Author:Eberechukwu Uneze,Sabastine Akongwale&Ibrahim Tajudeen
Publication Date:June, 2011
Document Size:52 pages
Despite the efforts made by the Nigerian government, policy makers and other stakeholder toincrease children vaccination against infections, measles vaccination coverage remains verylow. While this problem is more profound in the northern part of Nigeria, its present form inBorno State even requires urgent attention. This study is an attempt to expose the issue. Itconducts a policy simulation exercise on two measles immunization programs for children ofage 9-23 months free immunization against measles with media awareness campaign (PolicyA) and free immunization against measles with house to house campaign (Policy B) to boostchildren measles immunization coverage. The study estimates the relative cost and theeffectiveness measure such as the health benefits morbidity avoided and mortality averted. Inwhat follows, it compares the cost per child covered and the cost-effectiveness ratios of thepolicy alternatives. The cost per child indicates that policy A has a lower cost and lower level ofcoverage, while policy B has a higher cost and a higher level of immunization coverage. In termsof cost of treating measles and the value of statistical life (VSL), the results of the costeffectivenessanalysis show that both policies are efficient. However, policy A has a lower costeffectivenessratio than policy B.
In terms of paying for the policy alternatives, two funding scenarios as well as the equitydistribution were analysed. The equity aspect of the exercise is to ensure that the policies arepro-poor. The findings of sensitivity analysis performed to determine the stability of the resultsshow that the results are not sensitive to changes in the values of the parameters. Overall,since both programs can be implemented (as shown by their cost-effectiveness ratios), therecommendation is that policy B be introduced in the rural areas characterized with high levelof illiteracy, uneven distribution of government hospitals, and poor electronic and print mediacoverage which often discourage or keep parent out of touch of the next vaccination date.However, policy A can be deployed in urban areas where there is reasonable distribution andaccessibility of government hospitals, organized electronic and print media coverage and highlevel of literacy. Lastly, in semi urban areas with moderate literacy, and electronic and mediacoverage, the best option will be for the government to implement both policies ascomplements, depending on resource availability.