IDEAS home Printed from https://ideas.repec.org/a/eee/socmed/v66y2008i8p1709-1718.html
   My bibliography  Save this article

Achieving better measles immunization in developing countries: does higher coverage imply lower inequality?

Author

Listed:
  • Meheus, Filip
  • Van Doorslaer, Eddy

Abstract

Changes 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.

Suggested Citation

  • Meheus, Filip & Van Doorslaer, Eddy, 2008. "Achieving better measles immunization in developing countries: does higher coverage imply lower inequality?," Social Science & Medicine, Elsevier, vol. 66(8), pages 1709-1718, April.
  • Handle: RePEc:eee:socmed:v:66:y:2008:i:8:p:1709-1718
    as

    Download full text from publisher

    File URL: http://www.sciencedirect.com/science/article/pii/S0277-9536(07)00650-8
    Download Restriction: Full text for ScienceDirect subscribers only

    As the access to this document is restricted, you may want to search for a different version of it.

    References listed on IDEAS

    as
    1. repec:aph:ajpbhl:2000:90:10:1521-1525_9 is not listed on IDEAS
    2. Wagstaff, Adam & Paci, Pierella & van Doorslaer, Eddy, 1991. "On the measurement of inequalities in health," Social Science & Medicine, Elsevier, vol. 33(5), pages 545-557, January.
    3. Wagstaff, Adam, 2002. "Inequality aversion, health inequalities and health achievement," Journal of Health Economics, Elsevier, vol. 21(4), pages 627-641, July.
    4. Yitzhaki, Shlomo, 1983. "On an Extension of the Gini Inequality Index," International Economic Review, Department of Economics, University of Pennsylvania and Osaka University Institute of Social and Economic Research Association, vol. 24(3), pages 617-628, October.
    5. Owen O'Donnell & Eddy van Doorslaer & Adam Wagstaff & Magnus Lindelow, 2008. "Analyzing Health Equity Using Household Survey Data : A Guide to Techniques and Their Implementation," World Bank Publications, The World Bank, number 6896.
    6. FFF1Alberto NNN1Minujin & FFF2Enrique NNN2Delamonica, 2004. "Socio-economic inequalities in mortality and health in the developing world," Demographic Research Special Collections, Max Planck Institute for Demographic Research, Rostock, Germany, vol. 2(13), pages 331-354, April.
    7. Bonu, Sekhar & Rani, Manju & Baker, Timothy D., 2003. "The impact of the national polio immunization campaign on levels and equity in immunization coverage: evidence from rural North India," Social Science & Medicine, Elsevier, vol. 57(10), pages 1807-1819, November.
    8. Deon Filmer & Lant Pritchett, 1999. "The Effect of Household Wealth on Educational Attainment: Evidence from 35 Countries," Population and Development Review, The Population Council, Inc., vol. 25(1), pages 85-120.
    9. 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.
    10. Adam Wagstaff, 2005. "The bounds of the concentration index when the variable of interest is binary, with an application to immunization inequality," Health Economics, John Wiley & Sons, Ltd., vol. 14(4), pages 429-432.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. 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.
    2. 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.
    3. repec:eme:reinzz:s1049-258520160000024008 is not listed on IDEAS
    4. Bénédicte H. Apouey & Jacques Silber, 2016. "Performance and Inequality in Health: A Comparison of Child and Maternal Health across Asia," Research on Economic Inequality,in: Inequality after the 20th Century: Papers from the Sixth ECINEQ Meeting, volume 24, pages 181-214 Emerald Publishing Ltd.
    5. Bénédicte H. Apouey & Jacques Silber, 2016. "Performance and Inequality in Health: A Comparison of Child and Maternal Health across Asia," Working Papers halshs-01357085, HAL.
    6. 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.

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:eee:socmed:v:66:y:2008:i:8:p:1709-1718. See general information about how to correct material in RePEc.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: (Dana Niculescu). General contact details of provider: http://www.elsevier.com/wps/find/journaldescription.cws_home/315/description#description .

    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 CitEc recognized a reference but did not link an item in RePEc 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 RePEc Author Service 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.

    IDEAS is a RePEc service hosted by the Research Division of the Federal Reserve Bank of St. Louis . RePEc uses bibliographic data supplied by the respective publishers.