Comprehensive costing and financial flows analysis of the national immunization program in Honduras

Honduras has a leading immunization program, both within the region and globally. From 2009 to 2011, the national immunization program adopted two new vaccines to protect children against rotaviral diarrhea and pneumococcal disease, two important child killers. These vaccines are far more expensive than other traditional childhood vaccines that the government has financed and provided to the population at no cost for nearly 40 years. Additionally, the program has expanded its reach by covering new risk groups, potentiating a transition towards rebranding the program as an intervention to provide protection against vaccine-preventable diseases to the entire family. In the context of concerns about long-term financial sustainability associated with the adoption of new, more expensive vaccines and expanding targets for immunization programs, the Bill and Melinda Gates Foundation (BMGF) supported a multi-country study on the cost and financing of delivering routine immunization services in developing countries (EPIc). With the Foundation’s financial support and technical assistance from the Pan American Health Organization (PAHO) ProVac Initiative, the Honduran Expanded

Programme on Immunization (EPI) implemented a two-pronged study to assess the economic costs of routine immunization service delivery and the financial flows associated with financing the program for the year 2011. The study design followed a country-specific adaption of the EPIc Common Approach, which was developed to harmonize methods for costing and financing analyses under the umbrella of the BMGF financed multi-country studies. Along with the findings from the other five country studies in Africa and Europe selected for EPIc, the results described in this report aim to contribute to the global evidence base on immunization costs and improve planning and budgeting processes at the local level and more broadly.