Understanding the Financial Toll of Childhood Illness

by Dagna Costenla


While vaccines are widely regarded as one of the most cost-effective public health interventions we still lack evidence on the broader economic impact of vaccines, including the costs of illness of vaccine-preventable diseases. 

Launched by the Johns Hopkins International Vaccine Access Center (IVAC) in 2011, the Decade of Vaccine Economics project estimates the global economic benefits, costs, financing, funding gap, and return on investment in national immunization programs. 

As part of the project’s fourth phase (DOVE IV), IVAC, in collaboration with International Centre for Diarrhoeal Disease Research, Bangladesh (ICDDRB), is collecting primary data on the costs of illness associated with diarrhea, measles, and pneumonia. This research will help stakeholders in Bangladesh and other countries make more informed decisions about the true economic burden of childhood diseases—and provide evidence to support ongoing investment in the vaccines targeting these diseases.

DOVE IV will estimate both the cost of treatment and productivity losses in both public and private settings across multiple levels of care. Using robust data collection methods, our team will quantify the costs of disease control interventions. These data could help inform the ongoing financial commitment and prioritization of national immunization programs around the world.  


Building capacity in Bangladesh for costing studies on common childhood diseases

The first phase of DOVE IV includes capacity building for local researchers. IVAC team met with ICDDRB experts in Dhaka, Bangladesh July 26-28. 

Attendees discussed standardized methods for collecting, entering, and monitoring cost data. In addition, field research officers and field research assistants learned the use of these methods in participating healthcare facilities, pharmacies, and households in Bangladesh. 

Participants include Field Research Officers, Tajmul Haque and Palash Matsuddi, and Field Research Assistants, Md. Joynal Abedin, Md. Mosabbirul Hasan, Md. Kamal Hossain and Rakibul Haider Chowdhury, all pictured below, engaged in role-playing activities and case study exercises to reinforce data entry and data monitoring procedures. 


Following training, a pilot study was conducted to assess the applicability of data collection tools in the Bangladesh context and to evaluate the accuracy of entering data electronically


Micro-costing study on childhood illness

The next phase of the project will consist of primary data collection on the costs of illness associated with diarrhea, measles, and pneumonia— taking into account both public and private settings across multiple levels of care. The project’s data collection will take place in two divisions starting in 2017. This is a prospective and retrospective micro-costing study that includes three components: 

  1. An assessment of costs for child health services at the healthcare facility level;

  2. An assessment of costs for child health services at the pharmacy level; and

  3. An assessment of the costs of accessing care by caretakers.

We are looking forward to sharing results by the end of 2018.



Other team members focused on this effort include Jorge Martin del Campo and Gatien de Broucker of IVAC as well as Sayem Ahmed, Wazed Ali, and Jasim Uddin of IDDRB.Other members of the study team includes —the Line Director, Maternal Neonatal Child and Adolescent Health and Program Manager, Expended Program on Immunization of the Ministry of Health and Family Welfare of the Government of Bangladesh.This project is supported by the Bill & Melinda Gates Foundation.


For more information, contact: 

Dagna Constenla (dconste1@jhu.edu)

Director, Economics & Finance | International Vaccine Access Center - Johns Hopkins Bloomberg School of Public Health