Factors impacting sustained coverage in the context of donor transitions: experience from Sri Lanka

Author:

Perera Prasadini N12ORCID,Amarasinghe Sarasi N1,Fonseka Sachini H1,Abeysinghe Nihal3,Rannan-Eliya Ravindra P1

Affiliation:

1. Institute for Health Policy (IHP) , 72, Park Street, Colombo 02, Sri Lanka

2. Department of Pharmacy, Faculty of Allied Health Sciences, University of Peradeniya , Peradeniya, Sri Lanka

3. Institute for Research & Development , Battaramulla, Sri Lanka

Abstract

Abstract Although not reliant on donor funding for health, the external assistance that Sri Lanka receives contributes to the improvement of the health system and health outcomes. In this study, we evaluated transition experiences of the expanded programme on immunization (EPI) that received Gavi funding to expand the vaccine portfolio and the Anti-Malaria Campaign (AMC) that received funding from the Global Fund for AIDS, Tuberculosis and Malaria to scale-up interventions to target and achieve malaria elimination. We assessed if EPI and AMC programmes were able to sustain coverage of previously donor-funded interventions post-transition and explain the facilitators and barriers that contribute to this. We used a mixed methods approach using quantitative data to assess coverage indicators and the financing mix of the health programmes and qualitative analysis guided by a framework informed by the Walt and Gilson policy triangle that brought together document review and in-depth interviews to identify facilitators and barriers to transition success. The EPI programme showed sustained coverage of Gavi-funded vaccines post-transition and the funding gap was bridged by mobilizing domestic financing facilitated by the Gavi co-financing mechanism, full integration within existing service delivery structures, well-established and favourable pharmaceutical procurement processes for the public sector and stewardship and financial advocacy by technically competent managers. Although the absence of indigenous cases of malaria since 2012 suggests overall programme success, the AMC showed mixed transition success in relation to its different programme components. Donor-supported programme components requiring mobilization of operational expenses, facilitated by early financial planning, were successfully transitioned (e.g. entomological and parasitological surveillance) given COVID-19-related constraints. Other key programme components, such as research, training, education and awareness that are dependent on non-operational expenses are lagging behind. Additionally, concerns of AMC’s future financial sustainability within the current structure remain in the context of low malaria burden.

Funder

Alliance for Alliance for Health Policy and Systems Research, WHO in collaboration with the WHO Department of Health Governance and Financing and UHC 2030

Publisher

Oxford University Press (OUP)

Reference56 articles.

1. Malaria control and elimination in Sri Lanka: documenting progress and success factors in a conflict setting;Abeyasinghe;PLoS One,2012

2. Sri Lanka’s national health accounts: national health expenditures 1990-2019;Amarasinghe,2021

3. National strategic plan for prevention of re-introduction of Malaria in Sri Lanka 2018-2022;Anti Malaria Campaign - MoH,2018

4. Anti Malaria Campaign | Sri Lanka;Anti Malaria Campaign - MoH,2022

5. Growing Old Before Becoming Rich:

同舟云学术

1.学者识别学者识别

2.学术分析学术分析

3.人才评估人才评估

"同舟云学术"是以全球学者为主线,采集、加工和组织学术论文而形成的新型学术文献查询和分析系统,可以对全球学者进行文献检索和人才价值评估。用户可以通过关注某些学科领域的顶尖人物而持续追踪该领域的学科进展和研究前沿。经过近期的数据扩容,当前同舟云学术共收录了国内外主流学术期刊6万余种,收集的期刊论文及会议论文总量共计约1.5亿篇,并以每天添加12000余篇中外论文的速度递增。我们也可以为用户提供个性化、定制化的学者数据。欢迎来电咨询!咨询电话:010-8811{复制后删除}0370

www.globalauthorid.com

TOP

Copyright © 2019-2024 北京同舟云网络信息技术有限公司
京公网安备11010802033243号  京ICP备18003416号-3