The purpose of this study is to evaluate routine immunization program costs and financing as well as incremental costs and financing of a new vaccine introduction in the Republic of Moldova. Our study is part of a larger effort to evaluate costs and financing of routine immunization in six countries (Moldova, Benin, Uganda, Zambia, Ghana, Honduras) supported by the Bill & Melinda Gates Foundation.
The data analysis showed that unit cost of service provision per dose delivered amounted to 18.3 $US, cost per infant – 316.6 $US and cost per Fully Immunized Child (FIC) – 332.3 $US. However these unit costs differed by facility type, by facility scale (measured by annual doses delivered by a facility) and by urban-rural location, although in a latter case influence were only obvious when shared human resource costs were not accounted in a unit cost. From all of these factors the scale proved to be having strongest influence on the total unit cost of dose delivered. Cost per dose delivered ranged from 14.5 $US in a high scale facilities to 20.5 $US in a low scale facilities. Our findings were comparable with the available global evidence that scale of immunization services has strong and negative relationship with the unit cost of service provision. This means that facilities with a greater scale are able to deliver services more efficiently, by using available inputs more effectively and therefore reducing costs per unit of output.
