Delivery Costs of Typhoid Conjugate Vaccine Introduction in Navi Mumbai, India

Presenter: Dayoung Song

Co-authors: Vittal Mogasale

Poster file: please contact author at
Typhoid fever is a significant public health problem affecting young children in low and middle income countries, including India. New generation typhoid conjugate vaccines (TCVs) have been shown to have substantial impact in typhoid fever prevention and control. Navi Mumbai Municipal Corporation (NMMC), the local government body within Maharashtra State in India, introduced TCV in 2018 with first phase of vaccination including 11 of 22 urban primary health centers (UPHC) reaching 113,000 children. The objective of this study was to estimate the economic and financial costs of TCV vaccination introduction and generate empirical estimates of total and per dose TCV delivery cost in Navi Mumbai.

The data collection was done retrospectively using micro-costing approach. The cost information on resources used for campaign-related activities were collected from consultations and reviewing the financial records of NMMC, World Health Organization (WHO) financial and programmatic records, and interviews with the health staff of sampled UPHCs. Three UPHCs representing three dominant residence types in the catchment area: high rise, slum, and mixed (high rise and slum) areas were sampled. Delivery costs were collected in 9 different pre-defined sub-group activity categories.

The results showed that the financial delivery cost in 3 UPHCs range from $ 2.37 to $ 2.53 USD and economic delivery cost ranged from $ 4.35 to $ 6.98 USD. High rise area UPHC (Sector 48) had lower vaccination coverage (46.5%) compared to mixed area (Ghansoli 70.9%) and slum area (Indiranagar 76.1 %) and higher delivery cost per dose, both economic and financial, compared to slum (Indiranagar) and mixed area (Ghansoli) UPHC.

This study is the first costing study of large-scale implementation of TCV within a public sector program. As WHO has come-up with new recommendations for TCV use and Gavi has included it in their vaccine portfolio in 2018, the results from this study will inform and guide not only local and national policies, but also global decisions. Further delivery costing studies are needed in India and globally.