Cost recovery for immunization : a worldwide survey of experience

The sustainability of these gains is uncertain, however, due to EPI"s enormous burden on national health resources and the reluctance of donors to provide additional funding. For this reason, developing countries need to explore ways of securing alternative sources of funding from the communities, families, and individuals who receive immunization services. This document surveys cost recovery mechanisms for EPI that are currently in place or which have been attempted recently in developing countries. Information was collected from 79 countries in the Africa, Asia/Near East, and Latin America/Caribbean regions regarding the national policy towards consumer payments for immunization and/or primary health care (PHC) and the existence of any financing schemes for the EPI or PHC. Results indicate that a wide variety of cost recovery or alternative financing mechanisms have been tried in both the public and private sectors of developing countries. The most promising mechanisms (e.g., waiver systems that ensure utilization of immunization services by the most needy, universal health insurance, and contract services where females prepay for immunization services and are compensated after the schedule is completed) are identified for further research.