Summary statistics for variables.

IntroductionChild immunization, though cost-beneficial, experiences varying costs influenced by individual facility-level factors. A real-time solution is to optimize resources and enhance vaccination services through proper method to measure immunization facility efficiency using existing data. Additionally, examine the impact of COVID-19 on facility efficiency, with the primary goal of comprehensively assessing child immunization facility efficiency in Pakistan.MethodsUtilizing survey data collected in four rounds from May 2018 to December 2020, the research focuses on doses administered and stock records for the preceding six months in each phase. In the initial stage, Data Envelopment Analysis (DEA) is utilized to compute facility efficiency, employing two models with varied outputs while maintaining consistent inputs. Model 1 assesses doses administered, encompassing three outputs (pentavalent vaccine 1, 2, and 3). Meanwhile, Model 2, focuses on stock used featuring a single output (total doses used). The inputs considered in both models include stock availability, staff members, cold chain equipment, vaccine carriers, and vaccine sessions. The second stage involves the application of two competing regression specifications (Tobit and Simar-Wilson) to explore the impact of the COVID-19 pandemic and external factors on the efficiency of these facilities.ResultsIn 12 districts across Punjab and Sindh, we assess 466 facilities in Model 1 and 455 in Model 2. Model 1 shows 59% efficiency, and Model 2 shows 70%, indicating excess stock. Stock of vaccines need to be reduced by from 36% to 43%. In the stage, COVID-19 period reduced efficiency in Model 1 by 10%, however, insignificant in Model 2.ConclusionsThe proposed methodology, utilizing DEA, emerges as a valuable tool for immunization facilities seeking to improve resource utilization and overall efficiency. Model 1, focusing on doses administered indicates facilities low efficiency at average 59% and proves more pertinent for efficiency analysis as it directly correlates with the number of children vaccinated. The prevalent issue of overstocking across all facilities significantly impacts efficiency. This study underscores the critical importance of optimizing resources through the redistribution of excess stock with low efficiency.

引言：儿童免疫接种虽具备成本效益，但受各接种机构层面因素影响，其成本存在差异。借助现有数据，通过合理方法评估免疫接种机构的效率，是优化资源配置、提升疫苗接种服务水平的实时可行方案。本研究同时探讨新冠疫情（COVID-19）对机构效率的影响，核心目标是全面评估巴基斯坦的儿童免疫接种机构效率。

研究方法：本研究使用2018年5月至2020年12月间四轮收集的调研数据，聚焦各调研阶段前六个月的疫苗接种剂量与库存记录。第一阶段采用数据包络分析（Data Envelopment Analysis, DEA）计算机构效率，设置两组输出变量不同但输入变量一致的模型：模型1以接种剂量为评估目标，包含三项输出指标（五联疫苗第1、2、3剂）；模型2则以疫苗使用库存为核心，仅设置一项输出指标（总使用剂量）。两类模型的输入变量均包括疫苗库存可获得性、工作人员数量、冷链设备、疫苗运输箱及疫苗接种场次。第二阶段采用两种竞争性回归模型（Tobit回归与Simar-Wilson回归），探究新冠疫情及外部因素对上述机构效率的影响。

研究结果：本次研究在旁遮普省与信德省的12个行政区内，共评估了466家机构（模型1）与455家机构（模型2）。模型1的平均效率为59%，模型2为70%，这一差异提示存在疫苗库存过剩问题——所有机构的疫苗库存需削减36%至43%。在第二阶段分析中，新冠疫情使模型1的效率降低了10%，但该影响在模型2中并不显著。

研究结论：本研究采用的数据包络分析方法，可为旨在提升资源利用效率与整体运营水平的免疫接种机构提供极具价值的分析工具。以接种剂量为评估目标的模型1显示，受访机构的平均效率仅为59%，且由于该模型直接与接种儿童数量相关，因此更适用于免疫接种机构的效率分析。当前所有机构普遍存在的库存过剩问题，会对机构效率造成显著负面影响。本研究强调，通过对低效机构的过剩库存进行重新分配以优化资源配置，具备至关重要的现实意义。