Financing Comprehensive Immunization Services in Lao PDR: A Fiscal Space Analysis From a Public Policy Perspective.

Area of Science:

• Health economics
• Public health policy
• Immunization programs

Background:

• Immunization is a core component of the Essential Health Service Package (ESP) in Lao PDR.
• Assessing the cost and fiscal feasibility of the immunization program is crucial for policy decisions.

Purpose of the Study:

• To estimate the total cost of implementing the immunization program under ESP.
• To identify cost determinants and fiscal implications from the government's perspective.

Main Methods:

• A normative costing approach was used.
• Resource utilization for vaccine delivery was identified using Standard Treatment Guidelines.
• Fiscal space was assessed using a decomposition method.

Main Results:

• The total cost of immunization in Lao PDR was estimated at US$12 million in 2019, projected to reach US$21 million by 2025.
• The per capita budget needs to increase from US$2 to US$7.
• Introduction of new vaccines accounts for 60% of the increased cost, straining current government allocations.

Conclusions:

• Current fiscal space is insufficient for introducing new vaccines under the ESP in Lao PDR.
• Continued financing from the Global Alliance for Vaccine Initiative (GAVI) is recommended.
• A publicly financed immunization model requires significant strategic changes with limited short-term viability.