1. SIERRA LEONE: Existing Expenditure & Budget Tracking Process Peter N. Sam-Kpakra Deputy Financial Secretary Ministry of Finance and Economic Development (MoFED) Sierra Leone

2. PRESENTATION OUTLINE  Overview of Immunization Expenditure Tracking Process in Sierra Leone  Expenditure Tracking at District Level  Expenditure Tracking at Central Level  Joint Reporting Form (JRF) Process  Budget Process  Bottlenecks & Solutions

3. Overview of Immunization Expenditure Tracking Process in Sierra Leone The Resource tracking has been established and is operational. June 2012 – Finalized expenditure tracking tool developed by the EPI team August 2013 to January 2014 – Deputy Secretaries from the Ministry of Finance and Economic Development (MoFED) and other government officials used the SIF Budget Process Tool to illustrate the country’s top- down flow of immunization spending. The EPI accountant contributed to these advances, by submitting 2013 budget figures and 2010-2013 aggregate district-level health expenditures. MoFED is working to procure Chart of Accounts (CoA) – a financial coding tool used in part for Immunization Expenditure Tracking.

4. Overview of Immunization Expenditure Tracking Process in Sierra Leone The immunization expenditure tracking process covers two layers:  Central level  District Level Routine immunization (RI) data collection however covers three phases. Both data run parallel at all levels. Routine immunization Data Vs. Immunization Expenditure data Health Facility Central Level District Level Receive, manage & report on funds Allocate & Manage funds Collate & report Generates & report Collate & report Expenditure Data RI Vaccination Data

5. Expenditure Tracking at District Level Responsibility The District Health Management Teams (DHMTs) Local Government Finance Department- Ministry of Finance & Eco. Dev. Ministry of Health and Sanitation Public Expenditure and Tracking Survey (PETS) Technology Districts use MS Excel to collate and store both financial and immunization data. Disaggregation Expenditures on finances from public funds & partners are disaggregated.

6. Expenditure Tracking at District Level Shared Costs Shared costs are accounted for as separate budget lines such as Programme management, vehicle maintenance, Human resources, etc. Frequency Quarterly reporting on public fund expenditures. Report on Supplementary Immunization Activities (SIA) fund expenditures based on timeline set by partners. Origin Public funding to districts was revised and channeled through local councils in 2008.

7. Expenditure Tracking at Central Level Immunization Expenditure data is not readily available at this level Responsibility: Child Health / EPI Programme (MoHS) is responsible for planning and implementation of routine immunization activities MoFED allocates the approved budget to EPI (MoHS) Technology: A mixture of softwares are used for financial tracking: MS Excel & Integrated Financial Management System (IFMIS) Disaggregation: Expenditures on finances from public funds & partners are disaggregated. Mechanism CH/EPI develops POA DFR (MoHS) consolidates budgets MoFED Parliament PM MOF PS FS

8. Expenditure Tracking at Central Level Shared Costs Shared costs are accounted for as separate budget lines such as: 1.Programme management, 2.Vaccines supply & Logistics, 3.Service Delivery, 4.Advocacy & Communication, 5.Monitoring & Surveillance, 6.Supplementary Immunization activities (SIAs), and 7.Shared Health System Costs. Frequency Quarterly reporting on public fund expenditures. Report on SIA fund expenditures based on timeline set by partners. Routine immunization data are reported to partners on monthly basis. Annually, the WHO/UNICEF Joint Reporting Form (JRF), which captures both financial and immunization data, is being completed and shared with partners. Origin The current central level immunization expenditure tracking process has been in existence since 2006.

9. Joint Reporting Form (JRF) Process Responsibility The JRF is being completed by the CH/EPI Programme annually. Information required for the completion if this tool is collected from various partners within & without MoHS. Completed document is then submitted to WHO country office. Strategy Public routine immunization expenditure is calculated in the JRF as: 1.% of total expenditure on vaccines financed by government funds 2.% of total expenditure on routine immunization financed by government funds Under-reporting Human resource components of expenditure is often underreported or neglected. To address this data gap, the Directorate of Financial Resources (DFR) (MoHS) should annually hive out the human resource expenditure and share with the EPI Programme.

10. Budget Process Responsibility & Timing a). 3 rd/4th Quarter of every year: Annually, the CH/EPI Programme team review their Plan of Action (POA) and cost the activities. The EPI Programme Manager then submits the Program’s aspirational budget through the DFR to the Permanent Secretary (PS) for consolidation into the MoHS budget. PS then submits the budget to MoFED for consolidation into all MDAs’ Budget Minister of Finance presents the budget to parliament for approval. b). 1 st Quarter of the following year: The Minister of Finance is then notified by parliament about the approved funds. The National Financial Secretary allocates funds to all MDAs including MoHS. c). In every Quarter: The National Financial Secretary disburse funds to all MDAs including MoHS. The DFR (MoHS) keeps records of the allocated & disbursed funds from National Financial Secretary. The Programme Finance Officer keeps records of the funds assigned to EPI Programme

11. Sabin SIF budget flow analysis tool

12. Bottlenecks & Solutions Areas for Improvement. a.Neglected or underestimated human resource component of immunization expenditure. b.Poor financial management at the Local Councils c.Under reporting on immunizations funds from local partners. d.Poor accountability for the cost of wasted vaccines e.Low capacity of personnel in tracking immunization expenditures f.Difficulty in extracting required information from other Ministries, Department and Agencies (MDAs). Potential Solutions. a.Annual estimation of human resource component of immunization expenditure. b.Establish a system for tracking the cost of wasted vaccines in the EPI Programme. c.Set up structures specifically for Immunization finance tracking in all relevant MDAs. d.Training of personnel in tracking immunization expenditures & Financial Data Management.

13. Bottlenecks & Solutions Implementing Authority. a.MoHS: DFR (MoHS), Permanent Secretary (MoHS) & EPI Programme Management b.MoFED, (Local Government Finance Department) c.Partners: WHO, UNICEF, SABIN d.Parliamentarians Next Steps. The Sabin/SIF Programme & peers should help in identifying weaknesses & key strategies for improvement. Use of SABIN SIF Programme Tracking Tool. Sabin/SIF should also provide technical support in the implementation of solutions. EPI Programme presents strategy to ICC for approval. Partners should help in provision of supports for the capacity building process. Parliamentarians should take care of all legal aspects of immunization financing.

14. Thank you.