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Are immunization policies sustainable in the Indian context? Insights into wastage and inefficiencies

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  • Shivam, Utkarsh
  • Kumar, Anand
  • Srivastava, Samir K.

Abstract

Immunization programs globally have played a pivotal role in reducing mortality rates. However, the effectiveness of these programs often falls short of the intended coverage targets, primarily due to challenges within the supply chain, storage facilities, and distribution processes. Notably, a substantial percentage of vaccine wastage has been observed in numerous countries, thereby imposing a significant financial burden on immunization initiatives, and presenting a formidable challenge to policymakers. This paper undertakes a comprehensive study of the financial dynamics inherent in an immunization program within the context of India. Employing a systems perspective, we scrutinize the intricate interactions among various cost factors. Through a five-year system dynamics simulation, we derive insights into the amplified financial constraints resulting from vaccine wastage and the inefficiencies associated with shared personnel. Furthermore, our analysis extends to evaluate the impact of an additional investment aimed at enhancing the quality of the cold chain infrastructure and health worker proficiency on the overall funds of the immunization program. This research contributes to a nuanced understanding of the financial intricacies of immunization programs, offering valuable insights for policymakers and stakeholders seeking to optimize program efficiency and resource allocation.

Suggested Citation

  • Shivam, Utkarsh & Kumar, Anand & Srivastava, Samir K., 2024. "Are immunization policies sustainable in the Indian context? Insights into wastage and inefficiencies," Journal of Policy Modeling, Elsevier, vol. 46(3), pages 569-591.
    • Handle: RePEc:eee:jpolmo:v:46:y:2024:i:3:p:569-591
    DOI: 10.1016/j.jpolmod.2024.02.002
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    1. Akinlo, Anthony E. & Sulola, Abiola O., 2019. "Health care expenditure and infant mortality in sub-Saharan Africa," Journal of Policy Modeling, Elsevier, vol. 41(1), pages 168-178.
    2. Kolesar, Robert John & Pheakdey, Sambo & Jacobs, Bart & Phay, Sokchegn, 2021. "Decision time: Cost estimations and policy implications to advance Universal Health Coverage in Cambodia," Journal of Policy Modeling, Elsevier, vol. 43(1), pages 127-145.
    3. Sterman, J.D., 2006. "Learning from evidence in a complex world," American Journal of Public Health, American Public Health Association, vol. 96(3), pages 505-514.
    4. Sibel Eker & Jill Slinger & Els Daalen & Gönenç Yücel, 2014. "Sensitivity analysis of graphical functions," System Dynamics Review, System Dynamics Society, vol. 30(3), pages 186-205, July.
    5. Brock, Gregory & Jin, Yinghua & Zeng, Tong, 2015. "Fiscal decentralization and China's regional infant mortality," Journal of Policy Modeling, Elsevier, vol. 37(2), pages 175-188.
    6. Gupta, Sanjeev & Verhoeven, Marijn, 2001. "The efficiency of government expenditure: experiences from Africa," Journal of Policy Modeling, Elsevier, vol. 23(4), pages 433-467, May.
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