Assessing Efficiency for Financial Sustainability of EPI In Bangladesh

Ahmed, Shakil; Hossain, Md Rafi; Begum, Tahmina

Assessing Efficiency for Financial Sustainability of EPI In Bangladesh

Autores

Ahmed, Shakil

Hossain, Md Rafi

Begum, Tahmina

Editor

Washington, DC: World Bank

Descripción

Globally, the Bangladesh Expanded Program on Immunization (EPI) is recognized for its excellence in coverage and reach. However, there have been some concerns recently over the financial sustainability of the EPI in the context of diminishing development partner support and competition for scarce resources within the government budget. This diagnostic efficiency analysis has two objectives: (i) analyze and diagnose to identify bottlenecks that are important sources of inefficiency, which could be the target for a reform agenda; and (ii) inform the EPI and relevant stakeholders on the identified inefficiencies in the Bangladesh EPI with possible options to address them. The study examines elements of the immunization system that are considered critical for effective and efficient immunization services. The paper uses qualitative and quantitative methods of data collection and analysis. Both key informant interviews and documentary analysis were used to collect data on EPI inefficiencies and options. Data analysis from the document review and key informant interviews were guided by the World Health Organization’s (WHO’s) system-wide approach to analyzing efficiency across the health program framework and approach. The assessment identified several areas for improving efficiency. Related savings could be made by (i) improving planning, budgeting, and projecting vaccine needs; (ii) reducing immunization sessions held per month; and (iii) reducing vaccine wastage and dropout. Strategies for improved planning and delivery of immunization services can lead to increased efficiency and result in further cost savings. The total recurrent costs of the immunization program are influenced by the quality of planning and immunization sessions. This quality is reflected by the accuracy of the forecasts of vaccine requirements, quality of stock management, efficient immunization services, and other measures. The assessment estimated some potential cost savings to the immunization program.