The cost of delivering COVID-19 vaccines in Mozambique: a bottom-up costing study

Abstract Background Vaccines were a key tool in controlling the COVID-19 pandemic. However, the cost of delivering these vaccines in low- and middle-income countries was highly uncertain, due to the unprecedented delivery volume and the need to reach new target populations. To fill this evidence gap...

Full description

Saved in:
Bibliographic Details
Main Authors: Tozé Namalela, Flavia Moi, Amélia Dipuve, Pedro Marizane Pota, José Guambe, Maria Tereza Couto, Laura Boonstoppel
Format: Article
Language:English
Published: BMC 2025-04-01
Series:BMC Health Services Research
Subjects:
Online Access:https://doi.org/10.1186/s12913-025-12671-3
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1850184511518670848
author Tozé Namalela
Flavia Moi
Amélia Dipuve
Pedro Marizane Pota
José Guambe
Maria Tereza Couto
Laura Boonstoppel
author_facet Tozé Namalela
Flavia Moi
Amélia Dipuve
Pedro Marizane Pota
José Guambe
Maria Tereza Couto
Laura Boonstoppel
author_sort Tozé Namalela
collection DOAJ
description Abstract Background Vaccines were a key tool in controlling the COVID-19 pandemic. However, the cost of delivering these vaccines in low- and middle-income countries was highly uncertain, due to the unprecedented delivery volume and the need to reach new target populations. To fill this evidence gap, this study estimates the cost of delivering COVID-19 vaccines in Mozambique. Methods This retrospective, bottom-up costing study estimated the financial and economic costs of delivering COVID-19 vaccines in 2022 USD, during the first year of introduction. Recurrent costs were collected for the initial rollout period (March 8th to April 8th 2021) and for a later, higher-volume period (December 1st 2021 to February 28th 2022). The study was conducted from a payer perspective. Data was collected at health facilities from a purposively selected sample of 27 vaccination sites, as well as from 6 district and provincial health offices in 2 provinces, the Ministry of Health, and development partners. The overall cost per dose was obtained by estimating and aggregating the volume-weighted average cost per dose for each administrative level. Qualitative interviews were also conducted to contextualize cost findings. Results The cost per dose for the first year of implementation was $1.14 for economic costs and $0.50 for financial costs. For the initial rollout period, when the volume delivered was low (64 doses/vaccination day on average), the economic cost per dose was $3.56 and decreased considerably to $0.85 when the program delivered at scale and volume delivered increased to 225 doses/vaccination day. Opportunity costs made up a considerable share of the economic cost per dose, 73% and 49% respectively during the initial rollout and when the program delivered at scale. The qualitative interviews found that political prioritization and workers’ commitment made the program possible despite little financial investment. Conclusions The cost of delivering COVID-19 vaccines in Mozambique was found to be low compared to other countries, due to heavy reliance on existing resources and little additional investment into the program. Findings from this study can support the government in planning and budgeting for the future of the COVID-19 vaccination program as well as other vaccination efforts.
format Article
id doaj-art-ba325c2effa141bd9ce30dc378b5a9d0
institution OA Journals
issn 1472-6963
language English
publishDate 2025-04-01
publisher BMC
record_format Article
series BMC Health Services Research
spelling doaj-art-ba325c2effa141bd9ce30dc378b5a9d02025-08-20T02:17:01ZengBMCBMC Health Services Research1472-69632025-04-0125111110.1186/s12913-025-12671-3The cost of delivering COVID-19 vaccines in Mozambique: a bottom-up costing studyTozé Namalela0Flavia Moi1Amélia Dipuve2Pedro Marizane Pota3José Guambe4Maria Tereza Couto5Laura Boonstoppel6ThinkwellThinkwellExpanded Program on Immunization, Mozambique Ministry of HealthCentro de Estudos de Economia e Gestão, Universidade Eduardo MondlaneCentro de Estudos de Economia e Gestão, Universidade Eduardo MondlaneFaculdade de Medicina, Universidade Eduardo MondlaneThinkwellAbstract Background Vaccines were a key tool in controlling the COVID-19 pandemic. However, the cost of delivering these vaccines in low- and middle-income countries was highly uncertain, due to the unprecedented delivery volume and the need to reach new target populations. To fill this evidence gap, this study estimates the cost of delivering COVID-19 vaccines in Mozambique. Methods This retrospective, bottom-up costing study estimated the financial and economic costs of delivering COVID-19 vaccines in 2022 USD, during the first year of introduction. Recurrent costs were collected for the initial rollout period (March 8th to April 8th 2021) and for a later, higher-volume period (December 1st 2021 to February 28th 2022). The study was conducted from a payer perspective. Data was collected at health facilities from a purposively selected sample of 27 vaccination sites, as well as from 6 district and provincial health offices in 2 provinces, the Ministry of Health, and development partners. The overall cost per dose was obtained by estimating and aggregating the volume-weighted average cost per dose for each administrative level. Qualitative interviews were also conducted to contextualize cost findings. Results The cost per dose for the first year of implementation was $1.14 for economic costs and $0.50 for financial costs. For the initial rollout period, when the volume delivered was low (64 doses/vaccination day on average), the economic cost per dose was $3.56 and decreased considerably to $0.85 when the program delivered at scale and volume delivered increased to 225 doses/vaccination day. Opportunity costs made up a considerable share of the economic cost per dose, 73% and 49% respectively during the initial rollout and when the program delivered at scale. The qualitative interviews found that political prioritization and workers’ commitment made the program possible despite little financial investment. Conclusions The cost of delivering COVID-19 vaccines in Mozambique was found to be low compared to other countries, due to heavy reliance on existing resources and little additional investment into the program. Findings from this study can support the government in planning and budgeting for the future of the COVID-19 vaccination program as well as other vaccination efforts.https://doi.org/10.1186/s12913-025-12671-3Delivery costCostingImmunizationMozambiqueCOVID-19Vaccine delivery
spellingShingle Tozé Namalela
Flavia Moi
Amélia Dipuve
Pedro Marizane Pota
José Guambe
Maria Tereza Couto
Laura Boonstoppel
The cost of delivering COVID-19 vaccines in Mozambique: a bottom-up costing study
BMC Health Services Research
Delivery cost
Costing
Immunization
Mozambique
COVID-19
Vaccine delivery
title The cost of delivering COVID-19 vaccines in Mozambique: a bottom-up costing study
title_full The cost of delivering COVID-19 vaccines in Mozambique: a bottom-up costing study
title_fullStr The cost of delivering COVID-19 vaccines in Mozambique: a bottom-up costing study
title_full_unstemmed The cost of delivering COVID-19 vaccines in Mozambique: a bottom-up costing study
title_short The cost of delivering COVID-19 vaccines in Mozambique: a bottom-up costing study
title_sort cost of delivering covid 19 vaccines in mozambique a bottom up costing study
topic Delivery cost
Costing
Immunization
Mozambique
COVID-19
Vaccine delivery
url https://doi.org/10.1186/s12913-025-12671-3
work_keys_str_mv AT tozenamalela thecostofdeliveringcovid19vaccinesinmozambiqueabottomupcostingstudy
AT flaviamoi thecostofdeliveringcovid19vaccinesinmozambiqueabottomupcostingstudy
AT ameliadipuve thecostofdeliveringcovid19vaccinesinmozambiqueabottomupcostingstudy
AT pedromarizanepota thecostofdeliveringcovid19vaccinesinmozambiqueabottomupcostingstudy
AT joseguambe thecostofdeliveringcovid19vaccinesinmozambiqueabottomupcostingstudy
AT mariaterezacouto thecostofdeliveringcovid19vaccinesinmozambiqueabottomupcostingstudy
AT lauraboonstoppel thecostofdeliveringcovid19vaccinesinmozambiqueabottomupcostingstudy
AT tozenamalela costofdeliveringcovid19vaccinesinmozambiqueabottomupcostingstudy
AT flaviamoi costofdeliveringcovid19vaccinesinmozambiqueabottomupcostingstudy
AT ameliadipuve costofdeliveringcovid19vaccinesinmozambiqueabottomupcostingstudy
AT pedromarizanepota costofdeliveringcovid19vaccinesinmozambiqueabottomupcostingstudy
AT joseguambe costofdeliveringcovid19vaccinesinmozambiqueabottomupcostingstudy
AT mariaterezacouto costofdeliveringcovid19vaccinesinmozambiqueabottomupcostingstudy
AT lauraboonstoppel costofdeliveringcovid19vaccinesinmozambiqueabottomupcostingstudy