BACKGROUND:
The government of Eritrea received funding in 2002 from the Global Alliance for Vaccines and Immunizations (GAVI) and the Vaccine Fund (VF) to strengthen routine immunization services, to improve injection safety and to introduce the Hepatitis B vaccine into the routine immunization program. Since the country’s independence in 1991, no census has been conducted and population estimates vary greatly depending on the data source.

OBJECTIVE:
To demonstrate how the cost and financing of the Eritrean National Immunization Program vary depending on population data.

METHOD:
Using guidelines and costing tools from GAVI for the costing of the immunization program, program specific costs for the immunization program were estimated from 2001 to 2007.

RESULT:
The immunization coverage data from 4 different data sources provide estimates that vary from 52% (Eritrea Health Sector Note, World Bank, 2000) to 93.6% (Eritrea coverage survey report, 2000) for DTP3 in 2000. Financing projections for the National Immunization Program will change depending on how large of an increase in coverage is expected from the immunization program between now and 2007.

CONCLUSION:
The variation in denominators affect commonly used indicators such as cost per capita and cost per fully immunized child. In limited resource setting, it is important that financial resources be used in the most rational manner for the purchasing of vaccines. An underestimation of vaccines will lead to vaccine shortages in health posts while an overestimation of vaccines will lead to wastage of scarce financial resources.

LEARNING OBJECTIVES:
To learn how the lack of census data and accurate population estimates has led to inaccuracies which affect the planning and financing of the Eritrea National Immunization Program.