Comparing the health and social protection effects of measles vaccination strategies in Ethiopia: An extended cost-effectiveness analysis

Tuesday, 5th of April 2016

Soc Sci Med. 2015 Aug;139:115-22. doi: 10.1016/j.socscimed.2015.06.018. Epub 2015 Jun 16.

Comparing the health and social protection effects of measles vaccination strategies in Ethiopia: An extended cost-effectiveness analysis.

Driessen J¹ Olson ZD² Jamison DT³ Verguet S⁴.

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Abstract

Vaccination coverage rates often mask wide variation in access uptake and cost of providing vaccination. Financial incentives have been effective at creating demand for social services in a variety of settings. Using methods of extended cost-effectiveness analysis we compare the health and economic implications of three different vaccine delivery strategies for measles vaccination in Ethiopia: i) routine immunization ii) routine immunization with financial incentives and iii) mass campaigns known as supplemental immunization activities (SIAs). We examine annual birth cohorts of almost 3000000 births over a ten year period exploring variation in these outcomes based on economic status to understand how various options may improve equity. SIAs naturally achieve higher levels of vaccine coverage but at higher costs. Routine immunization combined with financial incentives bolsters demand among more economically vulnerable households. The relative appeal of routine immunization with financial incentives and SIAs will depend on the policy environment including short-term financial limitations time horizons and the types of outcomes that are desired. While the impact of financial incentives has been more thoroughly studied in other policy arenas such as education consideration of this approach alongside standard vaccination models such as SIAs is timely given the dialog around measles eradication.