Sydani supported Nepal in developing its Gavi-funded FPP by developing informed strategies to drive key immunization outcomes, leveraging $33.47 million in HSS2 and EAF3 funding (2025–2029). However, challenges persist in maintaining oversight of the EPI4 program and tracking its performance to ensure sustainable outcomes from these investments. To support Nepal’s goals and Gavi’s monitoring efforts, Gavi contracted Sydani to develop a comprehensive accountability framework to monitor the FPP implementation. The framework will focus on enhancing visibility between the Nepal government and Gavi, on the performance indicators to ensure efficient immunization efforts. Sydani leveraged innovative approaches for developing, testing and implementing Nepal’s accountability framework to support its immunization objectives

Sydani conducted stakeholder mapping, in-country stakeholder engagement, and alignment; conducted desk reviews on the existing health system accountability mechanisms; conducted a workshop to co-design framework elements, including establishing KPIs1 and reporting structures with stakeholders and integrating with GMRs2; and designed and developed accountability framework wireframe & dashboard. Review workshops were further conducted to test and obtain feedback on the first draft of the accountability framework, tools, strategies, and KPIs; the protocol developed for implementation of the AF tool and monitoring dashboard, and the accountability framework endorsement and dissemination meeting

The AF tool and monitoring dashboard were deployed at the national and sub-national levels, the Accountability Framework Task Team was identified, set-up and inaugurated, onboarding conducted for relevant cross-sectoral stakeholders across the national level, AFTT3 supported in the operationalization of the AF tool, knowledge products developed for public discourse and dissemination meeting conducted, scorecards developed for national and provincial level and high-level review of the AF indicators facilitated leveraging the NJAR in Nov 2025.