Somalilandsun: For over three decades, the Global Polio Eradication Initiative (GPEI) has funded the global polio eradication program. Somalia is one of the countries whose polio program depends exclusively on the GPEI. GPEI-funded activities in Somalia extend beyond the scope of polio eradication and include routine immunization, disease surveillance, social mobilization, and vaccine delivery. As the world approaches polio eradication, GPEI resources are progressively declining and will cease completely once global eradication is achieved. To ensure a smooth transition away from GPEI funding Somalia needs to sustain their national polio and immunization programs through other resources. This report describes an assessment of polio transition carried out in 2019.
Objectives
- Analyze current funding for Somalia’s immunization and polio programs
- Document progress in transition planning and implementation
- Determine risks the country faces with the wind down of GPEI funding
- Identify opportunities for civil society engagement to support integration of polio programfunded activities and help sustain essential polio programming as well as other immunization activities.
Methods
Desk review
A desk review of key documents including Somalia’s Polio Transition Plan, country health plans, the Essential Package of Health Services (EPHS), and reports from the World Health Organization (WHO) and other health sector organizations);
Key informant interviews
Country visits were done to conduct key informant interviews with representatives from the Ministry of Health, United Nations (UN) agencies, CSOs, and other stakeholders
Workshops
The consultant participated in the Gavi Joint Appraisal in November 2019.
Study limitations
The assessment involved a large proportion of government sector participants versus other stakeholders. A coordinating platform or mechanism coordination of CSO activities does not exist in Somalia. Such a forum could have generated more comprehensive and balanced information.
Key results
Somalia’s polio and immunization programs are supported exclusively by Gavi and GPEI funds, routed primarily through WHO and UNICEF. These programs received $28 million in direct funding in 2018 and $27 million ($15.6 million from GPEI and $11.4 million from Gavi) in 2019. Support from CSOs is mandated in the EPHS strategy, to help make immunization an integral part of community-level health service. Most CSO support for immunization is awarded through WHO and UNICEF.
Current and projected support from Gavi is not expected to cover funding gaps resulting from the expiration of GPEI funding. Sustaining assets of essential polio program components and other immunization activities will require a separate continuation of technical and financial support for the medium to long term. The largest gaps in withdrawal GPEI resources will be in salaries and will affect a wide range of activities including: service immunization delivery surveillance of polio and other vaccine-preventable diseases, capacity building resource mobilization community engagement Major opportunities are also inherent in Somalia’s polio transition, including scaled-up CSO engagement in advocacy and technical support to fill gaps and promote synergies between remaining polio activities and other health programs.
Recommendations
Somali government and UN system (primarily WHO/UNICEF)
- Ensure that relevant GPEI assets are integrated effectively with a fully operational EPHS strategy.
- Map implementing partners to improve coordination and efficiency across the health sector.
- Invite CSOs (from the health and humanitarian sectors) to contribute more to immunization efforts.
Donors
- Ensure that immunization becomes a central platform for assessing programmatic progress of the country’s EPHS strategy.
- Promote coordination across GPEI and Gavi to ensure full coordination of immunizationrelated financial and technical support.
- Advocate for CSOs to be involved in the government and partner planning processes.
Civil society
- Establish a CSO platform (nongovernment, non-UN) for all international nongovernmental development organizations (INGDOs) and national CSOs. a. Map CSO activities across all states.
- Provide advocacy support to create an enabling environment for immunization-strengthening and effective integration of relevant GPEI assets.
- Provide technical support for specific service delivery gaps within the context of the GPEI wind down.
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