Ten provinces of China were selected to estimate the cost per immunization of the 1994± 95 national immunization days (NIDs) at ®ve levels (e.g. province, prefecture, county, township and village). Personnel costs accounted for the largest overall share of costs (39 per cent), followed by publicity and promotion costs (27 per cent), and logistic costs (15 per cent). Without consideration of vaccine costs, the major part of NID expenses were shouldered at the township level, which paid for 47 per cent of all incremental costs, while county and village level covered 28 per cent and 18 per cent respectively. Estimation of average costs per immunization was 2.86 RMB yuan, or $0.34, including vaccine costs, buildings and equipment amortization and salaries at all levels. The factors aecting average cost of NID included the output volume, socio-economic development and geographic features.
Various approaches were recommended: to intensify the productivity of time and sta, to employ alternative inexpensive manpower resources, to make the best use of publicity and social promotion, the expansion of the age groups and utilization of multiintervention strategies. Good planning at township level was a decisive factor to ensure an eective NID conducted in an ecient manner. The average cost of China's NID was the lowest among all mass immunization campaigns ever documented. Much of the reduced average cost was attributable to economies of scale.