{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T22:37:18Z","timestamp":1792708638845,"version":"4.5.0"},"reference-count":31,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T00:00:00Z","timestamp":1785801600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Immunization coverage surveys are one of the best ways to assess program performance. However, surveys can be costly endeavors, and their costs are not well-documented, particularly in low- and middle-income countries (LMICs).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This research brought together a scoping review of the literature on survey methods and costs in LMICs; qualitative interviews from a range of funders of health and immunization coverage survey; and a quantitative analysis of costs from 33 surveys. We collected and systematically categorized survey design and cost information for a range of immunization coverage surveys conducted in low- and middle-income countries between 2013 and 2025. Total and unit costs were compared across regions, survey type, survey method, and conflict setting.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The median total survey cost was $300,000, ranging from $28,000 to $2.87\u202fm depending upon survey method and geographic scope. Lot Quality Assurance Sampling (LQAS) surveys had lower median total costs. The cost per household was highest in Latin American countries and lowest for East African countries. Post-campaign coverage surveys (PCCS) had the highest cost per person surveyed. Major cost drivers included personnel, transportation, and field work costs. Technical support can account for an average of 30% of survey costs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>Adequate planning and budgeting of immunization coverage surveys are essential for ensuring sufficient financing and quality implementation. Findings from this study can provide benchmarks for better budgeting and financing of immunization coverage surveys, leading to improved quality. Survey cost and budget information should be regularly analyzed and reported to enhance our ongoing knowledge.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fpubh.2026.1897118","type":"journal-article","created":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T04:26:53Z","timestamp":1785817613000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Cost of immunization coverage surveys in low- and middle-income countries"],"prefix":"10.3389","volume":"14","author":[{"given":"Logan","family":"Brenzel","sequence":"first","affiliation":[{"name":"Independent Consultant","place":["Paris, France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Helen","family":"Saxenian","sequence":"additional","affiliation":[{"name":"Independent Consultant","place":["Bethesda, MD, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katelyn","family":"Stahley","sequence":"additional","affiliation":[{"name":"Gates Foundation","place":["Seattle, WA, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emily","family":"Dansereau","sequence":"additional","affiliation":[{"name":"Gates Foundation","place":["Seattle, WA, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,8,4]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"5150","DOI":"10.1016\/j.vaccine.2018.07.019","article-title":"Collecting and using reliable vaccination coverage survey estimates: summary and recommendations from the \"meeting to share lessons learnt from the roll-out of the updated WHO vaccination coverage cluster survey reference manual and to set an operational research agenda around vaccination coverage surveys\", Geneva, 18-21 April 2017","volume":"36","author":"Danovaro-Holliday","year":"2018","journal-title":"Vaccine"},{"key":"ref2","year":"2015"},{"key":"ref3","year":"2023"},{"key":"ref4","year":"2016"},{"key":"ref5","first-page":"569","article-title":"Cost and results of information systems for health and poverty indicators in the United Republic of Tanzania","volume":"83","author":"Rommelmann","year":"2005","journal-title":"Bull World Health Organ"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"1756","DOI":"10.1111\/tmi.12605","article-title":"Comparing two survey methods of measuring health-related indicators: lot quality assurance sampling and demographic health surveys","volume":"20","author":"Anoke","year":"2015","journal-title":"Trop Med Int Health"},{"key":"ref7","first-page":"269","article-title":"Evaluation of immunization coverage by lot quality assurance sampling compared with 30-cluster sampling in a primary health Centre in India","volume":"74","author":"Singh","year":"1996","journal-title":"Bull World Health Organ"},{"key":"ref8","first-page":"847","article-title":"Immunization coverage surveys: methodological studies in Indonesia","volume":"65","author":"Lwanga","year":"1987","journal-title":"Bull World Health Organ"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"633","DOI":"10.1093\/ije\/dym025","article-title":"Comparison of two survey methodologies to assess vaccination coverage","volume":"36","author":"Luman","year":"2007","journal-title":"Intl J Epidemiol"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"111","DOI":"10.1007\/s11524-020-00485-z","article-title":"Addressing unintentional exclusion of vulnerable and Mobile households in traditional surveys in Kathmandu, Dhaka, and Hanoi: a mixed-methods feasibility study","volume":"98","author":"Thomson","year":"2021","journal-title":"J Urban Health"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"6","DOI":"10.1186\/1742-7622-5-6","article-title":"Precision, time, and cost: a comparison of three sampling designs in an emergency setting","volume":"5","author":"Deitchler","year":"2008","journal-title":"Emerg Themes Epidemiol"},{"key":"ref12","first-page":"128313","volume-title":"Comparing sampling approaches for assessing subnational vaccination coverage: a pilot study in Central African Republic and the Democratic Republic of Congo","author":"Kasonga","year":"2026"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"e0240734","DOI":"10.1371\/journal.pone.0240734","article-title":"How much does it cost to measure immunity? A costing analysis of a measles and rubella serosurvey in southern Zambia","volume":"15","author":"Carcelen","year":"2020","journal-title":"PLoS One"},{"key":"ref14","volume-title":"World Health Organization Vaccination Coverage Cluster Surveys: Reference Manual","year":"2018"},{"key":"ref15","volume-title":"Assessing Child Survival Programs in Developing Countries: Testing lot Quality Assurance Sampling","author":"Valadez","year":"1991"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"1648","DOI":"10.1016\/j.socscimed.2006.04.011","article-title":"Global review of health care surveys using lot quality assurance sampling (LQAS), 1984\u20132004","volume":"63","author":"Robertson","year":"2006","journal-title":"Soc Sci Med"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"60","DOI":"10.1093\/ije\/dyn366","article-title":"LQAS: User Beware","volume":"39","author":"Rhoda","year":"2010","journal-title":"Int J Epidemiol"},{"key":"ref18","doi-asserted-by":"publisher","first-page":"1257","DOI":"10.3390\/vaccines12111257","article-title":"Lessons from recent measles post-campaign coverage surveys worldwide","volume":"12","author":"Danovaro-Holliday","year":"2024","journal-title":"Vaccines (Basel)"},{"key":"ref19","year":"2025"},{"key":"ref20","year":"2025"},{"key":"ref21","volume-title":"Cuts in official development assistance: OECD projections for 2025 and the near term","year":"2025"},{"key":"ref22","doi-asserted-by":"publisher","first-page":"923","DOI":"10.3233\/SJI-220042","article-title":"Positioning household surveys for the next decade","volume":"38","author":"Carletto","year":"2022","journal-title":"Stat J IAOS"},{"key":"ref23","doi-asserted-by":"publisher","first-page":"1773","DOI":"10.3390\/vaccines11121773","article-title":"A practical guide to pilot testing community-based vaccination coverage surveys","volume":"11","author":"Rhoda","year":"2023","journal-title":"Vaccine"},{"key":"ref24","doi-asserted-by":"publisher","first-page":"247","DOI":"10.3233\/SJI-230042","article-title":"Using paradata to assess respondent burden and interviewer effects in household surveys: evidence from low- and middle-income countries","volume":"40","author":"Hasanbasri","year":"2024","journal-title":"Stat J IAOS"},{"key":"ref25","doi-asserted-by":"publisher","first-page":"6174","DOI":"10.1016\/j.vaccine.2020.05.058","article-title":"Combining cluster surveys to estimate vaccination coverage: experiences from Nigeria\u2019s multiple indicator cluster survey \/ national immunization coverage survey (MICS\/NICS)","volume":"38","author":"Rhoda","year":"2020","journal-title":"Vaccine"},{"key":"ref26","doi-asserted-by":"publisher","first-page":"100085","DOI":"10.1016\/j.jvacx.2021.100085","article-title":"Pairs of independent nationally representative vaccination coverage surveys conducted within one year of each other: a global overview covering 2000-2019","volume":"7","author":"Brown","year":"2021","journal-title":"Vaccine X"},{"key":"ref27","year":"2024"},{"key":"ref28","doi-asserted-by":"publisher","first-page":"102153","DOI":"10.1016\/j.foodpol.2021.102153","article-title":"Viewpoint: high-frequency phone surveys on COVID-19: good practices, open questions","volume":"105","author":"Gourlay","year":"2024","journal-title":"Food Policy"},{"key":"ref29","doi-asserted-by":"publisher","first-page":"25","DOI":"10.1186\/s12942-017-0098-4","article-title":"GridSample: an R package to generate household survey primary sampling units (PSUs) from gridded population data. 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