Cost - effective integration of immunization and basic health services in developing countries : the problem of joint costs

With limited budgets for rural primary health care, developing countries are under pressure to integrate the basic medical services that government health centres provide, with the vaccination programs that mobile immunization teams handle. Application of cost effectiveness analysis is complicated by two inherent difficulties. First, because the two types of health care programs improve the health of different target groups, some common measure of the effectiveness of the two programs must be agreed upon. Here the"healthy life years"saved by the two alternatives is implemented as a useful measure of effectiveness. The second difficulty is that of modelling the joint costs of simultaneously producing more than one health care service. Using the method described here, economists can address this problem in a way that does justice to both the superior efficiency of the mobile teams and the superior comprehensiveness of the fixed centres.