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The Journal of Health, Population and Nutrition
icddr,b
ISSN: 1606-0997
EISSN: 2072-1315
Vol. 22, No. 3, 2004, pp. 311-321
Bioline Code: hn04039
Full paper language: English
Document type: Research Article
Document available free of charge

The Journal of Health, Population and Nutrition, Vol. 22, No. 3, 2004, pp. 311-321

 en A Cost-Benefit Analysis of Typhoid Fever Immunization Programmes in an Indian Urban Slum Community
Poulos, Christine; Bahl, Rajiv; Whittington, Dale; Bhan, Maharaj K.; Clemens, John D. & Acosta, Camilo J.

Abstract

Many economic analyses of immunization programmes focus on the benefits in terms of public-sector cost savings, but do not incorporate estimates of the private cost savings that individuals receive from vaccination. This paper considers the implications of Bahl et al.'s cost-of-illness estimates for typhoid immunization policy by examining how community-level incidence estimates and information on distribution of costs of illness among patients and the public-health sector can be used in the economic analysis of vaccination-programme options. The findings illustrate why typhoid vaccination programmes may often appear to be unattractive to public-health officials who adopt a public budgetary perspective. Under many plausible sets of assumptions, public-sector expenditure on typhoid vaccination does not yield comparable public-sector cost savings. If public-health officials adopt a societal perspective on the economic benefits of vaccination, there are many situations in which different vaccination programmes will make economic sense. The findings show that this is especially true when public decision-makers recognize that (a) the incidence of typhoid fever is underestimated by blood culture-positive cases and (b) avoided costs of illness represent a significant underestimate of the actual economic benefits to individuals of vaccination.

Keywords
Typhoid fever; Cost-benefit analysis; Costs and cost analysis; Cost of illness; Vaccination; Typhoid-paratyphoid vaccines; Slums; Urban health; India

 
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