Achieving better measles immunization in developing countries: does higher coverage imply lower inequality?
AbstractChanges in measles immunization are commonly expressed in terms of a change in mean coverage rates but these mean changes may conceal substantial disparities within societies by poverty status. This paper analyzes trends in both the level and the socio-economic distribution of measles immunization coverage in the 1990s for 21 developing countries with two rounds of Demographic and Health Surveys available. We examine these trends using "achievement" indices that combine trends in means and in inequality. We propose and employ "achievement contours" to illustrate graphically how a greater degree of societal aversion to inequality may affect the ranking of countries in terms of achieved measles immunization coverage. The results indicate that most countries have experienced an improvement in their mean measles immunization rate but that this improvement was often unequally distributed across wealth groups, disfavouring the poor in all countries. Mean improvements were found to be associated with both increasing and decreasing inequality. When the trend in the mean and in the degree of inequality was opposite, the trend in the overall "achievement" score is determined by the assumed underlying degree of inequality aversion. As such, the achievement measure "penalizes" coverage improvements that leave the poor lagging behind.
Download InfoIf you experience problems downloading a file, check if you have the proper application to view it first. In case of further problems read the IDEAS help page. Note that these files are not on the IDEAS site. Please be patient as the files may be large.
As the access to this document is restricted, you may want to look for a different version under "Related research" (further below) or search for a different version of it.
Bibliographic InfoArticle provided by Elsevier in its journal Social Science & Medicine.
Volume (Year): 66 (2008)
Issue (Month): 8 (April)
Contact details of provider:
Web page: http://www.elsevier.com/wps/find/journaldescription.cws_home/315/description#description
You can help add them by filling out this form.
CitEc Project, subscribe to its RSS feed for this item.
- Costa-Font, Joan & Hernández-Quevedo, Cristina, 2012. "Measuring inequalities in health: What do we know? What do we need to know?," Health Policy, Elsevier, vol. 106(2), pages 195-206.
- Erreygers, Guido & Clarke, Philip & Van Ourti, Tom, 2012. "“Mirror, mirror, on the wall, who in this land is fairest of all?”—Distributional sensitivity in the measurement of socioeconomic inequality of health," Journal of Health Economics, Elsevier, vol. 31(1), pages 257-270.
- Clarke, Philip & Van Ourti, Tom, 2010. "Calculating the concentration index when income is grouped," Journal of Health Economics, Elsevier, vol. 29(1), pages 151-157, January.
For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: (Zhang, Lei).
If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.
If references are entirely missing, you can add them using this form.
If the full references list an item that is present in RePEc, but the system did not link to it, you can help with this form.
If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your profile, as there may be some citations waiting for confirmation.
Please note that corrections may take a couple of weeks to filter through the various RePEc services.