{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T07:12:37Z","timestamp":1792825957761,"version":"4.5.0"},"reference-count":25,"publisher":"BMJ","issue":"11","license":[{"start":{"date-parts":[[2024,11,21]],"date-time":"2024-11-21T00:00:00Z","timestamp":1732147200000},"content-version":"unspecified","delay-in-days":20,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000865","name":"Bill and Melinda Gates Foundation","doi-asserted-by":"publisher","award":["INV-007610"],"award-info":[{"award-number":["INV-007610"]}],"id":[{"id":"10.13039\/100000865","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2024,10,30]]},"published-print":{"date-parts":[[2024,11]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To evaluate the cost of delivering childhood respiratory syncytial virus (RSV) prevention interventions to the health system in Kenya.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>A prospective (cost projection) activity-based costing study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Kenya, national introduction of interventions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>Not applicable.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Interventions<\/jats:title>\n                    <jats:p>A single-dose RSV maternal vaccine and a single-dose, long-acting monoclonal antibody (mAb).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Primary and secondary outcome measures<\/jats:title>\n                    <jats:p>Cost per eligible target population; cost per dose administered; non-commodity cost of delivery. Costs are reported in 2023 USD.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>RSV interventions are expected to be delivered using existing systems: maternal vaccine using the antenatal care platform and the mAb delivered similar to existing birth dose vaccines. Assuming a price of US$3 per dose (for both interventions) and baseline coverage rates averaging 50% for the maternal vaccine and 86% for the mAb, the estimated cost of delivering maternal vaccine was US$1.74 (financial) and US$6.60 (economic) per vaccinated woman, and the cost of delivering mAbs was US$1.56 (financial) and US$6.27 (economic) per vaccinated child. Excluding commodity cost, the cost of delivering maternal vaccine was US$1.32 (financial) and US$2.72 (economic) and that for mAb was US$1.23 (financial) and US$2.48 (economic). Cost differences between the two interventions are driven by the anticipated baseline coverage. Health worker training, service delivery and programme planning and coordination were major cost drivers.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This study presents the prospective cost of new RSV intervention introduction and delivery in low-income and middle-income country settings, which is largely unknown. Cost estimates incorporate anticipated health system strengthening activities needed to deliver the future RSV interventions. These cost estimates support country-level and global-level decision-makers evaluating implementation feasibility and intervention affordability.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2024-084207","type":"journal-article","created":{"date-parts":[[2024,11,22]],"date-time":"2024-11-22T02:49:21Z","timestamp":1732243761000},"page":"e084207","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":6,"title":["Cost of delivering childhood RSV prevention interventions to the health system in Kenya: a prospective analysis"],"prefix":"10.1136","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3043-6070","authenticated-orcid":false,"given":"Ranju","family":"Baral","sequence":"first","affiliation":[{"name":"Center for Vaccine Innovation and Access, PATH, Seattle, Washington, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elkanah","family":"Otiang","sequence":"additional","affiliation":[{"name":"PATH, Nairobi, Kenya"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph","family":"Odiyo","sequence":"additional","affiliation":[{"name":"Independent Consultant, Nairobi, Kenya"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bryan O","family":"Nyawanda","sequence":"additional","affiliation":[{"name":"Kenya Medical Research Institute, Center for Global Health Research, Kisumu, Kenya"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joyce U","family":"Nyiro","sequence":"additional","affiliation":[{"name":"Kenya Medical Research Institute\u2013Wellcome Trust Research Programme, Kilifi, Kenya"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrick","family":"Munywoki","sequence":"additional","affiliation":[{"name":"Kenya Medical Research Institute\u2013Wellcome Trust Research Programme, Kilifi, Kenya"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rose E","family":"Jalang'O","sequence":"additional","affiliation":[{"name":"National Vaccines and Immunization Program, Ministry of Health, Nairobi, Kenya"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Clint","family":"Pecenka","sequence":"additional","affiliation":[{"name":"Center for Vaccine Innovation and Access, PATH, Seattle, Washington, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2024,11,21]]},"reference":[{"key":"2025120618430534000_14.11.e084207.1","doi-asserted-by":"publisher","DOI":"10.1016\/s0140-6736(22)00478-0"},{"key":"2025120618430534000_14.11.e084207.2","doi-asserted-by":"crossref","first-page":"2870","DOI":"10.1016\/j.vaccine.2016.03.109","article-title":"Advances in RSV vaccine research and development - A global agenda","volume":"34","author":"Higgins","year":"2016","journal-title":"Vaccine (Auckl)"},{"key":"2025120618430534000_14.11.e084207.3","unstructured":"PATH . 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