HeRAMS Health systems’ reliance on external aid: an assessment of vaccination services
July 2025
Overview
The Health Resources and Services Availability Monitoring System (HeRAMS) Initiative plays a critical role in strengthening health systems globally by supporting countries in the standardization and continuous collection, management, analysis, and dissemination of core information on the availability of and accessibility to essential health resources and services. This comprehensive approach supports the collaboration between ministries of health, humanitarian actors, and development partners, allowing them to collectively make evidence-based decisions in planning, coordination, and resource allocation for health service delivery.
This report assesses risks associated with health systems' dependence on external aid, focusing specifically on health service delivery units (HSDUs) that provide vaccination services. It introduces a risk index derived from HeRAMS data that enables comparisons across subnational, national, regional, and global levels, supporting decision-makers in understanding where health systems are most vulnerable during aid reprioritization processes.
The report is based on data reported in HeRAMS up until 4 July 2025. It should be noted that these HeRAMS deployments remain ongoing, including data verification and validation. Hence, the analysis presented here is not final and was produced solely for the purpose of informing operations.