Recorded presentation

Logan E. Brenzel, PhD, HDNHE, The World Bank, 1818 H Street, NW, Mail Stop G7-701, Washington, DC 20433, 202-458-5954, lbrenzel@worldbank.org

The World Health Organization estimates an additional 36 million children remain to be immunized. Achieving high rates of coverage will require an increasing rate of financing, as programs reach remote populations, accelerate strategies, and introduce new vaccines. There has been little research regarding the relationship between immunization coverage and program costs, and this study evaluates cost data collected from a stratified, random sample of health facilities in one district in South India. The study finds that outputs, prices, and other production factors are significant determinants of immunization program costs. Results show significant changes in total, variable, and unit costs as coverage rates increase. This finding calls into question the validity of using a single point-estimate of average unit costs (the result of most cost-effectiveness studies of immunization services to date) to determine the most cost-efficient uses of scarce public health resources. The study also finds evidence of increasing returns to scale with respect to provision of immunization services. Projections of future cost requirements based on average unit costs are likely to underestimate the total resources required unless they adjust for variable returns to scale. Investment decisions based on average costs are likely to result in sub-optimal resource allocations to immunization programs. Continued work in this area will be important for national investment decision-making and global resource allocation.

Learning Objectives:

• Recognize factors that influence the costs of immunization programs.
• Understand that the relationship between immunization program costs and coverage is not linear, and that current estimates of the cost of scaling up coverage do not take this yet into account.
• Recognize the gaps in policy-relevant information on costs and need for better data for decision-making.

Keywords: Cost Issues, Sustainability

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.

Recorded presentation