Estimating the costs of strengthening a Second Year of Life (2YL) healthy child visit in Namibia and Cape Verde

Presenter: Alex Adjagba

Twitter: '@UNICEF

Co-authors: Imran Mirza, Ulla Griffiths

Poster file: [download]
Abstract: Estimating Costs of Implementing a Second Year of Life (2YL) Healthy Child Visit in Namibia and Cape Verde. Alex Adjagba, Imran Mirza, Ulla Griffiths Background and Objectives The WHO recommends that immunization programs widen routine vaccination beyond the first year of life. The second year of life (2YL) platform is a critical step in extending immunization beyond infancy. In addition, the 2YL platform is an opportunity to integrate vaccination with other critical health interventions, such as malaria prevention, micronutrients, growth monitoring, and deworming. Both Namibia and Cape Verde already have existing 2YL activities, but also wanted to add new interventions to the existing ones, thus they wanted to generate evidence about total costs, costs per child and an aggregated figure that includes all costs, especially for operational and training costs cumulatively for 5 years. Such evidence will be used for advocacy discussion as part of their future strategic plans in the MoH. Methodology An Excel-based costing tool to standardize data collection and analysis for estimating the costs of introducing a 2YL healthy child visit was developed. The tool was populated with demographic data, chosen interventions, vaccine and commodity parameters, including prices, health personnel salaries, as well as training and communication costs. A series of meetings were with the national focal points for nutrition, malaria, immunization and supply, to identify the most relevant country information sources for each area. In Namibia, data were retrieved from various sources such as the national census data on the National Statistics Institute website for population data; MoH annual reports for malaria and nutrition data, complemented by WUENIC for immunization data, as well as UNICEF supply division and the National Vaccine procurement (CMS) for vaccine prices and presentation data. Similarly, in Cape Verde, data was retrieved from equivalent sources before the mission, by the department of maternal and new born health of the MoH. In both countries, salary and training cost information was received by government and predicted coverage for each intervention was based on expert opinion and existing national strategic plans. Results In Namibia, the total costs estimate with annualized startup costs over 5 years is US$ 2,453,358; with an average cost per child reached is US$8.24. In Cape Verde, the total costs estimate with annualized startup costs over 5 years is US$ 431,353, for an average cost of US$23.02. In both countries, vaccines and nutrition commodities costs represent the largest share of costs, while training and staff time were the less expensive components. Conclusion The use of the costing tool in the 2 countries tackled 2 different requests and allowed to establish evidence that can be used for advocacy and planning at country-level. Reducing vaccines procurement costs will significantly decrease the cost of establishing such platform, especially in middle income countries.