The Global Alliance for Vaccines and Immunizations (Gavi) mandated Swiss TPH in July 2019 to conduct a mission of Monitoring Agent (MA) to ensure the following-up of the 2019´s Anti-Measles vaccination campaign for children in Niger.
The main objective of the campaign monitoring is to evaluate the adequacy of systems in place for budgeting and financial management, as well as the programmatic relevance of the campaign. In addition, we designed the monitoring activities in pre-, intra-, and post-campaign to draw the lessons learned on the programmatic aspects and to make relevant recommendations to improve the financial management processes for future campaigns.
More specifically, the pre-campaign monitoring activities aimed to review the campaign budget, to describe the financial processes, to verify the existence and adequacy of budgeting, recording, reporting, planning and monitoring tools and to make relevant recommendations to improve the internal controls.
The intra-campaign monitoring activities were dedicated to verify the respect of the initial plan, to assess the compliance with the campaign work plan, budget and tools, to verify the timely distribution of vaccines and the actual realization of immunization activities. These activities also focused on making adequate recommendations to improve budgeting and financial management and overseeing the programmatic aspects of the campaign (processes, planning, supervisions, communication and adverse effects control).
In post-campaign, we initially put the accent on financial verifications. However, as a result of pre- and intra-campaign monitoring activities, we revised our scope to include necessary additional programmatic post-campaign verifications.
Three (3) MA teams composed each of two (2) experts: Programmatic and financial conducted the pre- and intra-campaign field monitoring activities from September 6 to 20. The MA teams covered a convenience sample of three (3) regions / axes (each by one MA team): Niamey, Maradi and Tahoua, two (2) districts per regions and three (3) vaccination centers per district. Niamey team experts insured the role of MA focal points and participated in central metings and restitutions.
Two (2) intermediary reports have been submitted to Gavi: the first synthetic report (submitted on September 15) dealt with 10 principal findings needing immediate corrective actions during the campaign. The second report (submitted on October 23) was more extensive. This report exposed the pre- and intra-campaign major findings, with more focus on the post-campaign MA proposed scope.
Our primary findings on the programmatic level indicated a poor reporting of vaccine stock movements and some difficulties in result recording and transmission processes. Besides, we noticed major weaknesses in the campaign financial management, especially on the following topics: internal control (database separation, SOP updating), tendering process (vehicle rental), Cash flow management (account number, direct payments to districts, district and CSI cash management), accountancy management (central and regional levels), supporting documents for some expenditures, per diems, etc.
Based on these results and in accordance with Gavi, we widened the proposed post-campaign scope on the programmatic level to include the assessment of the liability of campaign validated results, the adequacy between used vaccines and target population and to appreciate the global efficacy of the campaign.
From a financial perspective, our post-campaign verifications will focus on the separation of Gavi and Fungible fund databases, the completeness of Gavi financial and accounting reporting in Tompro and the respect of tendering and purchase procedures.
After validation by Gavi of the proposed ToRs, Swiss TPH will get in contact with the relevant MoH Directorates to plan the post-campaign stage.