Are vaccination sites in Bangladesh scale efficient?

OBJECTIVES The overall aim of this study is to discern whether and to what degree vaccination sites exhibit constant returns to scale. METHODS Data Envelopment Analysis is used to compare all the facilities in the sample in terms of input costs used to produce multiple outputs. The application considers the Expanded Program on Immunization (EPI), which operated in Dhaka City, Bangladesh, during 1999. RESULTS A preponderance of EPI sites were determined to be operating at increasing returns to scale. CONCLUSIONS Our findings question the applicability of cost-effectiveness analyses that assume constant returns to scale.