Determinants of cost of routine immunization programme in India

Vaccine
Susmita ChatterjeeRamanan Laxminarayan

Abstract

The costs of delivering routine immunization services in India vary widely across facilities, districts and states. Understanding the factors influencing this cost variation could help predict future immunization costs and suggest approaches for improving the efficiency of service provision. We examined determinants of facility cost for immunization services based on a nationally representative sample of sub-centres and primary health centres (99 and 89 facilities, respectively) by regressing logged total facility costs, both including and excluding vaccine cost, against several explanatory variables. We used a multi-level regression model to account for the multi-stage sampling design, including state- and district-levelrandom effects. We found that facility costs were significantly associated with total doses administered, type of facility, salary of the main vaccinator, number of immunization sessions, and the distance of the facility from the nearest cold chain point. Use of pentavalent vaccine by the state was an important determinant of total facility cost including vaccine cost. India is introducing several new vaccines including some supported by Gavi. Therefore, the government will have to ensure that additional resour...Continue Reading

Citations

Jun 28, 2018·BMJ Global Health·Susmita ChatterjeeRamanan Laxminarayan
Jan 13, 2021·Value in Health : the Journal of the International Society for Pharmacoeconomics and Outcomes Research·So Yoon SimBryan N Patenaude
Sep 16, 2021·Health Policy and Planning·Emily SchuellerRamanan Laxminarayan
Sep 24, 2021·BMC Health Services Research·Shobhit SrivastavaAdrita Banerjee

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