By Sola Ogundipe
To improve child health investment, specifically routine immunisation in Lagos State, Save the Children International (SCI) has called for the adoption of sustainable health sector financing approaches.
The organisation emphasised the importance of accountability in health financing even as it stressed the importance of funding for immunisation and evidence-backed policies.
The Quality and Advocacy Coordinator for Save the Children International in Lagos, Better Opportunities for Optimising Targeted Immunization for Zero Dose and Under-immunised Children (BOOST) Project, Dr. Itunu Dave-Agboola, who made the call argued for sustained efforts towards improving child health investment, specifically routine immunisation towards self-sufficiency in the State.
Dave-Agboola, who spoke at a budget tracking and analysis event convened by the Lagos State Ministry of Health with support from Save the Children International, said that sustainable immunisation financing is not just a goal, but a necessity.
"This exercise is an eye-opener to the fact that Lagos State is progressing, but not yet there. Lagos State has been passionate about routine immunisation, and they are quick to respond to outbreaks of vaccine-preventable diseases, which require lots of funding.
The goal
“Our goal is to generate evidence-based advocacy briefs to influence policy and boost domestic resource mobilisation.
“The ultimate goal is a Lagos State where routine immunisation is sustainably financed, well-documented, and embraced at the community level.
“We are trying to understand the percentage of the total budget for Lagos State that is being allocated to child health. Out of that, we want to extract the percentage being allocated to immunisation, and beyond allocation, we want to know how much is being released and spent on routine immunisation.
“We are doing this to identify the best practices and the gaps in implementation to know if the funding being released for immunisation is adequate.
She explained that the findings of this budget tracking will be used as an advocacy tool to stakeholders at the Lagos State Ministry of Health, the Legislative body, the Executive, and all the high-level stakeholders to let them understand that more funding is needed for routine immunisation.
Advocacy
“We are doing this so that we'll have an evidence-based advocacy brief to engage the high-level stakeholders.
"This exercise is going to form the evidence for the advocacy brief we'll be using to engage the high-level stakeholders, for them to know the importance of releasing adequate funds for routine immunisation activities. Even beyond funds, we have issues of human resources for health.
"We need to engage more hands, so this is just going to be about engaging high-level stakeholders to let them understand why we need more funding for routine immunisation.
“Beyond the support of implementing partners, we need to do a domestic resource mobilisation such that routine immunisation will be sustainable even beyond the support of partners because partners' projects are always time-bound.”
Self sufficiency
Dave-Agboola explained that beyond implementing partners, SCI seeks a situation where the State will be self-sufficient in routine immunisation.
"There is a need to follow up with allocation, because if funds are allocated and Directorates are not writing memos for the release of those funds, the funds will just be there, not released, and if they write and don't follow up, they may not be able to obtain approval.
"Beyond getting the funds released, there should be accountability for how the funds have been utilized because that would serve as the basis of asking for more if needed. There's a need to show transparency and accountability that the funds have been well utilized."
Zero dose children
On zero-dose children in Lagos State, she said there's remarkable improvement.
"I would say it's better than it used to be; however, the largest room is still the room for improvement because there are always opportunities to do better.
"The BOOST is a four-year project by Save the Children, at the end of which we want to see improvement in the service delivery, in the quality of services being delivered on routine immunization, such that the demand will increase because some stay away from clinics because of the attitude of healthcare providers.
"So we are conducting training for the healthcare providers to improve their attitude, and we are also supporting with the development of tools to ensure that everything is adequately captured and documented, because we also have challenges with data.
Documentation
"We want to see Lagos State where everything is accurately documented and we can actually showcase our efforts, and then from the social and behaviour communication component, we are engaging community leaders and religious leaders.
"We want to destroy myths and misconceptions against immunization, and we want to leverage the good office of our religious and community leaders to mobilize people through their influence to embrace immunization more because we are very religious in this part of the world.
" We have developed structures at the community level through the ward development committees and will be researching reasons why people are not embracing immunization, because when we do the root cause analysis, then we know how to address the problems.
"So, ultimately, we want to see Lagos State where there is improvement in the quality of services being delivered in routine immunization, where at the community level, people embrace immunization, and myths and misconceptions are destroyed.
"Then, from the advocacy perspective, we want to see a Lagos State where sufficient resources will be domestically mobilized for routine immunization and the state will be self-sustaining, and we are also going to be advocating for support from the private sectors as part of their corporate social responsibility.
" We want to see a scenario where the state at leadership coordinating platforms is strengthened. The technical working groups are at the state level, the Ministry of Health level, the primary healthcare board level, and the local government level."
Technical Working Group
Dave-Agboola noted that at the LGA level, the immunization technical working group is not active, but the SCI has started resuscitating. It is such that by the end of this year, it will be standing strong.
“We also want to achieve a situation whereby our traditional and religious leaders will be well involved in decision-making when it comes to health issues and routine immunization, even at the state level.
“I also know and we all know that primary healthcare centers play a very big role in immunization of children, of healthcare immunization in general, and we also know that those I mean, healthcare workers who do not want to stay, especially in hard-to-reach areas is also an issue. Some of them don't want to stay there.”
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