Factors Associated with the Funding Gap Between the Full Economic Delivery Costs and the Full Fiscal Delivery Costs of the Routine EPI in Vietnam
Presenter: Vu Quynh Mai
Co-authors: Hoang Van Minh
Poster file: [download]
Accurate cost data is needed to ensure adequate financing to achieve high coverage of vaccines offered as part of the National Expanded Program on Immunization (NEPI). A costing study was done as a first step in estimating the correct, complete calculation for the package of immunization services. Here we analyze the difference between full economic (adjusted fiscal cost based on Ministry of Finance (MOF) cost norms) and fiscal delivery costs (actual spending) of EPI at the sub-national levels in Vietnam. We present methods for this ingredients-based, retrospective economic and fiscal costing of routine activities of the EPI in 2017, calculation of the total funding gap and a multilevel regression analysis to determine the factors associated with the funding gap. Results indicate that the total funding gap is US$7.4 million, with the largest gaps at district and facility levels. By line item, volunteer labor and per diem contribute the most to funding gap. By activity, the largest contributing items are routine facility-based delivery, supervision, and vaccine storage & supply. Factors significantly associated with funding gap are storage at province level, waste management at district level, and number of full time equivalent staff at facility level.