Immunization, Vaccines and Biologicals

Country case studies

Country case studies undertaken in:

Burundi
Democratic Republic of Congo
Cameroon
Madagascar
Malawi
Mauritania
Mozambique
Senegal
United Republic of Tanzania
Uganda
Zambia

Case studies were produced for a limited number of priority countries. The objective was to shed some light on the question whether recent debt relief initiatives have led to increased fiscal space for public health spending in the particular country context. Besides quantifying the potential benefits for the health sector, the aim was to identify specific success stories and lessons learned, as well as constrains and difficulties which have hindered the efficient use of debt relief savings.

Three main criteria were used for selecting the priority countries:

1. Potential creation of fiscal space: the volumes of HIPC Initiative debt relief and of prospective MDRI assistance

2. Scaling up needs: Key health indicators
- Infant Mortality Rate - DTP3 Coverage

3. Heterogeneity with regard to geographical location/ language/ and the countries’ experience with sector wide approaches (swap) in the health sector and aid management

The case studies are based on data and information gathered through extensive literature review, an Excel tool used to facilitate data collection and finally, a country visit to complete data compilation and interview key officials from the ministry of health (including staff from Expanded Programme on Immunization), the ministry of finance, and development partners (World Bank, International Monetary Fund, African Development Bank, bilateral donor agencies, and NGOs).

Priority countries in a first phase were Cameroon, Madagascar and Mauritania. The country visits took place from March to June 2007 and were followed by an inter-country Workshop organized in Yaoundé, Cameroon.

In a second phase, the scope of this work had been extended to a set of five South-Eastern African HIPCs. Country visits have been conducted from September to October 2007 for Malawi, Mozambique, Tanzania, Uganda, and Zambia. These are countries with a relatively long swap experience and higher shares of aid delivered through general budget support.

Finally, the most recent case studies concerned Burundi, Senegal and the Democratic Republic of Congo.