Estimating total spending by source of funding on routine and supplementary immunisation activities in low-income and middle-income countries, 2000–17: a financial modelling study

Ikilezi, Gloria; Micah, Angela E; Bachmeier, Steven D; Cogswell, Ian; Maddison, Emilie R; Stutzman, Hayley; Tsakalos, Golsum; Brenzel, Logan; Dieleman, Joseph L

doi:10.1016/s0140-6736(21)01591-9

Cited by 17 publications

(14 citation statements)

References 13 publications

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“…Tables 2 and 3 present baseline characteristics and bivariate analyses of individual and contextual factors, respectively, in a weighted sample of 43,131 children aged 12-59 months in SSA. 16.5% of children were zero-dose, i.e., had not received any vaccines. 3 National measures of the Global Peace Index (GPI) overall score were obtained from the Institute for Economics and Peace (IEP).…”

Section: Descriptive Statistics and Bivariate Analysismentioning

confidence: 99%

“…Apart from these strategies, over USD 112 billion funding was provided for vaccine coverage between 2000 and 2017 [16]. However, the focus on "coverage" misses a potentially important population: children with zero-dose vaccination status.…”

Section: Introductionmentioning

confidence: 99%

“…These strategies include, Reaching Every District (RED) approach, Global Immunization Vision and Strategy (GIVS), and the Global Vaccine Action Plan (GVAP) [ 13 , 14 , 15 ]. Apart from these strategies, over USD 112 billion funding was provided for vaccine coverage between 2000 and 2017 [ 16 ]. However, the focus on “coverage” misses a potentially important population: children with zero-dose vaccination status.…”

Section: Introductionmentioning

confidence: 99%

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Correlates of Zero-Dose Vaccination Status among Children Aged 12–59 Months in Sub-Saharan Africa: A Multilevel Analysis of Individual and Contextual Factors

Ozigbu

Olatosi

et al. 2022

Vaccines

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Despite ongoing efforts to improve childhood vaccination coverage, including in hard-to-reach and hard-to-vaccinate communities, many children in sub-Saharan Africa (SSA) remain unvaccinated. Considering recent goals set by the Immunization Agenda 2030 (IA2030), including reducing the number of zero-dose children by half, research that goes beyond coverage to identify populations and groups at greater risk of being unvaccinated is urgently needed. This is a pooled cross-sectional study of individual- and country-level data obtained from Demographic and Health Surveys Program and two open data repositories. The sample includes 43,131 children aged 12–59 months sampled between 2010 and 2020 in 33 SSA countries. Associations of zero-dose status with individual and contextual factors were assessed using multilevel logistic regression. 16.5% of children had not received any vaccines. Individual level factors associated lower odds of zero-dose status included mother’s primary school or high school education, employment, use of antenatal care services and household wealth. Compared to children in countries with lower GDP, children in countries with relatively high GDP had nearly four times greater odds of being unvaccinated. Both individual and contextual factors are correlated with zero-dose status in SSA. Our results can inform efforts to identify and reach children who have not received any vaccines.

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Section: Descriptive Statistics and Bivariate Analysismentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Correlates of Zero-Dose Vaccination Status among Children Aged 12–59 Months in Sub-Saharan Africa: A Multilevel Analysis of Individual and Contextual Factors

Ozigbu

Olatosi

et al. 2022

Vaccines

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“…For all unit cost inputs related to service provision, we subtracted the share contributed by international donors, to obtain unit costs reflecting the contribution of domestic resources to service provision. For vaccination costs, we assumed a donor share stratified by World Bank income level (69.4% for low-income countries, 39.4% for lower middle-income countries, 0.2% for upper middle-income countries) based on Ikilezi, et al 24 For TB diagnosis and treatment costs, we estimated country-specific donor shares using spending estimates from the WHO Global TB Report 2022 (Appendix S1). 1 For antiretroviral therapy costs, we assumed a country-specific donor share based on spending estimates from the Global Burden of Disease Collaborative Network at IHME (Appendix S1).…”

Section: Methodsmentioning

confidence: 99%

The potential impact of novel tuberculosis vaccine introduction on economic growth in low- and middle-income countries

Portnoy¹,

Arcand

Clark

et al. 2022

Preprint

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Most individuals who develop tuberculosis (TB) are working-age adults living in low- and middle-income countries (LMICs). The resulting disability and death impacts economic productivity and burdens health systems. New TB vaccine candidates may reduce this burden. In this study, we estimated the impact of introducing novel TB vaccines on GDP growth in 105 LMICs, using a macroeconomic model to simulate country-level GDP trends between 2020 and 2080, in 2020 USD. We compared scenarios for introduction of infant and adolescent/adult vaccine candidates to a no-new-vaccine counterfactual. Compared to the no-new-vaccine counterfactual, both vaccination scenarios produced greater cumulative GDP in the modelled countries over the study period, equivalent to $1.6 (95% uncertainty interval: $0.8-3.0) trillion for the adolescent/adult vaccine, and $0.2 ($0.1-0.4) trillion for the infant vaccine. These GDP gains were substantially lagged relative to the time of vaccine introduction, and concentrated in countries with higher current TB incidence.

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“…While some of the Ministerial Conference commitments included strengthening supply chains and delivery systems, and increasing universal access to vaccines and sustainable immunisation financing, the latter remains the most critical and arduous to achieve 1. This is because international donors are gradually reducing their funding for immunisation programmes in low-income and middle-income countries (LMICs),4 5 as other health priorities, such as HIV/AIDS programmes, compete for limited health funding 6. Additionally, the financial resources needed for the successful implementation of immunisation programmes in LMICs are increasing because of prohibitive costs associated with the provision of the recent WHO-recommended vaccines such as the pneumococcal conjugate vaccine (PCV) and the cost of extending immunisation activities to hard-to-reach areas 7.…”

Section: Introductionmentioning

confidence: 99%

Is health expenditure on immunisation associated with immunisation coverage in sub-Saharan Africa? A multicountry analysis, 2013–2017

Idris,

Ouma,

Tapkigen

et al. 2024

BMJ Open

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ObjectivesThe designing of contextually tailored sustainable plans to finance the procurement of vaccines and the running of appropriate immunisation programmes are necessary to address the high burden of vaccine-preventable diseases and low immunisation coverage in sub-Saharan Africa (SSA). We sought to estimate the minimum fraction of a country’s health budget that should be invested in national immunisation programmes to achieve national immunisation coverage of 80% or greater depending on the context, with and without donors’ support.DesignMulticountry analysis of secondary data using retrieved publicly available data from the WHO, Global Alliance for Vaccines and Immunization (GAVI) and World Bank databases.SettingData on 24 SSA countries, between 2013 and 2017.MethodsWe model the variations in immunisation coverage across the different SSA countries using a fractional logit model. Three different generalised linear models were fitted to explore how various explanatory variables accounted for the variability in each of the three different vaccines—measles-containing vaccine (MCV)1, diphtheria, pertussis, tetanus (DPT3) and BCG.ResultsWe observed an association between current health expenditure (as a percentage of gross domestic product) and immunisation coverage for BCG (OR=1.01, 95% CI: 1.01 to 1.04, p=0.008) and DPT3 (OR=1.01, 95% CI: 1.0 to 1.02, p=0.020) vaccines. However, there was no evidence to indicate that health expenditure on immunisation (as a proportion of current health expenditure) could be a strong predictor of immunisation coverage (DPT, OR 0.96 (95% CI 0.78 to 1.19; p=0.702); BCG, OR 0.91 (0.69 to 1.19; p=0.492); MCV, OR 0.91 (0.69 to 1.19; p=0.482)). We demonstrate in selected countries that to achieve the GAVI target of 80% in the countries with low DPT3 coverage, health expenditure would need to be increased by more than 45%.ConclusionsThere is a need to facilitate the development of strategies that support African countries to increase domestic financing for national immunisation programmes towards achieving 2030 targets for immunisation coverage.

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Estimating total spending by source of funding on routine and supplementary immunisation activities in low-income and middle-income countries, 2000–17: a financial modelling study

Cited by 17 publications

References 13 publications

Correlates of Zero-Dose Vaccination Status among Children Aged 12–59 Months in Sub-Saharan Africa: A Multilevel Analysis of Individual and Contextual Factors

Correlates of Zero-Dose Vaccination Status among Children Aged 12–59 Months in Sub-Saharan Africa: A Multilevel Analysis of Individual and Contextual Factors

The potential impact of novel tuberculosis vaccine introduction on economic growth in low- and middle-income countries

Is health expenditure on immunisation associated with immunisation coverage in sub-Saharan Africa? A multicountry analysis, 2013–2017

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