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Immunization campaigns are a vital delivery strategy to improve coverage and decrease morbidity and mortality from vaccine-preventable diseases. Campaigns are used frequently to administer a variety of lifesaving vaccines such as measles, cholera, yellow fever, and Covid-19. Immunization campaigns require significant resources over a short period of time. Inadequate funding can decrease a campaign’s effectiveness, and a low-impact campaign may be a considerable waste of resources. 

It is crucial that the costs of different immunization campaigns are accurately estimated to inform planning, budgeting, and resource mobilization. Although various guidance documents cover the costing of health interventions and routine immunization programs specifically, none discuss the specifics of costing immunization campaigns.  

The How to Cost an Immunization Campaign guide released as part of the ICAN project in 2021 offers methodological advice for field researchers, country practitioners, and academics worldwide on costing an immunization campaign. Learnings from campaign costing studies in India, Nigeria, and Sierra Leone were used to inform the guidance. This guide complements the literature on costing studies with specific methodological considerations for immunization campaigns, clear instructions fitting potential scenarios, and concrete examples. It is intended to improve the standardization of campaign costing processes and reporting, enhance the availability and comparability of evidence, and improve its use by country and global stakeholders.  

The guide is also accompanied by practical tips for costing studies, information on the differences between routine immunization and campaign costing, FAQs on campaign costing, data collection tools at facility, district, state, and national levels plus user manual, and practical examples on how to annualize capital costs and calculate unit costs in Excel, and run a calibration exercise in R. 

You can find out more about ThinkWell’s work on campaign costing here. 

This piece originally appeared on MOMENTUM, USAID here.

MOMENTUM Private Healthcare Delivery is supporting and strengthening private sector providers’ capacity to sustainably integrate and participate in public purchasing programs, including for family planning services. Led by ThinkWell, MOMENTUM has conducted a rapid landscape review that identifies the common barriers for private providers when engaging in public purchasing programs. The landscape draws on literature from across 23 countries and presents opportunities and recommendations to address private health provider challenges in engagement and collaboration within the public health sector.

Download the PowerPoint 

“To achieve and sustain access to quality primary health care services for all consumers, our health system needs to engage, optimize, and mobilize both the public
and private sectors to provide primary health care services.” 
—Kenneth Ronquillo, Assistant Secretary Department of Health

Our team in the Philippines held a forum that brought together public and private stakeholders to discuss the current state of Health Care Provider Networks (HCPNs) in the country and identify possible opportunity areas to engage private sector partners and increase their participation in HCPNs.  

During PSPH Series 2 Back on Track, Full Speed Ahead: Engaging Private Providers in HCPN, Kenneth Ronquillo, Assistant Secretary Department of Health, recalled that it had been two years since the UHC Bill became law—ensuring citizens have access to all the health care they need without financial hardship. Yet, there is still room to develop guidelines to improve the health system goals.

Though private and public stakeholders have been taking strides towards more co-equal participation of private healthcare providers in HCPNs. The three sessions in this forum further created an opportunity for stakeholders to identify ways to improve public-private partnerships, an information-sharing platform, fund pooling and purchasing mechanisms, and capacity development of private sector partners to be engaged in HCPNs. 

Watch the sessions here and learn more about our work in the Philippines here

Many thanks to all participants who took part in the conversation and helped explore concrete opportunities to move UHC forward.

AC Health
Antique Provincial Health Office
Antique Provincial DOH Office
Asian Development Bank Philippines
Commission on Population and Development
DOH Bureau of Local Health Systems Development
DKT International
Family Planning Organization of the Philippines
Guimaras Provincial Health Office
Guimaras Provincial DOH Office
Integrated Midwives Association Of The Philippines
Likhaan Center for Women’s Health
Mt. Grace Hospitals, Inc.
PhilHealth
Philippine Center for Population and Development
Philippine Primary Care Studies of the University of the Philippines
The Medical City
UNFPA Philippines

Since 2011, ThinkWell has expanded access to high quality health services to underserved populations in low- and middle-income countries by addressing health system challenges that rarely get the attention they need. Universal health coverage lies at the center of our work, and while there are hundreds of initiatives to address hundreds more health issues, diseases, and economic gaps, global immunization is a unique opportunity to save lives, increase productivity and economic gains, and improve quality of life for individuals and families. What’s more, immunization is considered one of the most cost-effective investments available, which means that limited financial resources are well spent and have high health returns when invested in vaccines. 

While national governments, especially those of low- and middle-income countries, seek to expand national immunization programs to include newer vaccines, like those for human papillomavirus and dengue fever, the financing rarely matches the desired scale of these programs. Financing should not only cover the cost of procuring vaccines, but it should also cover increased investments in cold chain management and logistics, training of providers, and social mobilization and awareness-building efforts. So, while strong immunization programming is considered a “good buy,” it isn’t cheap and requires sustained investment. 

As the world’s immunization experts fortify global health systems with knowledge gained from COVID-19, ThinkWell’s immunization projects have continued to generate economic evidence informing planning and investment in vaccine delivery for marginalized people across the globe. Every day, our world moves closer to global immunization standards. Following this World Immunization Week, we’d like to celebrate the progress we’ve made as a global health community and look ahead to the steps yet to be taken. 

The Investment of a Lifetime 

According to the World Health Organization, before COVID-19, only 11% of public spending on health was for prevention in low- and middle-income countries, and governments account for less than half of total spending on disease prevention. Policymakers may place a high value on immunization and public health, yet many immunization budgets remain flat, as prevention results are far less visible than curative intervention. 

Financing shortfalls mean low vaccine adoption rates and variable coverage which compromises the efficacy of lifesaving vaccines. ThinkWell’s Sustainable Immunization Financing team has seen these patterns time and again, but the economic evidence behind the health returns on vaccines is too large to ignore. Our teams work with local experts and government officials in geographically diverse countries to develop financing evidence and policy recommendations built to withstand evolving sociopolitical agendas and unpredictable events like global pandemics. 

Relative to other health initiatives, immunization has excellent value-for-money and has proven itself an unfailing investment in current and future generations. To this end, advocates, civil society organizations, immunization program managers, and researchers alike can take the following actions to raise awareness and galvanize support: 

  1. Tell the full story of vaccination success to generate societal and political demand. 
  2. Create and maintain a shared agenda across the health advocacy spectrum. 
  3. Articulate the shared needs of the products, systems, and people involved in immunization. 
  4. Integrate immunization into primary health care. 

To champion routine immunization in the long term, advocates and immunization program managers need to provide ministers of health and finance a clear picture of what their countries would be facing without immunization programs. These steps are a clear way to push the immunization financing agenda forward. 

Immunization Equity 

Immunization programs and budgets require continuous honing and nuanced understanding of local needs and capacities. Once budgets are built and funds are earmarked, nations need to ensure that there is local capacity for education and deployment. The global immunization economics community churns out data around costs per dose, campaign financing, and workforce shortages daily. The Immunization Economics community of practice, managed by ThinkWell, is a conglomerate of researchers from all over who make their research public so that policymakers and civil society organizations can create efficient budgets and advocate for mass immunization in local communities. 

A global network of experts ensures that underserved populations whose health needs rarely get the required attention can access vaccines from childhood and reap the long-term health and economic benefits of stopping a disease before it starts. And when populations are vaccinated, fewer need intensive health care services later in life, reducing the economic burden on national health coverage schemes. 

Our Global Responsibility 

Health professionals in every country work tirelessly to reach new populations and deliver essential health services like vaccines in areas where demand is the greatest, but without visibility and increased support from national stakeholders, immunization will fall short of global goals and people who need them will not receive lifesaving vaccines. 

As we rebound from COVID-19 with boundless new information on budgeting for health crises and rapid vaccine deployment, knowledge-sharing is an indispensable way to make sure low- and middle-income countries have evidence on which to build sustainable immunization financing policy. 

When governments are equipped with current data, digestible research, and clear health goals, the value of vaccines will be made abundantly clear and immunization financing will become a health priority. Following World Immunization Week 2022 and beyond, ThinkWell joins the global health community to share ideas, research, and support for health professionals and researchers around the world and ensuring every person has access to lifesaving vaccines. 

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