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How to estimate incremental resource requirements and costs of alternative TT immunization strategies: a manual for health and program managers. Revised version.
Arlington, Virginia, John Snow, Inc. [JSI], Resources for Child Health Project [REACH], 1989 Jun. , 22 p. (USAID Contract No. DPE-5927-C-00-5068-00)The REACH Project originally prepared this manual for health and program managers for WHO workshops in Africa on the control of neonatal tetanus. The manual provides rapid methods for determining incremental resource requirements and costs of tetanus toxoid (TT) immunization programs. Its design allows for flexibility. It categorizes costs into variable costs such as vaccines, syringes, and needles and fixed costs such as training, personnel, supervision, and transportation. The manual provides a worksheet for calculating the variable costs for programs which requires the managers to consider the target population (pregnant women or women of childbearing age) and coverage objective (TT2 or TT5). Further it presents a formula for determining costs of additional personnel (a variable cost): personnel costs=number of workers x proportion of time for TT vaccination for each worker x annual gross earnings of each workers. It also has guidelines for determining fixed costs such as cold chain equipment costs. Transportation costs consists mostly of fuel costs but also includes the costs of vehicles to move vaccines, supplies, and personnel. Training costs include production of training materials, travel, per diem, and proportion of annual salaries of trainers and trainees for training time. The manual also has worksheets for determining supervision and monitoring costs. Further it has a worksheet to calculate additional media costs for TT immunization including radio. TV, and posters. Once managers have determined the costs of various components of TT immunization programs, they can sum the costs up and determine the cost effectiveness of TT immunization strategies on another worksheet. The manual concludes with a formula to assist managers determine whether changing from 1 strategy to another would save them more money and be more cost effective.