Report on the cost-effectiveness of the expanded programme of immunization in the Republic of Sudan -- volume V : summary report of surveys in Kordofan, Darfur, middle and national capital regions

It represents the most extensive data collection and analysis effort undertaken so far in order to provide the EPI, UNICEF, and other providers and supporters of the program with practical information about how to use EPI resources more efficiently and effectively in the future. The study evaluates the costs and outcomes of alternative immunization strategies (i.e., mobile teams and fixed facilities) and assesses the total cost of the program at different levels of the health system. Individual regional studies were conducted in Kordofan, Darfur, National Capital, and Middle Regions and individual reports were produced for distribution to each region. This document summarizes the findings from these analyses. The EPI in the Republic of Sudan costs approximately $10 million, including all resources (human, material and financial) used in 1988. The average cost per dose was $1.89 and the cost per fully immunized child was $30. Wide variations were found between regions and districts in terms of their total annual operating costs and cost per child, suggesting that there is room for improving the overall efficiency and effectiveness of the EPI at these levels. In addition, the study found that mobile team services were more effective at providing immunizations but, on average, they were at least twice as expensive to operate as health facility strategies. The EPI should examine more closely policies concerning immunizations at health facilities in order to strengthen this strategy. It is not recommended that one strategy be selected over another on economic grounds as they are designed to serve different population groups. (Author abstract)