In Côte d’Ivoire, the financial cost of delivering COVID-19 vaccines was estimated to be US$0.67 during March-May 2022

To support the government in planning and budgeting for the C19 vaccination program, Genesis Analytics and ThinkWell conducted a study to estimate the cost of delivering C19 vaccines in Côte d’Ivoire. This was a retrospective, bottom-up costing study that estimated the financial and economic costs incurred in 2022. Data were collected retrospectively by a team from the Université Felix Houphouet Boigny from a sample of 30 health facilities within six districts in Abidjan 1, Abidjan 2, and Gbêkê, as well as from the national-level Ministry of Health and development partners.

• The financial cost of delivering C19 vaccines was relatively low at US$0.67 per dose. Vaccine injection and safety supplies were the largest financial cost driver (55%), followed by allowances for volunteers.

• The economic delivery costs were much higher ($3.16 per dose), due to the significant opportunity cost of labor (80% of the total). The value of volunteer allowances that were promised but not paid out were also significant (9%). Capital costs, such as those for cold chain equipment and vehicles, were very small.

• While the financial cost per dose is much lower than what COVAX expected for Côte d’Ivoire (between $0.96 and $2.53), the economic cost per dose found in this study is high compared with what is generally assumed to be the delivery cost of routine childhood vaccines (between $0.65 and $4.07).

Key takeaways

• The low financial cost per dose found in Côte d’Ivoire is likely a reflection of a lack of funding, as opposed to low financial requirements to support vaccination. There was limited additional hiring, limited funding for allowances and transport, and limited investments in additional cold chain equipment.

• The much higher economic cost per dose highlights the important role of both existing paid staff as well as volunteers. However, the additional burden on a health workforce that already suffered critical shortages pre-pandemic would not be sustainable in the long run.

• The unit cost of delivery was higher at low-volume sites, which is relevant to consider when planning for the next phase of Côte d’Ivoire’s C19 vaccination program. It is likely to involve reduced delivery volume, given that it has already reached relatively high coverage levels.

• Côte d’Ivoire must think critically about their role of volunteers in the next phase of C19 vaccination program. The program relied heavily on volunteers, and they should be regularly compensated to ensure the continuity of services. If in the longer term this support needs to be provided by regular staff, our estimations showed that this could increase costs by 15%.

This study is part of a multi-country project that utilizes standardized methods to generate cost evidence on the delivery of C19 vaccines in low- and middle-income countries. The project is led by ThinkWell, and supported by the Bill & Melinda Gates Foundation, and covers studies in Côte d’Ivoire, the Democratic Republic of Congo, Mozambique, Uganda, Vietnam, Bangladesh, and the Philippines.

For more information on efforts to cost the delivery of COVID-19 vaccines, please see the list of ongoing and completed projects here.