This brief examines the government’s budget credibility in relation to immunization services in Ghana. Budget credibility denotes the government’s ability to meet its revenue and expenditure targets in a financial year. This brief builds upon previous research on immunization spending which has highlighted potential issues with funding flows for immunization services in Ghana and their impact on immunization availability and coverage.
Funding for national campaigns for childhood vaccination is monitored and reported by Gavi and WHO. However, there is less information available about the local government financial and logistical support for immunization, even though the administration of routine immunization is conducted at the local level in the 261 Metropolitan, Municipal and District Assemblies (MMDAs) in Ghana. Section 92 (3) of the Local Government Act 1993 (Act 462) intends that the budgets of various departments within a district assembly to be consolidated into a single composite district budget to ensure a full rollout of fiscal decentralization for efficient, effective, transparent and accountable utilization of all public funds to improve service delivery. District Assemblies are responsible for budgeting and releasing funds for health-related activities, such as building health facilities, purchasing supplies, and providing support for health services including routine immunization within their jurisdictions. In addition, funding from the District Assemblies Common Fund (DACF) includes guidance that a share of funding should be allocated for health infrastructure. However, the specific allocation of DACF funds for health spending is determined at the discretion of the district assembly.
SEND Ghana and Hope for Future Generations (HFFG), in collaboration with the International Budget Partnership (IBP) and UNICEF, collected data and evidence on immunization budget execution in selected districts from October 2022 to January 2023. This initiative aligns with the Strategic Priority 2 of the Immunization Agenda 2030 (IA 2030), which calls for advocacy to demand that governments prioritize fiscal and legislative instruments for immunization and ensure sustained national and sub-national financing. The study explores district budgetary allocations, releases and disbursements for immunization-related activities and examines the effects of budget credibility issues on the delivery of immunization services.