Peer-reviewed article
The costs of developing, deploying and maintaining electronic immunisation registries in Tanzania and Zambia
Mercy Mvundura, Laura Di Giorgio, Dafrossa C. Lymo, Francis Dien Mwansa, Ngwegwe Bulula et al. ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This study documents the financial costs of developing and implementing electronic immunisation registries (EIRs) in Tanzania and Zambia between 2013 and 2018. Total spending was approximately US$4.2 million in Tanzania and US$3.6 million in Zambia, with system design and development accounting for about one-quarter to one-third of costs. The cost per child immunised ranged from US$3.30 to US$3.81 annually in Tanzania and US$8.46 in Zambia, partly reflecting differences in birth cohort sizes. The study suggests that other countries could implement EIRs at lower cost by building on these existing platforms and lessons learned.
Key points
- Total expenditure was US$4.2 million in Tanzania and US$3.6 million in Zambia over the 2013-2018 period
- System design and development represented 33% of costs in Tanzania and 26% in Zambia
- BID staff costs were significant, accounting for 39% of expenditure in Tanzania and 52% in Zambia
- Average rollout cost per facility ranged from US$709-US$1,320 in Tanzania and US$2,591 in Zambia
- Annualised cost per child was US$3.30-US$3.81 in Tanzania and US$8.46 in Zambia
Limitations
This is a cost documentation study that does not assess the effectiveness or outcomes of EIR implementation on immunisation coverage or child health. The document cannot indicate whether these systems improved vaccination rates, data quality, or whether the investment represented good value for money.
Abstract
OBJECTIVE: To determine the costs to develop, roll out and maintain electronic immunisation registries (EIRs) and a related suite of data use interventions. METHODS: The Better Immunisation Data (BID) Initiative conducted the activities from 2013 to 2018 in three regions in Tanzania and one province in Zambia. The Initiative's financial records were used to account for the financial costs of designing and developing the EIRs, BID staff time, expenditures for rolling out the EIR systems and the related suite of interventions to health facilities, and recurrent costs. Total financial costs, cost per facility and cost per child were calculated in 2018 US$. FINDINGS: Total expenditures were ~US$4.2 million in Tanzania and US$3.6 million in Zambia. System design and development costs accounted for ~33% and 26% of the expenditures in each country, respectively, while BID staff costs accounted for 39% and 52%, respectively. Average expenditures per health facility for rolling out the EIR system were between US$709 and US$1320 for the Tanzania regions and US$2591 for Zambia. The annualised average expenditure per child was estimated to be between US$3.30 and US$3.81 for the regions in Tanzania and US$8.46 in Zambia. Expenditures per child were higher in Zambia partly because of a much smaller birth cohort compared with Tanzania. CONCLUSION: Other countries may benefit from the investments made and lessons learnt in Tanzania and Zambia by leveraging these now existing EIR platforms and rollout strategies, and hence may be able to implement EIRs at lower costs than reported here.