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11 recordsLinked to original sources
PubMed1989

The Thai expanded programme on immunization: role of immunization sessions and their cost-effectiveness.

A cost-effectiveness study of the Thai expanded programme on immunization was carried out in district hospitals and health centres in Thailand during early 1987. The total annual spending on immunization was US $3852 in hospitals and US $813 in health centres. The percentage distribution of annual costs was similar in both facilities. Salaries were the largest component, followed by building and vaccine costs. The frequency of immunization sessions was the most important factor in determining total costs--immunization costs increasing with the frequency of sessions. In hospitals the average number of fully immunized children was 184, compared with 49 in health centres. The cost per fully immunized child varied widely from US $5.30 to US $33.20, and the most cost-effective facilities were those that immunized the greatest number of children. With the present number of health facilities in all areas of the country, which correspond to saturation levels, the most likely way for the Thai programme to reduce costs would be to make better use of staff time by decreasing the frequency of the services offered, thereby increasing the efficiency of each session. Hospitals should adjust the frequency of their immunization sessions according to the number of children being served, but health centres should offer sessions only monthly or once every two months.

Community Health Centers↗
PubMed1992

Childhood immunization practices of primary care physicians.

OBJECTIVE: To assess if immunization utilization practices differ between rural and urban primary care physicians in Kentucky. DESIGN: Survey of 200 primary care physicians. PARTICIPANTS: Pediatricians, family physicians, and general practitioners in Kentucky. SELECTION PROCEDURES: Participants completed a 20-item questionnaire that surveyed selected demographics with regard to the physician and practice, immunizations offered to children, and reasons why the responding physicians did not offer immunizations and where they referred patients for this service. RESULTS: Physicians practicing in rural counties offered immunizations to their patients less frequently than did urban physicians (54% vs 77%). Rural and urban physicians cited immunization costs to patients as the chief reason that immunizations were not used more often and referred patients primarily to county health departments. CONCLUSIONS: Rising costs have limited physician use of immunizations in rural areas to a greater extent than that seen in urban areas. This may make access to immunizations more difficult for children living in rural areas.

Child↗
PubMed1986

Cost effectiveness of potential immunization interventions against diarrhoeal disease.

Estimates are made of the costs per death averted and the costs per case prevented by three possible immunization interventions against diarrhoeal disease in children. These estimates are based on cost information collected from a number of on-going national immunization programmes and from effectiveness estimates reported in previously published reviews. The first part of the paper reviews the state of current knowledge regarding immunization costs and converts data from 9 different studies into a common set of price equivalents. The second section assesses the composition of typical immunization programme costs and estimates the likely effect on existing costs of introducing new vaccines. Compatibility between existing EPI activity and the administration schedule of the new vaccine is likely to be a major determinant of increments in cost per fully immunized child. The third section brings together the cost information with estimates of the likely impact of measles, rotavirus and new cholera vaccines on mortality and morbidity from diarrhoea.

Adolescent↗
PubMed1990

Door-to-door canvassing for immunization program acceleration in Mozambique: achievements and costs.

The Expanded Program on Immunization has made remarkable progress in raising coverage in developing countries. Countries have been urged to accelerate their programs, especially in urban areas. In Mozambique, as part of program acceleration, volunteers from grassroots organizations conducted door-to-door canvassing for the Program. Concurrently, the availability of immunization was increased in health centers and in outreach visits. By 1987, over 90 percent coverage for all vaccines was achieved in the capital, Maputo; two other cities doubled their immunization coverage to over 50 percent fully immunized children, and rural areas of the pilot province achieved 60 percent coverage. Immunization costs were estimated in one city as $6.9 (U.S. dollars) per fully vaccinated child. Door-to-door canvassing accounted for more than 40 percent of personnel costs, and may have diverted attention from the quality of service in the health centers. In this article we outline the achievements and costs of door-to-door canvassing and discuss other strategies to raise coverage. The analysis of the need to balance the mobilization of demand with the capacity to respond is relevant to other countries in their efforts to develop sustainable immunization services.

Cost-Benefit Analysis↗
PubMed1979

Benefits of immunization versus risk factors in tetanus.

The risk of tetanus is universal, but it depends on numerous factors (socio-economic, environmental and biological) which combine to determine the force of infection. Tetanus is a murderous and costly disease. Its morbidity has greatly regressed in industrialized countries (less than 1 case per 100,000, involving mainly aged persons). On the contrary, developing countries are still severely affected (10 to 50 cases per 100,000, involving mainly neonates and children). Tetanus vaccine is one of the most effective, best tolerated and least expensive vaccines. Vaccination is the main weapon for starting disease control in developing countries, and the only way of eradicating tetanus in developed countries. Whatever the socio-economic level may be, some evaluations show that immunization cost is approximately equal to avoided treatment and seroprevention expenditures. The essential benefit of vaccination is the prevention of death, suffering and disability.

Adolescent↗
PubMed1979

Immunization against poliomyelitis: risk/benefit/cost in a changing context.

Benefit/risk factors in immunization against poliomyelitis are examined from the viewpoint of the relative risk and efficacy of killed and live poliovirus vaccines in the currently changing contexts of poliomyelitis prevalence in developed and developing countries. Risk factors include virus of vaccine origin gaining access to the CNS, and failure of the vaccine to immunize. Data are presented to illustrate the degree to which the respective risks occur in developed and developing countries. The ultimate elimination of risk by eradication of wild and vaccine virus from the population is discussed.

Adolescent↗
PubMed1989

Cost-effectiveness of routine and campaign vaccination strategies in Ecuador.

A national household coverage survey of 3697 Ecuadorean children, carried out in July 1986, provided an opportunity for a cost-effectiveness analysis of (1) routine vaccination services based in fixed facilities and (2) mass immunization campaigns. A major purpose of the campaigns was to complement the routine services and to accelerate immunization activities. Based on the coverage survey, the Program for Reduction of Maternal and Childhood Illness (PREMI) and earlier campaigns increased the proportion of children under 5 years who were fully vaccinated from 43% to 64%. In one year, the PREMI campaign was responsible for fully vaccinating 11% of children under one year, 21% of 1-2-year-old children, and 13% of all children under 5 years. The campaign also helped ensure that vaccinations were completed when children were still very young and at greatest risk. The average cost per vaccination dose (in 1985 US$ prices) was approximately $0.29 for fixed facilities and $0.83 for the PREMI campaign. Total national costs were $675,000 and $1,665,000 for routine and campaign services respectively. The cost per fully vaccinated child (FVC) was $4.39 for routine vaccination services and $8.60 for the campaign. The cost per death averted was about $1900 for routine vaccination services, $4200 for the PREMI campaign, and $3200 for the combined programme. Because of Ecuador's lower mortality rates, the costs per death averted in Ecuador from both vaccination strategies are not as low as those from studies of vaccinations in Africa. The campaigns, though less cost-effective than routine services, significantly improved the vaccination coverage of younger children who had been missed by the routine services. The costs per FVC of both the campaign and the routine services compare favourably with such programmes in other countries.

Child↗
PubMed1984

Service volume and other factors affecting the costs of immunizations in the Gambia.

The total cost of the Expanded Programme on Immunization and of its various components in the Gambia over a period of one year (from July 1980 to June 1981) was investigated, and the costs per immunization dose and per fully immunized child were calculated. The total costs were to a large extent (45%) due to the cost of personnel and fixed costs. Where there was efficient delivery of immunizations, the average cost per dose was about one-fifth of that in the most costly facilities (range: US$2.32 to $0.41). The lower costs were related to more intensive use of the facilities. The national average cost was $1.09. The implications of the results of this study for policies to reduce costs are discussed, and further areas of research are suggested that will provide improved information to guide decision-makers in the use of scarce immunization programme resources for better health in the world.

Child↗