The Impact of Public Financing, Economic Growth, and Corruption on Immunization Performance: Evidence from 37 Sub-Saharan African Countries

BackgroundIn sub-Saharan Africa, where many countries continue to experience high burdens of vaccine-preventable diseases, increasing immunization access have been a priority for the governments and international organizations such as Gavi, the Vaccine Alliance.Over 40 Gavi-supported African countries have been impacted, with 364 million children reached and over US$5.7 billion disbursed, averting over 8.9 million child deaths.Despite this progress, the African region has struggled with immunization coverage due to various factors.Nevertheless, some African countries are transitioning out of Gavi support due to economic growth.However, many require strong political will to increase their expenditure on immunization.This study therefore aims to understand the factors influencing immunization performance and its relationship to public expenditure. Methods Data on 37 Gavi-eligible sub-Saharan African countries between 2006 and 2019was obtained from the World Bank's World Development Indicators, the WHO and UNICEF Joint Reporting Form and the Transparency International's Corruption Perception Index.Descriptive immunization and health expenditure were analyzed using a panel regression of variables.DPT3 was used as an indicator of immunization uptake.The indicator for public expenditure on immunization per child was based on government spending on immunization divided by the number of children in the birth cohort.