period 2018 to 2021 and examining the effects of budget credibility issues on immunisation services were the objectives of the visits while the monitoring and analysis of findings were done from April 22 to January 23.