Introduction

Information on the costs of routine immunization programs is needed for budgeting, planning, and domestic resource mobilization. This information is particularly important for countries such as Tanzania that are preparing to transition out of support from Gavi, the Vaccine Alliance. This study aimed to estimate the total and unit costs for of child immunization in Tanzania from July 2016 to June 2017 and make this evidence available to key stakeholders.

Methods

We used an ingredients-based approach to collect routine immunization cost data from the facility, district, regional, and national levels. We collected data on the cost of vaccines as well as non-vaccine delivery costs. We estimated total and unit costs from a provider perspective for each level and overall, and examined how costs varied by delivery strategy, geographic area, and facility-level service delivery volume. An evidence-to-policy plan identified key opportunities and stakeholders to target to facilitate the use of results.

Results

The total annual economic cost of the immunization program, inclusive of vaccines, was estimated to be US$138 million (95% CI: 133, 144), or $4.32 ($3.72, $4.98) per dose. The delivery costs made up $45 million (38, 52), or $1.38 (1.06, 1.70) per dose. The costs of facility-based delivery were similar in urban and rural areas, but the costs of outreach delivery were higher in rural areas than in urban areas. The facility-level delivery cost per dose decreased with the facility service delivery volume.

Discussion

We estimated the costs of the routine immunization program in Tanzania, where no immunization costing study had been conducted for five years. These estimates can inform the program’s budgeting and planning as Tanzania prepares to transition out of Gavi support. Next steps for evidence-to-policy translation have been identified, including technical support requirements for policy advocacy and planning.

中文翻译：

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从证据到政策的免疫成本：坦桑尼亚具有全国代表性的成本研究和政策翻译工作的发现

介绍

预算，规划和国内资源动员需要有关常规免疫计划成本的信息。对于准备从疫苗联盟Gavi过渡过来的坦桑尼亚等国家而言，此信息尤其重要。这项研究旨在估算2016年7月至2017年6月坦桑尼亚坦桑尼亚儿童免疫的总成本和单位成本，并将这一证据提供给主要利益相关者。

方法

我们使用了一种基于成分的方法来收集来自机构，地区，区域和国家各级的常规免疫费用数据。我们收集了有关疫苗成本以及非疫苗运送成本的数据。我们从提供商的角度估计了每个级别和总体的总成本和单位成本，并检查了成本根据交付策略，地理区域和设施级别的服务交付量如何变化。从证据到政策的计划确定了关键的机会和利益相关者，目标是促进成果的使用。

结果

包括疫苗在内的免疫计划每年的总经济成本估计为1.38亿美元（95％CI：133、144），或每剂$ 4.32（$ 3.72，$ 4.98）。运送费用由每剂$ 4,500万（38，52）或$ 1.38（1.06，1.70）组成。在城市和农村地区，基于设施的交付成本相似，但在农村地区，外展交付成本要高于城市地区。单位剂量的设施级交付成本随设施服务交付量而降低。

讨论区

我们估计了坦桑尼亚常规免疫计划的费用，该国五年未进行任何免疫成本研究。当坦桑尼亚准备从Gavi支持过渡时，这些估计数可以为计划的预算和计划提供信息。已经确定了将证据转换为政策的后续步骤，包括政策倡导和计划的技术支持要求。