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Cost of conducting Measles-Rubella vaccination campaign in India
Susmita Chatterjee1,2,3, Dayoung Song4, Palash Das1
1Department of Research, George Institute for Global Health, New Delhi, India.
Insights
The Measles-Rubella (MR) vaccination campaign in India cost between $0.16 and $0.34 per dose. Delivery costs exceeded government budgets, highlighting potential underutilization and the need for better financial planning for future immunization programs.
Area of Science:
- Public Health
- Health Economics
- Vaccine Delivery Systems
Background:
- India launched a large-scale Measles-Rubella (MR) vaccination campaign in 2017.
- Limited data exists on the actual costs of delivering such vaccination campaigns.
- Understanding delivery costs is crucial for efficient public health resource allocation.
Purpose of the Study:
- To estimate the financial and economic delivery costs of the MR vaccination campaign from a government provider perspective.
- To identify key cost drivers and compare estimated costs with the allocated budget.
- To provide unit cost information for future vaccination campaign planning in India.
Main Methods:
- A mixed-methods approach using top-down and bottom-up costing was employed.
- Data was collected from 84 sites across four Indian states (Assam, Gujarat, Himachal Pradesh, Uttar Pradesh).
- Costs were analyzed from August 2019 to March 2020 and presented in 2019 US$ and INR.
Main Results:
- Financial cost per dose ranged from $0.16 in Uttar Pradesh to $0.34 in Gujarat.
- The full economic cost per dose in Uttar Pradesh was $0.87.
- Key cost drivers included incentives, record-keeping, social mobilization, and advocacy.
Conclusions:
- Estimated delivery costs exceeded the government's pre-fixed budget, suggesting potential underfunding.
- Some states showed budget underutilization, indicating a need for improved financial management.
- The study provides valuable unit cost data for planning future vaccination campaigns in India.
Abstract:
A Measles-Rubella (MR) vaccination campaign was launched in India in a phased manner in February 2017 to cover children aged 9 months to 15 years. As evidence on campaign vaccine delivery costs is limited, the delivery cost for MR campaign from a government provider perspective was estimated in four Indian states, namely, Assam, Gujarat, Himachal Pradesh, and Uttar Pradesh. Costs were calculated in top-down and bottom-up approaches using data collected from 84 sites at different administrative levels and immunization partners in the study states from August 2019 to March 2020. All costs were presented in 2019 US$ and Indian Rupee (INR). The financial cost per dose of the MR campaign including all partner support ranged from US$0.16 (INR 10.95) in Uttar Pradesh to US$0.34 (INR 24.13) in Gujarat. In Uttar Pradesh, the full economic cost per dose was US$0.87 (INR 61.39). The key financial cost drivers were incentives related to service delivery and supervision, the printing of reporting formats for record-keeping, social mobilization, and advocacy. The financial delivery cost per dose estimated was higher than the government pre-fixed budget per child for the MR campaign, probably indicating an insufficient budget. However, the study found underutilization of MR budget in two states and use of other sources of funding for the campaign indicating the need for proper utilization of the campaign budgets by the states. Unit cost information generated from this study will be useful for planning, cost projections, and economic analysis of future vaccination campaigns in India.
