Report of cost-effectiveness study of the expanded programme of immunization in the Republic of Sudan -- volume IV : middle region

The study determined and compared the costs of delivering EPI services through mobile teams and fixed facility strategies, and determined the cost of the program at different levels of the health system. It is estimated that it costs $17,738 (LS 78,934) per year on average to operate a mobile team in Middle Region, compared to $8,305 (LS 36,957) for health facility operations. Personnel and per diem costs accounted for the largest proportion of total cost for both mobile teams and health facilities. Equipment costs represented a large share of total cost for the mobile teams. The cost per dose was lower for mobile teams ($1.00 or LS 4.45) than for health facilities ($3.62 or LS 16). This difference was due primarily to lower numbers of doses administered at the health facility level -- 10 times less than mobile teams. The mobile teams also had a lower cost per fully immunized child ($13 or LS 59) as compared to health facilities ($29 or LS 127) due to higher numbers of fully immunized children for the mobile teams. Several factors were identified which influenced the cost and cost-effectiveness ratios of mobile teams and fixed facilities: the numbers and types of health workers, the density of the population, the proximity of the delivery site to district or regional headquarters, and the total volume of services delivered. Cost information was combined with operational data to arrive at performance and operational indicators for the teams and facilities. The number of doses administered per health worker per immunization day was 5.7 for facilities compared to 51 for mobile teams, suggesting that the mobile team strategy was more productive in this region. (Author abstract)