Health and Social Protection Effects of Measles Vaccination in Ethiopia: Extended CEA


Vaccination coverage rates often mask wide variation in access, uptake, and cost of providing vaccination. Financial incentives have been effective at creating demand for social services in a variety of settings. Using methods of extended cost-effectiveness analysis, the authors compare the health and economic implications of three different vaccine delivery strategies for measles vaccination in Ethiopia: (1) routine immunization, (2) routine immunization with financial incentives, and (3) mass campaigns, known as supplemental immunization activities (SIAs).

The analysis examined annual birth cohorts of almost 3,000,000 births over a ten year period, exploring variation in these outcomes based on economic status to understand how various options may improve equity. SIAs achieve higher levels of vaccine coverage, but at higher costs. Routine immunization combined with financial incentives bolsters demand among more economically vulnerable households. The relative appeal of routine immunization with financial incentives and SIAs will depend on the policy environment, including short-term financial limitations, time horizons, and the types of outcomes that are desired.

The authors suggest, while the impact of financial incentives has been more thoroughly studied in other policy arenas, such as education, consideration of this approach alongside standard vaccination models may be timely given the dialog around measles eradication.


This description is based on the abstract available here.



Driessen J, Olson ZD, Jamison DT, Verguet S. Comparing the Health and Social Protection Effects of Measles Vaccination Strategies in Ethiopia: An Extended Cost-Effectiveness Analysis. Social Science and Medicine 2015; 139: 115-122.