Fiscal space for the immunisation program in Zambia- an efficiency analysis approach

Area of Science:

• Public Health
• Health Economics
• Health Services Research

Background:

• The national immunisation programme in Zambia is a highly effective public health initiative.
• However, the long-term financial sustainability of this vital program is uncertain.
• Assessing efficiency is crucial for resource allocation and program viability.

Purpose of the Study:

• To determine the technical efficiency of immunisation service delivery across 24 districts in Zambia.
• To identify the fiscal space available for immunisation based on efficiency levels.
• To pinpoint areas for improvement in resource utilization for immunisation.

Main Methods:

• Utilized administrative data from 24 districts, including immunisation coverage, vaccine use, health facility and human resource numbers, health promotion expenditure, and outreach services.
• Employed Data Envelopment Analysis (DEA) to calculate technical efficiency scores.
• Calculated the potential vaccine savings and fiscal space based on efficiency improvements.

Main Results:

• 38% of the sampled districts (9 out of 24) demonstrated technical inefficiency in immunisation service provision.
• The average technical efficiency scores were high, reaching 0.92 (CRS technology) and 0.95 (VRS technology).
• Improving technical efficiency could yield enough vaccine doses to serve an additional 5 to 14 districts, highlighting significant potential savings.

Conclusions:

• While overall efficiency is high, a notable proportion of districts are technically inefficient in delivering immunisation services.
• Significant vaccine resources can be saved by addressing the identified sources of technical inefficiency.
• Enhancing technical efficiency presents a viable strategy to expand immunisation coverage and improve financial sustainability in Zambia.