The drivers of facility-based immunization performance and costs. An application to Moldova

Objective. This paper identifies factors that affect the cost and performance of the routine immunization program in Moldova through an analysis of facility-based data collected as part of a multi-country costing and financing study of routine immunization (EPIC). Methods. A nationally representativ...

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Authors: Maceira, Daniel Alejandro, Ketevan Goguadze, George Gotsadze
Format: article
Status:Published version
Publication Date:2015
Country:Argentina
Institution:Consejo Nacional de Investigaciones Científicas y Técnicas
Repository:CONICET Digital (CONICET)
Language:English
OAI Identifier:oai:ri.conicet.gov.ar:11336/38396
Online Access:http://hdl.handle.net/11336/38396
Access Level:Open access
Keyword:Routine Immunization
Productivity
Costs
Middle-Income Country
https://purl.org/becyt/ford/3.3
https://purl.org/becyt/ford/3
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oai_identifier_str oai:ri.conicet.gov.ar:11336/38396
network_acronym_str AR
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spelling The drivers of facility-based immunization performance and costs. An application to MoldovaMaceira, Daniel AlejandroKetevan GoguadzeGeorge GotsadzeRoutine ImmunizationProductivityCostsMiddle-Income Countryhttps://purl.org/becyt/ford/3.3https://purl.org/becyt/ford/3Objective. This paper identifies factors that affect the cost and performance of the routine immunization program in Moldova through an analysis of facility-based data collected as part of a multi-country costing and financing study of routine immunization (EPIC). Methods. A nationally representative sample of health care facilities (50) was selected through multi-stage, stratified random sampling. Data on inputs, unit prices and facility outputs were collected during October 3rd 2012-January 14th 2013 using a pre-tested structured questionnaire. Ordinary least square (OLS) regression analysis was performed to determine factors affecting facility outputs (number of doses administered and fully immunized children) and explaining variation in total facility costs. Results. The study found that the number of working hours, vaccine wastage rates, and whether or not a doctor worked at a facility (among other factors) were positively and significantly associated with output levels. In addition, the level of output, price of inputs and share of the population with university education were significantly associated with higher facility costs. A 1% increase in fully immunized child would increase total cost by 0.7%. Conclusions. Few costing studies of primary health care services in developing countries evaluate the drivers of performance and cost. This exercise attempted to fill this knowledge gap and helped to identify organizational and managerial factors at a primary care district and national level that could be addressed by improved program management aimed at improved performance.Fil: Maceira, Daniel Alejandro. Centro de Estudios de Estado y Sociedad; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Ketevan Goguadze. Curatio International Foundation; Estados UnidosFil: George Gotsadze. Curatio International Foundation; Estados UnidosElsevier2015-05info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionhttp://purl.org/coar/resource_type/c_6501info:ar-repo/semantics/articuloapplication/pdfapplication/pdfhttp://hdl.handle.net/11336/38396Maceira, Daniel Alejandro; Ketevan Goguadze; George Gotsadze; The drivers of facility-based immunization performance and costs. An application to Moldova; Elsevier; Vaccine; 33; 1; 5-2015; 72-780264-410XCONICET DigitalCONICETenginfo:eu-repo/semantics/altIdentifier/doi/10.1016/j.vaccine.2014.12.041info:eu-repo/semantics/altIdentifier/url/https://www.sciencedirect.com/science/article/pii/S0264410X14016946info:eu-repo/semantics/openAccesshttps://creativecommons.org/licenses/by-nc-sa/2.5/ar/reponame:CONICET Digital (CONICET)instname:Consejo Nacional de Investigaciones Científicas y Técnicas2024-05-08T14:17:11Zoai:ri.conicet.gov.ar:11336/38396instacron:CONICETInstitucionalhttp://ri.conicet.gov.ar/Organismo científico-tecnológicoNo correspondehttp://ri.conicet.gov.ar/oai/requestdasensio@conicet.gov.ar; lcarlino@conicet.gov.arArgentinaNo correspondeNo correspondeNo correspondeopendoar:34982024-05-08 14:17:12.158CONICET Digital (CONICET) - Consejo Nacional de Investigaciones Científicas y Técnicasfalse
dc.title.none.fl_str_mv The drivers of facility-based immunization performance and costs. An application to Moldova
title The drivers of facility-based immunization performance and costs. An application to Moldova
spellingShingle The drivers of facility-based immunization performance and costs. An application to Moldova
Maceira, Daniel Alejandro
Routine Immunization
Productivity
Costs
Middle-Income Country
https://purl.org/becyt/ford/3.3
https://purl.org/becyt/ford/3
title_short The drivers of facility-based immunization performance and costs. An application to Moldova
title_full The drivers of facility-based immunization performance and costs. An application to Moldova
title_fullStr The drivers of facility-based immunization performance and costs. An application to Moldova
title_full_unstemmed The drivers of facility-based immunization performance and costs. An application to Moldova
title_sort The drivers of facility-based immunization performance and costs. An application to Moldova
dc.creator.none.fl_str_mv Maceira, Daniel Alejandro
Ketevan Goguadze
George Gotsadze
author Maceira, Daniel Alejandro
author_facet Maceira, Daniel Alejandro
Ketevan Goguadze
George Gotsadze
author_role author
author2 Ketevan Goguadze
George Gotsadze
author2_role author
author
dc.subject.none.fl_str_mv Routine Immunization
Productivity
Costs
Middle-Income Country
https://purl.org/becyt/ford/3.3
https://purl.org/becyt/ford/3
topic Routine Immunization
Productivity
Costs
Middle-Income Country
https://purl.org/becyt/ford/3.3
https://purl.org/becyt/ford/3
description Objective. This paper identifies factors that affect the cost and performance of the routine immunization program in Moldova through an analysis of facility-based data collected as part of a multi-country costing and financing study of routine immunization (EPIC). Methods. A nationally representative sample of health care facilities (50) was selected through multi-stage, stratified random sampling. Data on inputs, unit prices and facility outputs were collected during October 3rd 2012-January 14th 2013 using a pre-tested structured questionnaire. Ordinary least square (OLS) regression analysis was performed to determine factors affecting facility outputs (number of doses administered and fully immunized children) and explaining variation in total facility costs. Results. The study found that the number of working hours, vaccine wastage rates, and whether or not a doctor worked at a facility (among other factors) were positively and significantly associated with output levels. In addition, the level of output, price of inputs and share of the population with university education were significantly associated with higher facility costs. A 1% increase in fully immunized child would increase total cost by 0.7%. Conclusions. Few costing studies of primary health care services in developing countries evaluate the drivers of performance and cost. This exercise attempted to fill this knowledge gap and helped to identify organizational and managerial factors at a primary care district and national level that could be addressed by improved program management aimed at improved performance.
publishDate 2015
dc.date.none.fl_str_mv 2015-05
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
http://purl.org/coar/resource_type/c_6501
info:ar-repo/semantics/articulo
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv http://hdl.handle.net/11336/38396
Maceira, Daniel Alejandro; Ketevan Goguadze; George Gotsadze; The drivers of facility-based immunization performance and costs. An application to Moldova; Elsevier; Vaccine; 33; 1; 5-2015; 72-78
0264-410X
CONICET Digital
CONICET
url http://hdl.handle.net/11336/38396
identifier_str_mv Maceira, Daniel Alejandro; Ketevan Goguadze; George Gotsadze; The drivers of facility-based immunization performance and costs. An application to Moldova; Elsevier; Vaccine; 33; 1; 5-2015; 72-78
0264-410X
CONICET Digital
CONICET
dc.language.none.fl_str_mv eng
language eng
dc.relation.none.fl_str_mv info:eu-repo/semantics/altIdentifier/doi/10.1016/j.vaccine.2014.12.041
info:eu-repo/semantics/altIdentifier/url/https://www.sciencedirect.com/science/article/pii/S0264410X14016946
dc.rights.none.fl_str_mv info:eu-repo/semantics/openAccess
https://creativecommons.org/licenses/by-nc-sa/2.5/ar/
eu_rights_str_mv openAccess
rights_invalid_str_mv https://creativecommons.org/licenses/by-nc-sa/2.5/ar/
dc.format.none.fl_str_mv application/pdf
application/pdf
dc.publisher.none.fl_str_mv Elsevier
publisher.none.fl_str_mv Elsevier
dc.source.none.fl_str_mv reponame:CONICET Digital (CONICET)
instname:Consejo Nacional de Investigaciones Científicas y Técnicas
instname_str Consejo Nacional de Investigaciones Científicas y Técnicas
reponame_str CONICET Digital (CONICET)
collection CONICET Digital (CONICET)
repository.name.fl_str_mv CONICET Digital (CONICET) - Consejo Nacional de Investigaciones Científicas y Técnicas
repository.mail.fl_str_mv dasensio@conicet.gov.ar; lcarlino@conicet.gov.ar
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score 15.812429

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