Pendanaan Program Imunisasi Dasar di 71 Kabupaten/Kota di Indonesia Tahun 2013-2014

Immunization is an effective and efficient health intervention to prevent severe illness, disability and child deaths. Funding support is important in order to achieve targeted universal child immunization (UCI) at high coverage. An Analysis of 2015’s National Survey on Health Financing in the Implementation of National Health Insurance (JKN) was conducted by using District Health Account method to figure out the sources and budget allocation on routine immunization programs in 71 districts / cities in 2013-2014. The results shows that the routine Immunization budget varies from 0.10% to 2.3% of the 2013 APBD (district budget), with a wide disparity. The main sources of funding for immunization programs in districts/cities are PAD, Jurnal Penelitian dan Pengembangan Pelayanan Kesehatan, Vol. 2, No. 2, Agustus 2018 122 DAU, Dekon and BOK, which were still depend on central transfer funds (APBN). National immunization funding in 2014 increased significantly by 2.6x from 2013. Sources for the routine immunization program was around 90% funded by APBN (central budget), the rest from donors (GAVI, WHO, Unicef). At national level, funding allocation was mostly for vaccines procurement, introduction of new vaccines and investments. While, allocations in districts / cities was mostly used for service delivery and less than 8% for surveillance and training. District/city with high fiscal capacity doesn’t significantly having a large immunization budget or high coverage. It is recommended to maintain centralistic mechanism on immunization funding for high-cost components (vaccine, vaccine refrigerator, cold room) by APBN; while the Province and District / City provide a budget for training, distribution, vaccines carrier along with consumables gods and injection kits adjusted by fiscal capacity and service demands. Special crash programs need to carry out with additional accompaniment fund source from the provincial or district budget for targeted areas which never reached 80% coverage. Other funding resources should be widely explored to examine alternatives budget, such as capitation (JKN), private fund. Puskesmas competency also should be improved on budget planning and effective purchasing.