title: Maternal tetanus immunization in Aceh Province, Sumatra: the cost-effectiveness of alternative strategies.
abstract: This paper compares the cost per completed maternal tetanus immunization and an estimate of the cost per death averted in the routine EPI program with similar results from an experimental mass campaign in Aceh Province, Indonesia. The cost-effectiveness of the mass campaign in achieving complete immunization is similar to the routine program. However, the mass campaign is probably less cost-effective in averting neonatal tetanus deaths, due to its broader targetting. Factors affecting efficiency, coverage, and financing of tetanus immunization programs are assessed. While expansion of the routine EPI program is the preferred goal, mass campaigns are judged to be a reasonable part of the multi-year strategy for tetanus control in the province. Recent experiments with an accelerated routine program may provide further alternatives.
authors.affiliation: Department of Population Sciences, Harvard School of Public Health, Boston, MA 02119.
authors.forename: P
authors.initials: P
authors.lastname: Berman
authors.forename: J
authors.initials: J
authors.lastname: Quinley
authors.forename: B
authors.initials: B
authors.lastname: Yusuf
authors.forename: S
authors.initials: S
authors.lastname: Anwar
authors.forename: U
authors.initials: U
authors.lastname: Mustaini
authors.forename: A
authors.initials: A
authors.lastname: Azof
authors.lastname: Iskandar
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D003362:Cost-Benefit Analysis; D005260:Female; D005102:Health Expenditures; D006801:Humans; D007114:Immunization / Q000191:economics*; D007214:Indonesia; D007231:Infant, Newborn; D008403:Mass Screening / Q000191:economics*; D008427:Maternal Health Services / Q000191:economics*; D009313:National Health Programs / Q000191:economics*; D011247:Pregnancy; D013742:Tetanus / Q000517:prevention & control*; D013745:Tetanus Toxoid / Q000008:administration & dosage; D026712:Value of Life
chemical_list: D013745:Tetanus Toxoid