Cost analysis of the national immunization and control of diarrheal disease programs in the Republic of Turkey

The programs" financial sustainability is projected based on reviews of current cash expenditures, services provided, and financing mechanisms. It was found that the Government of Turkey currently provides nearly all of the full costs and most of the expenditures for the EPI, but has less of a commitment to the CCD program, financing about 50% of expenditures. While EPI is on its way to becoming a financially sustainable program, this situation is jeopardized by the current trend of decreasing budget allocations to the Ministry of Health and Social Assistance (MOHSA) by the central government. A second factor found to threaten the programs" sustainability is that training costs are being borne primarily by donor organizations. Other factors impacting on sustainability include the need for: (1) routine monitoring of program costs; (2) improvements in the distribution of supplies and services; (3) assessment of other potential in-country resources for providing financial support to the two programs; (4) further studies on the costs for upgrading current services, on the future recurrent cost burden on the MOHSA, and on the potential for private-sector delivery of EPI and CDD.