A cost-effectiveness analysis of traditional and geographic information system-supported microplanning approaches for routine immunization program management in northern Nigeria
A cost-effectiveness analysis of traditional and geographic information system-supported microplanning approaches for routine immunization program management in northern Nigeria
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DOI：
10.1016/j.vaccine.2019.12.002
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发表时间：
2020-02-05
期刊：
影响因子：
5.5
通讯作者：
Dougherty, Leanne
中科院分区：
文献类型：
--
作者：
Ali, Disha;Levin, Ann;Dougherty, Leanne
有效的康复和再培训微观规划需要准确的人口估计数和显示保健设施和村庄及目标人口位置的地图。传统的微观规划依靠人口普查数字来预测目标人口，依靠社区对距离的估计，而地理信息系统微观规划则利用卫星图像来估计目标人口，利用空间分析来估计距离。本文评估了北方两个州基于地理信息系统（GIS）的常规免疫（RI）规划微规划的成本效益。对于我们的成本效益分析，我们捕获了两种方法的所有投入成本，以捕获GIS相对于传统微规划的增量成本，并给出了每种疫苗可预防疾病、死亡、我们考虑了两种情景来估计每种微观规划方法的疫苗需求，一种是基于行政疫苗接种覆盖率，另一种是基于全国营养和健康调查率。根据行政费率，在包奇州和索科托州，地理信息系统微观规划预计所需疫苗接种比传统微观规划多约194 000人和157 000人;根据调查费率，包奇州所需疫苗接种增加近113 000人，索科托州约47 000人。对于每种情景下的每个州，我们提出了麻疹和百日咳病例、死亡和通过额外疫苗接种避免的腹泻的数量和成本，以及年度成本。正如预期的那样，基于GIS的微观规划比传统的微观规划产生更高的成本，主要是由于以前未覆盖的人群需要额外的疫苗接种。然而，我们对避免DALY成本的估计表明，在两种覆盖场景下，GIS微规划比传统的微规划更具成本效益，并且GIS微规划所产生的更高成本值得采用。(C)2019作者爱思唯尔有限公司出版
Effective RI microplanning requires accurate population estimates and maps showing health facilities and locations of villages and target populations. Traditional microplanning relies on census figures to project target populations and on community estimates of distances, while GIS microplanning uses satellite imagery to estimate target populations and spatial analyses to estimate distances. This paper estimates the cost-effectiveness of geographical information systems (GIS)-based microplanning for routine immunization (RI) programming in two states in northern Nigeria.For our cost-effectiveness analysis, we captured the cost of all inputs for both approaches to capture the incremental cost of GIS over traditional microplanning and present the incremental cost-effectiveness ratios for each vaccine-preventable illness, death, and disability-adjusted life year (DALY) averted.We considered two scenarios for estimating vaccine requirements for each microplanning approach, one based on administrative vaccination coverage rates and one based on National Nutrition and Health Survey rates. With the administrative rates, GIS microplanning projected approximately 194,000 and 157,000 more required vaccinations than traditional microplanning in Bauchi and Sokoto States; with the survey rates, the additional number of vaccinations required was nearly 113,000 in Bauchi and about 47,000 in Sokoto. For each state under each scenario, we present numbers of and costs per measles and pertussis cases, deaths, and DALYs averted by the additional vaccinations, as well as annual costs.As expected, GIS-based microplanning incurs higher costs than traditional microplanning, due mainly to the additional vaccinations required for populations previously unreached. Our estimates of cost per DALY averted suggest, however, that GIS microplanning is more cost-effective than traditional microplanning in both states under both coverage scenarios and that the higher costs incurred by GIS microplanning are worth adopting. (C) 2019 The Authors. Published by Elsevier Ltd.