The Costs of Digital Health Interventions to Improve Immunization Data in Low- and Middle-Income Countries:...

Area of Science:

• Public Health
• Health Informatics
• Health Economics

Background:

• Digital health interventions, including electronic immunization registries (eIR) and electronic logistic management information systems (eLMIS), offer potential improvements for immunization data management and vaccine logistics in low- and middle-income countries (LMICs).
• Despite increasing adoption, comprehensive data on the financial and economic costs of implementing these digital systems compared to traditional paper-based methods remains limited.

Purpose of the Study:

• To quantify the financial and economic costs associated with implementing eIR and eLMIS systems in LMICs.
• To compare these costs against the expenses of previous paper-based registry systems.

Main Methods:

• A comparative cost analysis was conducted across four LMICs: Guinea, Honduras, Rwanda, and Tanzania.
• Data collection involved retrospective cost data from implementers and National Immunization Program offices, supplemented by primary survey data using an activity-based costing approach in 275 facilities.
• Costs were reported in 2023 international dollars (I$) and analyzed for national-level impact and affordability within national immunization budgets.

Main Results:

• Total implementation costs for eIR/eLMIS varied significantly across countries, ranging from I$2.2 million (Guinea) to I$44.3 million (Tanzania).
• Implementation resulted in higher costs per facility in Honduras and Rwanda, a cost reduction in Tanzania, and no significant difference in Guinea.
• The cost of managing data with electronic systems represented between 0.7% and 7.7% of total national immunization budgets.

Conclusions:

• Digital health tools like eIR and eLMIS can potentially enhance efficiency and reduce costs in immunization programs within LMICs.
• The actual cost savings are contingent upon the effective integration of digital systems, replacing paper-based methods, and their utilization in decision-making at the facility level.
• Strategic planning and investment are crucial for maximizing the economic benefits of digital health interventions in LMICs.