Integrated campaigns: Implications for cost and policy
17 March 2022
As part of efforts through ICAN to standardize campaign costing, the team has released a policy brief with findings from three costing studies of immunization campaigns conducted in India, Nigeria, and Sierra Leone. Two of these campaigns were integrated (more than one intervention was delivered), a mode of delivery that is more of a priority than ever due to the COVID-19 pandemic. However, evidence is lacking on how integration affects delivery cost.
The policy brief presents the findings from costing studies of three campaigns:
- Measles-rubella catch-up campaign in India
- Yellow Fever campaigns in three states in Nigeria (Anambra, Katsina, and Rivers), co-delivered with meningitis A vaccine in Anambra
- Measles-rubella catch-up campaign in Sierra Leone that was co-delivered with oral polio vaccine nationwide, and vitamin A and deworming tablets in half of the country
The financial delivery cost per targeted person—including costs for all administrative levels, net of capital costs, vaccines, syringes, and safety boxes—for sampled vaccination campaign sites in India, Sierra Leone, and Nigeria ranged from US$0.15 to US$0.42. However, there was significant variation in operational costs across sampled sites, and low-volume sites appeared to have higher operational costs per targeted person, suggesting a need for more sophisticated subnational planning and financing of campaigns.
Financial efficiencies were evident in districts in Sierra Leone which co-delivered all interventions, though higher labor costs were also found in these areas, suggesting that integration may require greater use of existing resources. In Nigeria, results painted a more complex picture, and higher financial unit cost in the co-delivery state of Anambra was likely due to differences in volume delivered across sites, existing capacity, and the way the campaigns were funded.
The studies in Nigeria and Sierra Leone are the first on the cost of integrated campaigns and can form the basis for future research on the cost and policy implications of integration.