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Immunization in developing countries : its political and organizational determinants

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Author Info
Gauri, Varun
Khaleghian, Peyvand

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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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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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Related research
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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References listed on IDEAS
Please report citation or reference errors to , or , if you are the registered author of the cited work, log in to your RePEc Author Service profile, click on "citations" and make appropriate adjustments.:
  1. 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. [Downloadable!]
  2. 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.
  3. Bhargava, A & Franzini, L & Narendranathan, W, 1982. "Serial Correlation and the Fixed Effects Model," Review of Economic Studies, Blackwell Publishing, vol. 49(4), pages 533-49, October. [Downloadable!] (restricted)
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Cited by:
(explanations, Please report citation or reference errors to , or , if you are the registered author of the cited work, log in to your RePEc Author Service profile, click on "citations" and make appropriate adjustments.)

  1. 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. [Downloadable!]
  2. 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. [Downloadable!]
  3. Timothy Besley & Masayuki Kudamatsu, 2006. "Health and Democracy," American Economic Review, American Economic Association, vol. 96(2), pages 313-318, May. [Downloadable!]
  4. 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). [Downloadable!] (restricted)
  5. Khaleghian, Peyvand, 2003. "Decentralization and public services : the case of immunization," Policy Research Working Paper Series 2989, The World Bank. [Downloadable!]
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