A cost-effectiveness analysis of traditional and geographic information system-supported microplanning approaches for routine immunization program management in northern Nigeria

Effective RI microplanning requires accurate population estimates and maps showing health facilities and locations of villages and target populations. Traditional microplanning relies on census figures to project target populations and on community estimates of distances, while GIS microplanning uses satellite imagery to estimate target populations and spatial analyses to estimate distances. This paper estimates the cost-effectiveness of geographical information systems (GIS)-based microplanning for routine immunization (RI) programming in two states in northern Nigeria.

Results: The study compares the total number of vaccinations that would take place (or projected) applying either administrative or the 2018 NNHS coverage for traditional microplanning vs. GIS-driven microplanning in three LGAs in each state. We show two scenarios: (1) using the administrative coverage (85% for traditional microplanning and 87% coverage for GIS) and (2) using the NNHS 2018 coverage for Bauchi and Sokoto States. We estimated the total number of vaccines required for all antigens in the RI schedule. For vaccines other than pentavalent and measles, we made the following assumptions: (1) penta3 coverage for pneumococcal conjugate vaccines and oral and injectable polio vaccines, (2) antenatal care prevalence for tetanus toxoid, (3) measles coverage for yellow fever, and 4) delivery with a trained attendant coverage for BCG and hepatitis B birth dose.

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