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Financing Comprehensive Immunization Services in Lao PDR: A Fiscal Space Analysis From a Public Policy Perspective

INTRODUCTION: A comprehensive package of immunization services is an internal component of the Essential Health Service Package (ESP) implemented by Government of Lao People’s Democratic Republic (Lao PDR). Thus, the cost of delivering the immunization program and its feasibility given the fiscal sp...

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Autores principales: Bahuguna, Pankaj, Masaki, Emiko, Jeet, Gursimer, Prinja, Shankar
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer International Publishing 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9492462/
https://www.ncbi.nlm.nih.gov/pubmed/36136264
http://dx.doi.org/10.1007/s40258-022-00763-8
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author Bahuguna, Pankaj
Masaki, Emiko
Jeet, Gursimer
Prinja, Shankar
author_facet Bahuguna, Pankaj
Masaki, Emiko
Jeet, Gursimer
Prinja, Shankar
author_sort Bahuguna, Pankaj
collection PubMed
description INTRODUCTION: A comprehensive package of immunization services is an internal component of the Essential Health Service Package (ESP) implemented by Government of Lao People’s Democratic Republic (Lao PDR). Thus, the cost of delivering the immunization program and its feasibility given the fiscal space emerges as an important policy question. The present analysis was undertaken to estimate the total cost of implementing the immunization program under ESP, determinants of total cost and the program’s fiscal implications from the government’s perspective. METHODOLOGY: We employed a normative costing approach for costing of immunization services under ESP. Standard treatment guidelines (STGs) from both within and outside Lao PDR were considered to identify the resource use for each vaccine delivery. Subsequently, cost per dose administered and fully immunized beneficiary were computed. We assessed the fiscal space for financing immunization services in Lao PDR by adapting the decomposition method given by Tandon et al. RESULTS: In 2019, the estimated total cost of financing immunization in Lao PDR was US$12 million, which will increase in 2025 by 1.75 times, to US$21 million. The per capita budget for immunization needs to increase from about US$2 to US$7. Introduction of newer vaccines in the immunization schedule accounts for the major share (60%) of the increased cost for financing immunization. In view of current fiscal space, the government immunization expenditure (GIE) allocations will be adequate only in a scenario where no new vaccine is introduced under ESP in future years. CONCLUSION: The current fiscal space would fall short of meeting the aspirational goals of ESP–Immunization for the introduction of newer vaccines in Lao PDR. The present analysis of the fiscal space provides important evidence to support a greater role for the Global Alliance for Vaccine Initiative (GAVI) to continue to finance immunization in Lao PDR. A publicly financed immunization model in Lao PDR would require significant strategic amendments with low short-term viability.
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spelling pubmed-94924622022-09-22 Financing Comprehensive Immunization Services in Lao PDR: A Fiscal Space Analysis From a Public Policy Perspective Bahuguna, Pankaj Masaki, Emiko Jeet, Gursimer Prinja, Shankar Appl Health Econ Health Policy Original Research Article INTRODUCTION: A comprehensive package of immunization services is an internal component of the Essential Health Service Package (ESP) implemented by Government of Lao People’s Democratic Republic (Lao PDR). Thus, the cost of delivering the immunization program and its feasibility given the fiscal space emerges as an important policy question. The present analysis was undertaken to estimate the total cost of implementing the immunization program under ESP, determinants of total cost and the program’s fiscal implications from the government’s perspective. METHODOLOGY: We employed a normative costing approach for costing of immunization services under ESP. Standard treatment guidelines (STGs) from both within and outside Lao PDR were considered to identify the resource use for each vaccine delivery. Subsequently, cost per dose administered and fully immunized beneficiary were computed. We assessed the fiscal space for financing immunization services in Lao PDR by adapting the decomposition method given by Tandon et al. RESULTS: In 2019, the estimated total cost of financing immunization in Lao PDR was US$12 million, which will increase in 2025 by 1.75 times, to US$21 million. The per capita budget for immunization needs to increase from about US$2 to US$7. Introduction of newer vaccines in the immunization schedule accounts for the major share (60%) of the increased cost for financing immunization. In view of current fiscal space, the government immunization expenditure (GIE) allocations will be adequate only in a scenario where no new vaccine is introduced under ESP in future years. CONCLUSION: The current fiscal space would fall short of meeting the aspirational goals of ESP–Immunization for the introduction of newer vaccines in Lao PDR. The present analysis of the fiscal space provides important evidence to support a greater role for the Global Alliance for Vaccine Initiative (GAVI) to continue to finance immunization in Lao PDR. A publicly financed immunization model in Lao PDR would require significant strategic amendments with low short-term viability. Springer International Publishing 2022-09-22 2023 /pmc/articles/PMC9492462/ /pubmed/36136264 http://dx.doi.org/10.1007/s40258-022-00763-8 Text en © The Author(s), under exclusive licence to Springer Nature Switzerland AG 2022, Springer Nature or its licensor holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law. This article is made available via the PMC Open Access Subset for unrestricted research re-use and secondary analysis in any form or by any means with acknowledgement of the original source. These permissions are granted for the duration of the World Health Organization (WHO) declaration of COVID-19 as a global pandemic.
spellingShingle Original Research Article
Bahuguna, Pankaj
Masaki, Emiko
Jeet, Gursimer
Prinja, Shankar
Financing Comprehensive Immunization Services in Lao PDR: A Fiscal Space Analysis From a Public Policy Perspective
title Financing Comprehensive Immunization Services in Lao PDR: A Fiscal Space Analysis From a Public Policy Perspective
title_full Financing Comprehensive Immunization Services in Lao PDR: A Fiscal Space Analysis From a Public Policy Perspective
title_fullStr Financing Comprehensive Immunization Services in Lao PDR: A Fiscal Space Analysis From a Public Policy Perspective
title_full_unstemmed Financing Comprehensive Immunization Services in Lao PDR: A Fiscal Space Analysis From a Public Policy Perspective
title_short Financing Comprehensive Immunization Services in Lao PDR: A Fiscal Space Analysis From a Public Policy Perspective
title_sort financing comprehensive immunization services in lao pdr: a fiscal space analysis from a public policy perspective
topic Original Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9492462/
https://www.ncbi.nlm.nih.gov/pubmed/36136264
http://dx.doi.org/10.1007/s40258-022-00763-8
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