Background

The resource requirements for national immunizations have rapidly increased in the last decade with the introduction of costly new vaccines. In this context, accurate information on the cost and financing of national immunization programs is essential for strategic planning and program management activities of national ministries as well as for donors.

Despite the existence of tools such as the World Health Organization’s Comprehensive Multi-Year Planning Tool (CMYP) and the Joint Reporting Form, high-quality information on costs, expenditures, and funding flows are generally lacking. Where such information exists, it is not easily comparable across settings, and it is rarely used to examine productive efficiency. 

To address this gap, the Bill & Melinda Gates Foundation provided financing for EPIC--a coordinated set of immunization costing and financing studies in 2012-2014 in six countries (Benin Ghana Uganda Zambia Moldova and Honduras). These studies collected data at central, subnational, and facility-level and were notable for their rigor in terms of sample design and comprehensiveness of resource use measurement.