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Immunization in india 1993-1999: Wealth, gender, and regional inequalities revisited


  • Gaudin, Sylvestre
  • Yazbeck, Abdo S.


Previously published evidence from the 1992-1993 Indian National Family and Health Survey (NFHS) on the state of childhood immunization showed the importance of analyzing immunization outcomes beyond national averages. Reported total system failure (no immunization for all) in some low performance areas suggested that improvements in immunization levels may come with a worsening of the distribution of immunization based on wealth. In this paper, using the second wave of the NFHS (1998-1999), we take a new snapshot of the situation and compare it to 1992-1993, focusing on heterogeneities between states, rural-urban differentials, gender differentials, and more specifically on wealth-related inequalities. To assess whether improvements in overall immunization rates (levels) were accompanied by distributional improvements, or conversely, whether inequalities were reduced at the expense of overall achievement, we use a recently developed methodology to calculate an inequality-adjusted achievement index that captures performance both in terms of efficiency (change in levels) and equity (distribution by wealth quintiles) for each of the 17 largest Indian states. Comparing 1992-1993 to 1998-1999 achievements using different degrees of "inequality aversion" provides no evidence that distributional improvements occur at the expense of overall performance.

Suggested Citation

  • Gaudin, Sylvestre & Yazbeck, Abdo S., 2006. "Immunization in india 1993-1999: Wealth, gender, and regional inequalities revisited," Social Science & Medicine, Elsevier, vol. 62(3), pages 694-706, February.
  • Handle: RePEc:eee:socmed:v:62:y:2006:i:3:p:694-706

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    References listed on IDEAS

    1. Wagstaff, Adam, 2002. "Inequality aversion, health inequalities and health achievement," Journal of Health Economics, Elsevier, vol. 21(4), pages 627-641, July.
    2. David H. Peters & Abdo S. Yazbeck & Rashmi R. Sharma & G. N. V. Ramana & Lant H. Pritchett & Adam Wagstaff, 2002. "Better Health Systems for India's Poor : Findings, Analysis, and Options," World Bank Publications, The World Bank, number 14080.
    3. Kakwani, Nanak & Wagstaff, Adam & van Doorslaer, Eddy, 1997. "Socioeconomic inequalities in health: Measurement, computation, and statistical inference," Journal of Econometrics, Elsevier, vol. 77(1), pages 87-103, March.
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    Cited by:

    1. Sylvestre Gaudin, 2011. "Son Preference in Indian Families: Absolute Versus Relative Wealth Effects," Demography, Springer;Population Association of America (PAA), vol. 48(1), pages 343-370, February.

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