Micro-costing for national-scale azithromycin mass drug administration to improve child survival in Niger

Brittany Peterson, William Nguyen, Laminou Maliki Haroun, Farissatou Oumarou, Ahmed M Arzika, Ramatou Maliki, Abdou Amza, Karamba Alio, Nasser Gallo, Bawa Aichatou, Ismael Issa Sara, Diallo Beidi, James G Kahn, Stefano M Bertozzi, Elodie Lebas, Benjamin F Arnold, Thomas M Lietman, Kieran S O’Brien, Meagan C Fitzpatrick and the AVENIR Study Group

PLOS Global Public Health, 2026, vol. 6, issue 6, 1-16

Abstract: As programs for azithromycin mass drug administration (AZ-MDA) to reduce child mortality have begun in some parts of West Africa, it is imperative to understand their financial costs. We combined a micro-costing framework and observations from an implementation-focused sub-study within the AVENIR trials in 80 communities in the Dosso region of Niger to estimate the national health sector financial costs of a scaled-up programmatic approach for azithromycin biannual distribution to children aged 1–59 months of age living in nonurban areas, using the door-to-door modality. Our outcomes of interest were the annual budget at the regional and national levels for Niger and the cost per dose delivered. We found that the annual national budget required for AZ-MDA achieving 90% average coverage would be $12.5 million (M) (95% Uncertainty Interval (UI) $12.2M, $13.0M) translating to $1.59 (95% UI $1.40, $2.30) per dose delivered. Across regions, cost per dose would vary from $1.17 (95% UI $1.03, $1.69) to $3.61 (95% UI $3.20, $5.16), with higher cost per dose expected for more sparsely populated regions. Training costs represented a large fraction (16.4%) of total costs, and integration of training with that for existing health interventions may provide opportunities for efficiency.

Date: 2026
References: Add references at CitEc
Citations:

Downloads: (external link)
https://journals.plos.org/globalpublichealth/artic ... journal.pgph.0006039 (text/html)
https://journals.plos.org/globalpublichealth/artic ... 06039&type=printable (application/pdf)

Related works:
This item may be available elsewhere in EconPapers: Search for items with the same title.

Export reference: BibTeX RIS (EndNote, ProCite, RefMan) HTML/Text

Persistent link: https://EconPapers.repec.org/RePEc:plo:pgph00:0006039

DOI: 10.1371/journal.pgph.0006039

Access Statistics for this article

More articles in PLOS Global Public Health from Public Library of Science
Bibliographic data for series maintained by globalpubhealth ().