Researchers from the Center for Disease Dynamics, Economics and Policy (CDDEP) have completed a study which outlines the cost of delivering routine childhood vaccines in seven Indian states. The findings, published in the British Medical Journal Global Health, provide useful information to India's Universal Immunization Program (UIP), where the data collected can be used to accurately plan and budget. The UIP is the largest public vaccination program in the world, yet its budget is prepared based on historical expenditure data.
The main finding in the research was the broad range of cost per dose delivered, from US$1.38 (INR 88) to US$2.93 (INR 187) . The weighted average national cost per dose delivered, including the cost of the vaccine itself, was US$2.29 (INR 147).
There was also a substantial range in the total cost of vaccinating a child, from US$20.08 (INR 1,285) to US$34.81 (INR 2,228) across the states of Bihar, Gujarat, Kerala, Meghalaya, Punjab, Uttar Pradesh and West Bengal. Currently, India's Universal Immunization Program (UIP) allocates approximately US$25 per child for vaccination costs.
The researchers visited 255 health facilities of different types and collected cost data using standardized and pre-tested questionnaires. The cost categories were personnel, vaccines and supplies, transport, training, maintenance and overhead, incentives, and the annual value of capital expenditures. Personnel cost accounted for 57% of the total costs, making this the largest contributor to the total cost.
"This study is of significant value to India's Universal Immunization Program as it's the first of its kind on a micro-level scale" according to Arindam Nandi of CDDEP, one of the study's co-authors. "It shows that it costs the Indian government about $2 (INR 128), without vaccine price, to deliver a dose of vaccine to a child. The findings serve as an important benchmark for both planning and future research purposes."
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Susmita Chatterjee et al, Variation in cost and performance of routine immunisation service delivery in India, BMJ Global Health (2018). DOI: 10.1136/bmjgh-2018-000794