HeRAMS卫生系统对外部援助的依赖：疫苗接种服务评估

©World Health Organization 2025Some rights reserved. This work is available under the Creative Commons Attribution-NonCommercial-ShareAlike 3.0 IGO licence (CC BY-NC-SA 3.0IGO;https://creativecommons.org/licenses/by-nc-sa/3.0/igo).Under the terms of this licence, you may copy, redistribute and adapt the work for non-commercial purposes, provided the work is appropriatelycited, as indicated below. In any use of this work, there should be no suggestion that WHO endorses any specific organization, products or ser-vices. The use of the WHO logo is not permitted. If you adapt the work, then you must license your work under the same or equivalent CreativeCommons licence. If you create a translation of this work, you should add the following disclaimer along with the suggested citation:“This translation was not created by the World Health Organization (WHO). WHO is not responsible for the content or accuracy of this translation.The original English edition shall be the binding and authentic edition”.Any mediation relating to disputes arising under the licence shall be conducted in accordance with the mediation rules of the World IntellectualProperty Organization (http://www.wipo.int/amc/en/mediation/rules/).Suggested citation. HeRAMS. Health systems’ reliance on external aid an assessment of vaccination services July 2025; 2025Third-party materials. If you wish to reuse material from this work that is attributed to a third party, such as tables, figures or images, it is yourresponsibility to determine whether permission is needed for that reuse and to obtain permission from the copyright holder. The risk of claimsresulting from infringement of any third-party-owned component in the work rests solely with the user.General disclaimers.The designations employed and the presentation of the material in this publication do not imply the expression of anyopinion whatsoever on the part of WHO concerning the legal status of any country, territory, city or area or of its authorities, or concerning the de-limitation of its frontiers or boundaries. Dotted lines on maps represent approximate border lines for which there may not yet be full agreement.The mention of specific companies or of certain manufacturers’ products does not imply that they are endorsed or recommended by WHO inpreference to others of a similar nature that are not mentioned. Errors and omissions excepted, the names of proprietary products are distin-guished by initial capital letters.All reasonable precautions have been taken by WHO to verify the information contained in this publication. However, the published material isbeing distributed without warranty of any kind, either expressed or implied. The responsibility for the interpretation and use of the material lieswith the reader. In no event shall WHO be liable for damages arising from its use. Health systems’ relianceon external aidAn assessment ofvaccination servicesJuly 2025 EPIExpanded Programme on ImmunizationFBOFaith-based OrganizationHeRAMSHealth Resources and Services Availability Monitoring SystemHSDUHealth Service Delivery UnitNGONongovernmental OrganizationUNUnited NationsWHOWorld Health OrganizationACRONYMSIV TABLE OF CONTENTSAcronymsIntroductionDisclaimerMethodologyPart I: Global summary resultsPart II: Country-level analysisReader’s guideAfghanistanBangladesh (Cox’s Bazar)Burkina FasoCentral African RepublicDemocratic Republic of the Congo (Ituri)EthiopiaHaitiIraqLibyaMaliMozambique (Northeast)NigerNigeria (Northeast)occupied Palestinian territorySudanSyrian Arab Republic (Northeast)UkraineYemen IV23461112142026323640444852566268748084889296 INTRODUCTIONThe global humanitarian sector is undergoing an unprecedented funding crisis, forcing many organizations to substantiallyreduce their operations worldwide. This scaling back is expected to severely affect health systems that depend on external part-ner support for routine service delivery. The degree of reliance on humanitarian aid varies significantly both within and acrosscountries. Assessing the degree of reliance and measuring these variations is crucial to ensure that decision-makers engaged inthe reprioritization of aid can anticipate where the greatest risks to health systems lie and take timely action to mitigate potentialimpacts before they occur.This report is a follow-up to theHeRAMS assessment of health systems’ reliance on external aid1and focuses specificallyon vaccination services. It assesses the risks of potential interruptions to vaccination services in Health Service Delivery Units(HSDUs) reliant on external aid. It introduces a risk index derived from HeRAMS data that enables comparisons at subnational,national, regional, and global levels with the aim to support decision-makers involved in aid reprioritization in understandingwhere health systems are most vulnerable.Health resources and services availability monitoring systemTheHealth Resources and Services Availability Monitoring System (HeRAMS)Initiative plays a c