The objective of this review was to evaluate costing, strategic planning, and budgeting tools with a focus on immunization. The review was conducted to guide development of a new approach for estimating the costs of a National Immunization Strategy (NIS). The aim was to learn from previous experiences and integrate some of the best practices into the new NIS costing approach.
A total of eight tools were evaluated; six tools were immunization specific, one tool was developed for tuberculosis budgeting and funding analysis, and the OneHealth tool takes a health systems approach. The tools were assessed according to four components: (i) Functions and objectives, (ii) Purpose and scope, (iii) Methodology and (iv) Institutionalization.
The comprehensive Multi-Year Planning costing tool for immunization, the OneHealth tool and the tuberculosis budgeting and funding analysis were all developed for estimating resource requirements of a strategic plan. PAHO’s Expanded Programme of Immunization costing tool was developed for estimating resource requirements of an Annual Operational Plan. The Uzbekistan template for annual budgeting of vaccines and injection tool was designed so that resource requirements can be directly linked with budget templates. The Supply Division Forecasting Tool is useful for estimating quantity requirements and gaps for vaccines and supplies, but it cannot be used for predicting costs. The Flu tool and the Cervical Cancer Prevention and Control Costing tool estimate incremental costs of vaccine introduction and are not suited for budgeting and planning cycles.
An approach that links strategies and activities in the NIS with immunization services components is recommended. Resource requirements for activities should be calculated using relatively simple costing methods. Since vaccine procurement is considered the most important expenditure of the immunization budget, these costs should be calculated in detail. It is essential that the costing exercise is tailored to the Ministry of Health budget structure and process.
