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Immunization in developing countries : its political and organizational determinants

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  • Gauri, Varun
  • Khaleghian, Peyvand

Abstract

The authors use cross-national social, political, economic, and institutional data to explain why some countries have stronger immunization programs than others, as measured by diphtheria-tetanus-pertussis (DTP) and measles vaccine coverage rates and the adoption of the hepatitis B vaccine. After reveiwing the existing literature on demand- and supply-side side factors that affect immunization programs, the authors find that the elements that most affect immunization programs in low- and middle-income countries involve broad changes in the global policy environment and contact with international agencies. Democracies tend to have lower coverage rates than autocracies, perhaps because bureaucratic elites have an affinity for immunization programs and are granted more autonomy in autocracies, althought this effect is not visible in low-income countries. The authors also find that the quality of a nation's institutions and its level of development are strongly related to immunization rate coverage and vaccine adoption, and that coverage rates are in general more a function of supply-side than demand effects. there is no evidence that epidemics or polio eradication campaigns affect immunization rates one way or another, or that average immunization rates increase following outbreaks of diphtheria, pertussis, or measles.

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Bibliographic Info

Paper provided by The World Bank in its series Policy Research Working Paper Series with number 2769.

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Date of creation: 31 Jan 2002
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Handle: RePEc:wbk:wbrwps:2769

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Keywords: Health Monitoring&Evaluation; Disease Control&Prevention; Insurance&Risk Mitigation; Public Health Promotion; Early Child and Children's Health; Health Monitoring&Evaluation; Early Child and Children's Health; Insurance&Risk Mitigation; ICT Policy and Strategies; Health Economics&Finance;

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  1. Bhargava, A & Franzini, L & Narendranathan, W, 1982. "Serial Correlation and the Fixed Effects Model," Review of Economic Studies, Wiley Blackwell, vol. 49(4), pages 533-49, October.
  2. Anne Pebley & Noreen Goldman & Germán Rodríguez, 1996. "Prenatal and delivery care and childhood immunization in guatemala: Do family and community matter?," Demography, Springer, vol. 33(2), pages 231-247, May.
  3. Muraskin, William, 1995. "Bucking the health establishment: Alexander Milne and the fight for a New Zealand hepatitis B immunization program," Social Science & Medicine, Elsevier, vol. 41(2), pages 211-225, July.
  4. Knack, Stephen & Keefer, Philip, 1997. "Does Social Capital Have an Economic Payoff? A Cross-Country Investigation," The Quarterly Journal of Economics, MIT Press, vol. 112(4), pages 1251-88, November.
  5. Langsten, Ray & Hill, Kenneth, 1998. "The accuracy of mothers' reports of child vaccination: evidence from rural Egypt," Social Science & Medicine, Elsevier, vol. 46(9), pages 1205-1212, May.
  6. Beck, Thorsten & Clarke, George & Groff, Alberto & Keefer, Philip & Walsh, Patrick, 2000. "New tools and new tests in comparative political economy - the database of political institutions," Policy Research Working Paper Series 2283, The World Bank.
  7. Nichter, Mark, 1995. "Vaccinations in the third world: A consideration of community demand," Social Science & Medicine, Elsevier, vol. 41(5), pages 617-632, September.
  8. Sonalde Desai & Soumya Alva, 1998. "Maternal education and child health: Is there a strong causal relationship?," Demography, Springer, vol. 35(1), pages 71-81, February.
  9. Kim Streatfield & Masri Singarimbun & Ian Diamond, 1990. "Maternal Education and Child Immunization," Demography, Springer, vol. 27(3), pages 447-455, August.
  10. Anastasia Gage & A. Sommerfelt & Andrea Piani, 1997. "Household structure and childhood immunization in Niger and Nigeria," Demography, Springer, vol. 34(2), pages 295-309, May.
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Citations

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Cited by:
  1. McGuire, James W., 2006. "Basic health care provision and under-5 mortality: A Cross-National study of developing Countries," World Development, Elsevier, vol. 34(3), pages 405-425, March.
  2. Mukherjee, D., 2006. "A Note on Polio Count: Some empirical evidence from India," Applied Econometrics and International Development, Euro-American Association of Economic Development, vol. 6(3).
  3. Anja Breitwieser & Katharina Wick, 2013. "What We Miss By Missing Data: Aid Effectiveness Revisited," Vienna Economics Papers 1302, University of Vienna, Department of Economics.
  4. Das Gupta, Monica & Khaleghian, Peyvand & Sarwal, Rakesh, 2003. "Governance of communicable disease control services : a case study and lessons from India," Policy Research Working Paper Series 3100, The World Bank.
  5. Mani, Anandi & Mukand, Sharun, 2007. "Democracy, visibility and public good provision," Journal of Development Economics, Elsevier, vol. 83(2), pages 506-529, July.
  6. Dietrich, Simone, 2011. "The Politics of Public Health Aid: Why Corrupt Governments Have Incentives to Implement Aid Effectively," World Development, Elsevier, vol. 39(1), pages 55-63, January.
  7. Timothy Besley & Masayuki Kudamatsu, 2006. "Health and Democracy," American Economic Review, American Economic Association, vol. 96(2), pages 313-318, May.
  8. Varun Gauri, 2011. "The cost of complying with human rights treaties: The convention on the rights of the child and basic immunization," The Review of International Organizations, Springer, vol. 6(1), pages 33-56, March.
  9. Khaleghian, Peyvand, 2003. "Decentralization and public services : the case of immunization," Policy Research Working Paper Series 2989, The World Bank.
  10. Masayuki Kudamatsu, 2007. "Has Democratization Reduced Infant Mortality in Sub-Saharan Africa? Evidence from Micro Data," ISER Discussion Paper 0685, Institute of Social and Economic Research, Osaka University.
  11. World Bank, 2005. "Benchmarking Immunization Program Performance in the Africa Region," World Bank Other Operational Studies 8619, The World Bank.
  12. Eggen, Andrea & Bezemer, Dirk J, 2007. "Do Poverty Reduction Strategies Help Achieve The Millennium Development Goals?," MPRA Paper 7030, University Library of Munich, Germany.

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