Is health expenditure on immunisation associated with immunisation coverage in sub-Saharan Africa? A multicountry analysis, 2013–2017
Objectives The designing of contextually tailored sustainable plans to finance the procurement of vaccines and the running of appropriate immunisation programmes are necessary to address the high burden of vaccine-preventable diseases and low immunisation coverage in sub-Saharan Africa (SSA). We sou...
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| Format: | Article |
| Language: | English |
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BMJ Publishing Group
2024-01-01
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| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/14/1/e073789.full |
| _version_ | 1826805238435151872 |
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| author | Francis Ifeanyi Ayomoh Israel Oluwaseyidayo Idris Janet Tapkigen Luke Ouma Gabriel Omoniyi Ayeni |
| author_facet | Francis Ifeanyi Ayomoh Israel Oluwaseyidayo Idris Janet Tapkigen Luke Ouma Gabriel Omoniyi Ayeni |
| author_sort | Francis Ifeanyi Ayomoh |
| collection | DOAJ |
| description | Objectives The designing of contextually tailored sustainable plans to finance the procurement of vaccines and the running of appropriate immunisation programmes are necessary to address the high burden of vaccine-preventable diseases and low immunisation coverage in sub-Saharan Africa (SSA). We sought to estimate the minimum fraction of a country’s health budget that should be invested in national immunisation programmes to achieve national immunisation coverage of 80% or greater depending on the context, with and without donors’ support.Design Multicountry analysis of secondary data using retrieved publicly available data from the WHO, Global Alliance for Vaccines and Immunization (GAVI) and World Bank databases.Setting Data on 24 SSA countries, between 2013 and 2017.Methods We model the variations in immunisation coverage across the different SSA countries using a fractional logit model. Three different generalised linear models were fitted to explore how various explanatory variables accounted for the variability in each of the three different vaccines—measles-containing vaccine (MCV)1, diphtheria, pertussis, tetanus (DPT3) and BCG.Results We observed an association between current health expenditure (as a percentage of gross domestic product) and immunisation coverage for BCG (OR=1.01, 95% CI: 1.01 to 1.04, p=0.008) and DPT3 (OR=1.01, 95% CI: 1.0 to 1.02, p=0.020) vaccines. However, there was no evidence to indicate that health expenditure on immunisation (as a proportion of current health expenditure) could be a strong predictor of immunisation coverage (DPT, OR 0.96 (95% CI 0.78 to 1.19; p=0.702); BCG, OR 0.91 (0.69 to 1.19; p=0.492); MCV, OR 0.91 (0.69 to 1.19; p=0.482)). We demonstrate in selected countries that to achieve the GAVI target of 80% in the countries with low DPT3 coverage, health expenditure would need to be increased by more than 45%.Conclusions There is a need to facilitate the development of strategies that support African countries to increase domestic financing for national immunisation programmes towards achieving 2030 targets for immunisation coverage. |
| first_indexed | 2024-03-07T21:53:59Z |
| format | Article |
| id | doaj.art-205fd27ca566411fb9da8191ea616916 |
| institution | Directory Open Access Journal |
| issn | 2044-6055 |
| language | English |
| last_indexed | 2025-03-17T02:07:16Z |
| publishDate | 2024-01-01 |
| publisher | BMJ Publishing Group |
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| series | BMJ Open |
| spelling | doaj.art-205fd27ca566411fb9da8191ea6169162025-02-13T11:05:10ZengBMJ Publishing GroupBMJ Open2044-60552024-01-0114110.1136/bmjopen-2023-073789Is health expenditure on immunisation associated with immunisation coverage in sub-Saharan Africa? A multicountry analysis, 2013–2017Francis Ifeanyi Ayomoh0Israel Oluwaseyidayo Idris1Janet Tapkigen2Luke Ouma3Gabriel Omoniyi Ayeni41 University of Oxford Nuffield Department of Primary Care Health Sciences, Oxford, UKImmunization Analysis & Insights Unit, NAIJAHEALTH Initiative, Lagos, NigeriaDepartment of Health Sciences, University of Tampere, Tampere, FinlandPopulation Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UKImmunization Analysis & Insights Unit, NAIJAHEALTH Initiative, Lagos, NigeriaObjectives The designing of contextually tailored sustainable plans to finance the procurement of vaccines and the running of appropriate immunisation programmes are necessary to address the high burden of vaccine-preventable diseases and low immunisation coverage in sub-Saharan Africa (SSA). We sought to estimate the minimum fraction of a country’s health budget that should be invested in national immunisation programmes to achieve national immunisation coverage of 80% or greater depending on the context, with and without donors’ support.Design Multicountry analysis of secondary data using retrieved publicly available data from the WHO, Global Alliance for Vaccines and Immunization (GAVI) and World Bank databases.Setting Data on 24 SSA countries, between 2013 and 2017.Methods We model the variations in immunisation coverage across the different SSA countries using a fractional logit model. Three different generalised linear models were fitted to explore how various explanatory variables accounted for the variability in each of the three different vaccines—measles-containing vaccine (MCV)1, diphtheria, pertussis, tetanus (DPT3) and BCG.Results We observed an association between current health expenditure (as a percentage of gross domestic product) and immunisation coverage for BCG (OR=1.01, 95% CI: 1.01 to 1.04, p=0.008) and DPT3 (OR=1.01, 95% CI: 1.0 to 1.02, p=0.020) vaccines. However, there was no evidence to indicate that health expenditure on immunisation (as a proportion of current health expenditure) could be a strong predictor of immunisation coverage (DPT, OR 0.96 (95% CI 0.78 to 1.19; p=0.702); BCG, OR 0.91 (0.69 to 1.19; p=0.492); MCV, OR 0.91 (0.69 to 1.19; p=0.482)). We demonstrate in selected countries that to achieve the GAVI target of 80% in the countries with low DPT3 coverage, health expenditure would need to be increased by more than 45%.Conclusions There is a need to facilitate the development of strategies that support African countries to increase domestic financing for national immunisation programmes towards achieving 2030 targets for immunisation coverage.https://bmjopen.bmj.com/content/14/1/e073789.full |
| spellingShingle | Francis Ifeanyi Ayomoh Israel Oluwaseyidayo Idris Janet Tapkigen Luke Ouma Gabriel Omoniyi Ayeni Is health expenditure on immunisation associated with immunisation coverage in sub-Saharan Africa? A multicountry analysis, 2013–2017 BMJ Open |
| title | Is health expenditure on immunisation associated with immunisation coverage in sub-Saharan Africa? A multicountry analysis, 2013–2017 |
| title_full | Is health expenditure on immunisation associated with immunisation coverage in sub-Saharan Africa? A multicountry analysis, 2013–2017 |
| title_fullStr | Is health expenditure on immunisation associated with immunisation coverage in sub-Saharan Africa? A multicountry analysis, 2013–2017 |
| title_full_unstemmed | Is health expenditure on immunisation associated with immunisation coverage in sub-Saharan Africa? A multicountry analysis, 2013–2017 |
| title_short | Is health expenditure on immunisation associated with immunisation coverage in sub-Saharan Africa? A multicountry analysis, 2013–2017 |
| title_sort | is health expenditure on immunisation associated with immunisation coverage in sub saharan africa a multicountry analysis 2013 2017 |
| url | https://bmjopen.bmj.com/content/14/1/e073789.full |
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