New findings from a survey conducted by SEND Ghana have revealed a significant challenge facing the implementation of immunization services in five districts across the country, with data from the WHO and UNICEF showing that as many as 25 million children in Ghana missed out on life-saving vaccines in 2021.

The report highlights how the delays in the release of funds from the national level to the district are affecting the level of support the district assemblies provide to the DHMTs, as DWO data shows that some 46 districts are behind in coverage.

According to the findings, the five district assemblies stated that they are unable to adequately finance immunization due to financial constraints, with the two main problems being the inadequate and irregular release of funding.

The districts rated their satisfaction with the district's immunization budget in terms of adequacy of allocations, adequacy of receipts, timeliness of release, and disbursement, with Asuogyaman, Ho, Tatale/Sanguli, and Kasena Nankana districts being unsatisfied with the untimely releases of funds. The DHMT of Shai Osudoku was the only district that was somewhat satisfied with the adequacy of allocations, receipts, and timeliness of disbursement.

The report also revealed that the inadequate and late releases of funds are hindering the implementation of immunization outreach service delivery and regular monitoring and supportive supervision. As a result, some children who need immunization may not be reached with all the required vaccines.

For example, the inadequacy of funds in Ho Municipal in June 2020 has affected T&T support for staff going to the field and organising an outreach programme, leading to a decrease in coverage for that month.

The Ministry of Finance has been called upon to create a separate budget line for allocations to immunization in the national health budget and to fully release the funds allocated to the Ministry of Health.

The government has also been advised to deliberately increase allocation and releases for preparation towards full self-financing of immunization in the next few years.

To uphold budget credibility, the government must keep its commitment to fully releasing funds allocated to the Ministry of Health and transfers to fulfill its obligation to the Gavi Alliance.

The report also recommends that district assemblies must incorporate immunization financing into their district plans and budgets and include it as part of their Medium-Term Development Plan (MTDP).

The report notes that the current MTDP (2022-2025) which captures immunization, and guidelines for preparing district plans and budgets should come with a specific line on funding for immunization.

The district assemblies have also been advised to prioritise the improvement of immunization budget execution by releasing funds allocated for immunization in a timely and adequate manner.

Essentially, the report of the SEND Ghana survey highlights the urgent need for action to be taken to ensure the sustainability and success of immunization services in the country.

The government, district assemblies, and other stakeholders must come together to prioritise and fully fund immunization activities to ensure that children have access to essential health services, including vaccines.

This will not only help to improve the health of future generations but will also help the country to meet its targets as outlined in the Sustainable Development Goals Indicator 16.6.1, which calls for high health budget execution.