Supplementary immunization activities are vast operations to deliver vaccines to every household. In 2012-2013, 32% of the total budget is allocated to operational costs. There is great variation in operational costs between and within countries, primarily driven by variations in population density. For example, in India costs are low (cost per child US$ 0.15 in 2012) as high population density allows a single health or communication initiative to reach large swathes of the population. The average operational cost to reach one child with vaccine during one round of immunization activities is US$ 0.20 per child.
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