A case study using the United Republic of Tanzania: costing nationwide HPV vaccine delivery using the WHO Cervical Cancer Prevention and Control Costing Tool.
A case study using the United Republic of Tanzania: costing nationwide HPV vaccine delivery using the WHO Cervical Cancer Prevention and Control Costing Tool.
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DOI：
10.1186/1741-7015-10-136
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发表时间：
2012-11-13
期刊：
影响因子：
9.3
通讯作者：
Broutet N
中科院分区：
文献类型：
--
作者：
Hutubessy R;Levin A;Wang S;Morgan W;Ally M;John T;Broutet N
介绍了世界卫生组织 (WHO) 宫颈癌预防和控制成本计算 (C4P) 工具背后的目的、方法、数据来源和假设，该工具是为帮助低收入和中等收入国家 (LMIC) 规划和计算其全国人乳头瘤病毒 (HPV) 疫苗接种计划而开发的。坦桑尼亚作为一个案例研究，其中世界卫生组织 C4P 工具被用来计算和规划在全国范围内推广 HPV 疫苗，作为国家宫颈癌综合预防和控制战略的一部分。世卫组织 C4P 工具侧重于通过学校、卫生设施和/或外展战略来估算卫生系统为少女接种疫苗的增量成本。不包括用户（女学生、家长或看护者）的任何费用。估算财务（或卫生部的成本）和经济成本。服务提供的成本组成部分包括培训、疫苗接种（卫生人员的时间和交通、统计单和疫苗接种卡的文具等）、社会动员/IEC（信息、教育和沟通）、监督以及监测和评估（M&E）。用于 HPV 疫苗接种的所有资源的成本都会总计并显示，无论是否包含疫苗的估计成本。总成本还除以施用的剂量数和完全免疫的女孩（FIG）的数量，以估计每剂的成本和每图的成本。在五年内（2011年至2015年），假设疫苗价格为5美元（GAVI），在坦桑尼亚建立HPV疫苗计划，通过分阶段全国推广（第一年三个地区，第二年十个地区，第三年至第五年所有26个地区）向学校女童提供三剂疫苗的成本估计为920万美元（不包括疫苗费用）和3150万美元（含疫苗） 2011 年，前身为全球疫苗和免疫联盟）。这相当于每个FIG的财务成本为5.77美元，不包括疫苗成本。服务提供最重要的成本是社会动员/IEC 和服务提供运营成本。当各国扩大 HPV 疫苗等新疫苗的免疫接种计划时，它们面临着为关键的引进前活动提供资金的初始成本，以及持续提供疫苗所需的增量系统成本。预计政府需要提前计划非疫苗成本，以便获得充足的资金。需要重新分配现有人力资源或招聘新员工，才能使该计划以可持续和长期的方式成功实施。要覆盖以前国家免疫规划未常规提供三剂疫苗的目标群体，需要新的交付策略、更多的疫苗和卫生工作者运输以及更密集的 IEC 活动，从而导致免疫规划新的交付成本高于在现有婴儿免疫计划中添加新婴儿疫苗时产生的成本。世卫组织 C4P 工具旨在帮助中低收入国家提前规划并估计 HPV 疫苗接种的规划和运营成本。
The purpose, methods, data sources and assumptions behind the World Health Organization (WHO) Cervical Cancer Prevention and Control Costing (C4P) tool that was developed to assist low- and middle-income countries (LMICs) with planning and costing their nationwide human papillomavirus (HPV) vaccination program are presented. Tanzania is presented as a case study where the WHO C4P tool was used to cost and plan the roll-out of HPV vaccines nationwide as part of the national comprehensive cervical cancer prevention and control strategy. The WHO C4P tool focuses on estimating the incremental costs to the health system of vaccinating adolescent girls through school-, health facility- and/or outreach-based strategies. No costs to the user (school girls, parents or caregivers) are included. Both financial (or costs to the Ministry of Health) and economic costs are estimated. The cost components for service delivery include training, vaccination (health personnel time and transport, stationery for tally sheets and vaccination cards, and so on), social mobilization/IEC (information, education and communication), supervision, and monitoring and evaluation (M&E). The costs of all the resources used for HPV vaccination are totaled and shown with and without the estimated cost of the vaccine. The total cost is also divided by the number of doses administered and number of fully immunized girls (FIGs) to estimate the cost per dose and cost per FIG. Over five years (2011 to 2015), the cost of establishing an HPV vaccine program that delivers three doses of vaccine to girls at schools via phased national introduction (three regions in year 1, ten regions in year 2 and all 26 regions in years 3 to 5) in Tanzania is estimated to be US$9.2 million (excluding vaccine costs) and US$31.5 million (with vaccine) assuming a vaccine price of US$5 (GAVI 2011, formerly the Global Alliance for Vaccines and Immunizations). This is equivalent to a financial cost of US$5.77 per FIG, excluding the vaccine cost. The most important costs of service delivery are social mobilization/IEC and service delivery operational costs. When countries expand their immunization schedules with new vaccines such as the HPV vaccine, they face initial costs to fund critical pre-introduction activities, as well as incremental system costs to deliver the vaccines on an ongoing basis. In anticipation, governments need to plan ahead for non-vaccine costs so they will be financed adequately. Existing human resources need to be re-allocated or new staff need to be recruited for the program to be implemented successfully in a sustainable and long-term manner. Reaching a target group not routinely served by national immunization programs previously with three doses of vaccine requires new delivery strategies, more transport of vaccines and health workers and more intensive IEC activities leading to new delivery costs for the immunization program that are greater than the costs incurred when a new infant vaccine is added to the existing infant immunization schedule. The WHO C4P tool is intended to help LMICs to plan ahead and estimate the programmatic and operational costs of HPV vaccination.
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DOI：
10.1016/j.trstmh.2009.10.007
发表时间：
2010-03
影响因子：
2.2
作者：
Montresor A;Gabrielli AF;Diarra A;Engels D
通讯作者：
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影响因子：
50.5
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影响因子：
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作者：
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影响因子：
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作者：
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影响因子：
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作者：
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通讯作者：
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