The Cost of Routine Immunization Outreach in the Context of COVID-19: Estimates from Tanzania and Indonesia


Assessing the additional delivery costs of conducting immunization outreach during the COVID-19 pandemic due to measures needed to keep health workers and communities safe. 


To estimate the additional costs of minimizing the risk of COVID-19 transmission when conducting immunization outreach. 


To prevent disruptions in essential health services such as immunization during the COVID-19 pandemic, facilities must be equipped to provide services safely for health workers and communities. This analysis assesses the additional cost of delivering immunization through outreach in Tanzania and Indonesia. 

Key Points:

  • Adding handwashing stations and hand sanitizer to outreach sessions can increase the delivery cost per dose by 11-14%, PPE can add 45-61%, crowd control staff can add 9%, adding staff to take temperatures can add 42%. Altogether, the cost of delivery could increase by 20-129%. 
  • The cost-savings effect of reducing the frequency of outreach is limited (-2 to –16%), while the cost of doubling the frequency to reduce the size of each session is 18-40%. 
  • Changes in the outreach delivery costs are highly dependent on the initial strategy: the volume delivered through outreach, session size and session frequency, and remuneration for health workers. 
  • Personal Protective Equipment (PPE) and infection prevention and control (IPC) interventions are the biggest driver of delivery cost increases in outreach. The increase in delivery cost per dose is highest in rural areas. 

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