Costs of HPV Vaccination in Gavi-eligible Countries: a Case Study of Zimbabwe Open Access
Hidle, Anna (2016)
Abstract
Background: This study is an ingredients-based empirical cost analysis (guided by the WHO Cervical Cancer Prevention and Control Costing Tool (C4P)) of the HPV vaccination demonstration project that was carried out in two districts of Zimbabwe in 2014-2015. Funding support for the analysis was provided by GAVI, the Vaccine Alliance. The primary vaccination delivery strategy was school based. The target population was 6,508 ten-year-old-girls who received doses of the HPV vaccine based on e 2-dose schedule, following the World Health Organization (WHO) updated recommendations.
Methods: Incremental costs attributable to the HPV vaccination demonstration project were included in the analysis. Financial and economic costs were collected by activity and, under guidance of the WHO C4P tool, categorized as either an introduction or recurrent cost. Financial costs are the monetary outlays from the Ministry of Health and Child Care (MOHCC). Economic costs are the MOHCC financial costs plus the monetary and in-kind contributions from other partners plus in-kind costs from the MOHCC. Costs were collected and presented in current year US$.
Results: For both districts, both cohorts, 9,003 doses were administered and 4,412 Fully Immunized Girls (FIGs) were vaccinated. The total financial cost of the HPV vaccination demonstration project in Zimbabwe was US$256,074 and the total economic cost was US$703,534. The financial cost per Fully Immunized Girl (FIG) was US$58.04 and the economic cost per FIG was US$159.46. The total financial cost per dose was US$28.44 and the economic cost per dose was US$78.14. School-based delivery produced the lowest service delivery cost per FIG (financial cost: US$6.89; economic cost: US$28.25) when compared to other points (health facility and outreach). School based delivery also had the lowest service delivery cost per dose (financial cost: US$3.38; economic cost: US$13.84) as compared to other points (health facility and outreach).
Conclusion: The costs per dose and per FIG (financial and economic) in Zimbabwe's HPV vaccination demonstration project were higher than costs seen in other countries. During the HPV vaccination demonstration project in Zimbabwe many lessons were learned that can inform planning for national scale-up.
Table of Contents
Introduction........................................................1
Literature Review................................................7
Zimbabwe HPV Demonstration Project Methodology....24
Results..............................................................34
Discussion / Conclusion .....................................46
Implications / Recommendations........................55
References.........................................................60
Annexes............................................................62
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