Estimating the costs of the vaccine supply chain and service delivery for selected districts in Kenya and Tanzania |
| |
| Institution: | 1. PATH, 2201 Westlake Ave, Suite 200, Seattle, WA 98121, USA;2. PATH, A.C.S. Plaza, 4th Floor, Lenana and Galana Road, PO Box 76634, Nairobi 00100, Kenya;3. PO Box 33810, Dar es Salaam, Tanzania;4. Unit of Vaccines and Immunization, Ministry of Health, Nairobi, Kenya;5. Expanded Program on Immunizations, Ministry of Health and Social Welfare, Dar es Salaam, Tanzania;6. PATH, 10th Floor, Amani Place, Ohio Street, Dar es Salaam, Tanzania;1. World Health Organization, Geneva, Switzerland;2. Collaborative Centre for Cold Chain Management, Pretoria, South Africa;3. Western Cape Department of Health, Cape Town, South Africa;1. International Vaccine Access Center (IVAC), Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States;3. Department of Industrial Engineering, University of Pittsburgh, Pittsburgh, PA, United States;4. Pittsburgh Supercomputing Center (PSC), Carnegie Mellon University, Pittsburgh, PA, United States;1. Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland;2. University of Basel, Basel, Switzerland;3. Health Systems Governance and Financing, World Health Organization, Switzerland;1. HERMES Logistics Team, Pittsburgh, PA and Baltimore, MD, United States;2. Global Obesity Prevention Center (GOPC) at Johns Hopkins University, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States;3. Pittsburgh Supercomputing Center (PSC), Carnegie Mellon University, Pittsburgh, PA, United States;1. Pittsburgh Supercomputing Center (PSC), Pittsburgh, PA, USA;2. UNICEF, New York, NY, USA;3. Public Health Computational and Operations Research (PHICOR), Baltimore, MD, USA;4. Agence de Médicine Préventive (AMP), Paris, France;5. Agence de Médicine Préventive (AMP), Cotonou, Benin;6. PATH, Seattle, WA, USA;7. University of Pittsburgh, Pittsburgh, PA, USA;8. University of Washington, Seattle, WA, USA;9. Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA |
| |
| Abstract: | 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. |
| |
| Keywords: | Cost per dose Vaccine supply chain cost Expanded Program on Immunization Micro-costing Kenya Tanzania |
| 本文献已被 ScienceDirect 等数据库收录！ |
|
