Estimating the costs of the vaccine supply chain and service delivery for selected districts in Kenya and Tanzania
| Autor: | Debra Kristensen, Lyimo Dafrossa, Abner Otieno, Rosemary Kigadye, Amos Chweya, Lydia Kirika, Mercy Mvundura, Mohammed Makame, P. K. Kamau, Steven Mwangi, Peninah Murunga, Tom Omurwa, Kathryn Bartholomew, T. Patrick Lennon, Kristina Lorenson |
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| Rok vydání: | 2015 |
| Předmět: |
Service delivery framework
Total cost Cost-Benefit Analysis Health Personnel Stockout Supply chain Tanzania Agricultural economics Refrigeration Environmental protection Immunology and Microbiology(all) Humans Cold chain health care economics and organizations Stock (geology) Vaccines General Veterinary General Immunology and Microbiology biology Immunization Programs Vaccination Public Health Environmental and Occupational Health Health Care Costs biology.organism_classification Kenya veterinary(all) Outreach Infectious Diseases Molecular Medicine Business |
| Zdroj: | Vaccine. 33:2697-2703 |
| ISSN: | 0264-410X |
| DOI: | 10.1016/j.vaccine.2015.03.084 |
| Popis: | Having data on the costs of the immunization system can provide decision-makers with information to benchmark the costs when evaluating the impact of new technologies or programmatic innovations. This paper estimated the supply chain and immunization service delivery costs and cost per dose in selected districts in Kenya and Tanzania. We also present operational data describing the supply chain and service delivery points (SDPs). To estimate the supply chain costs, we collected resource-use data for the cold chain, distribution system, and health worker time and per diems paid. We also estimated the service delivery costs, which included the time cost of health workers to provide immunization services, and per diems and transport costs for outreach sessions. Data on the annual quantities of vaccines distributed to each facility, and the occurrence and duration of stockouts were collected from stock registers. These data were collected from the national store, 2 regional and 4 district stores, and 12 SDPs in each country for 2012. Cost per dose for the supply chain and immunization service delivery were estimated. The average annual costs per dose at the SDPs were $0.34 (standard deviation (s.d.) $0.18) for Kenya when including only the vaccine supply chain costs, and $1.33 (s.d. $0.82) when including immunization service delivery costs. In Tanzania, these costs were $0.67 (s.d. $0.35) and $2.82 (s.d. $1.64), respectively. Both countries experienced vaccine stockouts in 2012, bacillus Calmette-Guérin vaccine being more likely to be stocked out in Kenya, and oral poliovirus vaccine in Tanzania. When stockouts happened, they usually lasted for at least one month. Tanzania made investments in 2011 in preparation for planned vaccine introductions, and their supply chain cost per dose is expected to decline with the new vaccine introductions. Immunization service delivery costs are a significant portion of the total costs at the SDPs. |
| Databáze: | OpenAIRE |
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