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Health Policy and Planning Advance Access published online on May 23, 2006
Health Policy and Planning, doi:10.1093/heapol/czl012
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© The Author 2006. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine. All rights reserved.

Original Papers

Financial sustainability planning for immunization services in Cambodia

Sann Chan Soeung 1, John Grundy 2 *, Jim Maynard 3, Alan Brooks 4, Marian Boreland 2, Duong Sarak 5, Karl Jenkinson 2, and Beverley-Ann Biggs 6

1 National Immunization Program, Ministry of Health, Phnom Penh, Cambodia
2 Australian International Health Institute, University of Melbourne, Australia
3 Children's Vaccine Program, Program for Appropriate Technology in Health, Seattle, USA
4 Children's Vaccine Program, Program for Appropriate Technology in Health, Ferney, France
5 Children's Vaccine Program, Program for Appropriate Technology in Health, Phnom Penh, Cambodia
6 Department of Medicine, Royal Melbourne Hospital, University of Melbourne, Australia

* To whom correspondence should be addressed.
John Grundy, E-mail: johnjgrundy{at}hotmail.com


  Abstract

The expanded programme of immunization was established in Cambodia in 1986. In 2002, 67% of eligible children were immunized, despite significant health sector and macro-economic financial constraints. A financial sustainability planning process for immunization was introduced in 2002, in order to mobilize national and international resources in support of the achievement of child health objectives. The aim of this paper is to outline this process, describe its early impact as an advocacy tool and recommend additional strategies for mobilizing additional resources for health. The methods of financial sustainability planning are described, including the advocacy strategies that were applied. Analysis of financial sustainability planning results indicates rising programme costs associated with new vaccine introduction and new technologies. Despite this, the national programme has demonstrated important early successes in using financial sustainability planning to advocate for increased mobilization of national and international sources of funding for immunization. The national immunization programme nevertheless faces formidable system and financial challenges in the coming years associated with rising costs, potentially diminishing sources of international assistance, and the developing role of sub-national authorities in programme management and financing.

Keywords: immunization; EPI; Cambodia; financial sustainability.
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