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尼日利亚东南部阿南布拉州为儿童提供麻疹免疫接种的补充免疫活动成本分析。

Cost analysis of supplemental immunization activities to deliver measles immunization to children in Anambra state, south-east Nigeria.

机构信息

Department of Nursing Science, Nnamdi Azikiwe University, Nnewi Campus, Nnewi, Nigeria.

Department of Health Administration and Management, University of Nigeria, Enugu Campus, Enugu, Nigeria.

出版信息

Vaccine. 2020 Aug 18;38(37):5947-5954. doi: 10.1016/j.vaccine.2020.06.072. Epub 2020 Jul 7.

Abstract

BACKGROUND

Measles immunization is critical for reducing the societal burden of the disease, especially among children. However, the costs of the measles supplemental immunization activities, which are the main vaccine deployment strategy, are usually high and financing such immunization activities is a serious challenge in Nigeria. In Nigeria, little or no information exists on the costs of measles supplemental immunization activity for planning and sustenance of immunization programmes. This study aimed to determine the cost per child immunized and cost structure of a follow-up supplemental immunization activity (SIA) for measles immunization to children.

METHOD

Data on costs and outputs of SIA were collected from six Local Government area (LGAs) immunization offices in Anambra state, southeast Nigeria. The ingredient approach was used for costing, based on the providers' perspective. The sample results were extrapolated to state estimates using volume weighted mean method. The major indicator considered was cost per child immunized. Two-way sensitivity analysis was used to test the robustness of the results.

RESULT

The cost per child immunized through SIA was $1.37 and the cost per child for operational cost only was $0.81. The total cost of the SIA for the sample was $345,069.35 and the operational cost was $204,969.46. The cost of personnel (43.99%) and vaccine (36.22%) contributed the highest percentage to the total cost of SIA. The cost of personnel and transportation took the first (74.6%) and second (7.10%) highest percentages of the operational cost for the sample. The estimated total and operational costs of measles SIA for the state were $1,279,127.84 and $759,795.52 respectively.

CONCLUSION

The cost per child immunized with measles containing vaccine through SIA is relatively high in Nigeria. There is a need to review the activities with SIA, so as to ensure that resources are efficiently allocated and used for different activities of the programme.

摘要

背景

麻疹免疫对于减轻疾病的社会负担至关重要,尤其是在儿童中。然而,作为主要疫苗部署策略的麻疹补充免疫活动的成本通常很高,在尼日利亚,为这些免疫活动提供资金是一项严峻的挑战。在尼日利亚,规划和维持免疫规划所需的麻疹补充免疫活动的成本信息很少或根本不存在。本研究旨在确定为儿童进行麻疹补充免疫活动(SIA)的每个儿童免疫成本和成本结构。

方法

从尼日利亚东南部阿南布拉州的六个地方政府区域(LGA)免疫办公室收集 SIA 的成本和产出数据。成本核算采用投入成分法,基于提供者的视角。使用体积加权平均值法将样本结果外推至州估计值。主要考虑的指标是每个儿童的免疫成本。采用双向敏感性分析来测试结果的稳健性。

结果

通过 SIA 为每个儿童免疫的成本为 1.37 美元,仅运营成本的每个儿童的成本为 0.81 美元。样本的 SIA 总成本为 345,069.35 美元,运营成本为 204,969.46 美元。人员成本(43.99%)和疫苗成本(36.22%)对 SIA 总成本的贡献最高。人员成本和运输成本分别占样本运营成本的最高比例(74.6%和 7.10%)。该州麻疹 SIA 的估计总成本和运营成本分别为 1,279,127.84 美元和 759,795.52 美元。

结论

在尼日利亚,通过 SIA 为儿童接种含麻疹疫苗的每个儿童免疫成本相对较高。需要审查 SIA 活动,以确保资源得到有效分配和用于该规划的不同活动。

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