RESUMEN
PIP: This paper describes a cost-effectiveness analysis of the immunization programs in Indonesia, the Philippines, and Thailand, using the program costing guidelines developed for the WHO Expanded Program on Immunization (EPI). The principal organizational features of each program are outlined, and total costs and costs/fully immunized infant are assessed at a small sample of health centers in each country. Costs were found to average US $2.86 in Indonesia, US $4.97 in the Philippines, and US $10.73 in Thailand. At each health center the main element of total immunization costs was fixed, so that average costs/fully immunized child fell as coverage levels and activity rates rose. The implications of this preliminary analysis are considered for each country and common managerial issues in EPI in particular, and primary health care in general, are detailed. Program organization, health care input costs, and population accessibility are considered as explanations of the observed differences in immunization costs. The feasibility of undertaking routine cost-effectiveness monitoring of immunization and other primary health care programs is considered. (author's)^ieng
Asunto(s)
Inmunización/economía , Análisis Costo-Beneficio , Humanos , Indonesia , Lactante , Filipinas , Servicios Preventivos de Salud/organización & administración , Muestreo , Tailandia , Organización Mundial de la SaludAsunto(s)
Vacuna contra la Tos Ferina/administración & dosificación , Toxoide Tetánico/administración & dosificación , Anticuerpos Antibacterianos/análisis , Bordetella pertussis/inmunología , Antitoxina Diftérica/análisis , Toxoide Diftérico/administración & dosificación , Humanos , Esquemas de Inmunización , Lactante , Antitoxina Tetánica/análisisAsunto(s)
Inmunización , Niño , Servicios de Salud del Niño , Educación en Salud , Humanos , Lactante , Filipinas , Salud Rural , Salud Urbana , VacunaciónRESUMEN
In a controlled field-trial in infants in the Philippines, a two-dose schedule with an interval of 6 months between injections using a concentrated adsorbed DPT-vaccine was evaluated. The serologic response against the three components in the vaccine was satisfactory, whereas the side-effects in the concentrated vaccine group did not differ from those observed in a control DPT group. After two injections, the coverage percentage with DPT-vaccine was shown to be higher than 70%. Two implications of the introduction of the two-dose DPT-immunization schedule are discussed, i.e. (a) the possibility of using it as the nucleus of a complete schedule including immunization against poliomyelitis, BCG, smallpox and measles, and (b) the consequences which the interval of 6 months might have on the epidemiological spread of B. pertussis infections.