Jano, Quist, Porciuncula, 19th February 2015

Analysis of: “Estimating private benefits of vaccination against cholera in Beira, Mozambique: A travel cost

approach”and

“CBA of Cholera vaccination programs in Beira, Mozambique” by Jeuland et al

“Estimating private benefits of vaccination against cholera in Beira, Mozambique: A travel cost approach” Jeuland et al

(2010)BackgroundVaccine trial in BeiraOnly 9 outpostsMass communication

MethodPr. demand estimationEx post study8-sections surveySP vs RP3 models

FindingsDistance had effectElasticity and WTP estimatedIncreased cost = participation dropsHigher coverage to wealthy households

Conclusions•Abnormal trial •Useful to test WTP•Location was a problem•41% unaware

“CBA analysis of Cholera vaccination programs in Beira, Mozambique” Jeuland et al (2009)

Background•CBA not CEA•Uses data from paper 1.•“herd protection” theory

Method• CBA with different scenarios• 3 alternative programs•Different values of variables

(discount rate, fees, production, etc.)

Findings

Conclusions

Scenarios for CBA No herd

protection

herd protection

School-based

option (ages 5–14)

Fails CBA Always passes

School-based

option, all children

Fails CBA Always passes

Mass campaign

option

Fails CBA Passes if fee > 1

ReflectionsFirst study:

Travel costs are importantMeans of communication matters

Second study:Direct effect is normally taken into account in vaccine programs CBA Indirect effect - very relevant Normally underestimated (Jeuland et al 2009). Further research to expand the policy options available to governments and

donors.

School vaccination programs are most effective and easy to implement.

Mass vaccine campaigns become economically attractive to governments with a small user fee

Policy recommendations

Improve accessibility to centersFor informed decisions, focus on

hidden externalities (herd protection)

User fees led to disease burden reduction, but have political implications

Mind generalizations! technical issues to improve decision making

Program & health education activities to improve knowledge

Alternative means of communication to lower income population groups.

End of presentation!

Thank you!