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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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  • Gauri, Varun & Khaleghian, Peyvand, 2002. "Immunization in Developing Countries: Its Political and Organizational Determinants," World Development, Elsevier, vol. 30(12), pages 2109-2132, December.
  • Handle: RePEc:eee:wdevel:v:30:y:2002:i:12:p:2109-2132
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    Cited by:

    1. Ryoko Sato & Yoshito Takasaki, 2015. "Psychic vs. Economic Barriers to Vaccine Take-up: Evidence from a Field Experiment in Nigeria," CIRJE F-Series CIRJE-F-983, CIRJE, Faculty of Economics, University of Tokyo.
    2. 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.
    3. 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.
    4. repec:kap:hcarem:v:20:y:2017:i:4:d:10.1007_s10729-016-9367-1 is not listed on IDEAS
    5. Breitwieser, Anja & Wick, Katharina, 2016. "What We Miss By Missing Data: Aid Effectiveness Revisited," World Development, Elsevier, vol. 78(C), pages 554-571.
    6. Bonu, Sekhar & Rani, Manju & Razum, Oliver, 2004. "Global public health mandates in a diverse world: the polio eradication initiative and the expanded programme on immunization in sub-Saharan Africa and South Asia," Health Policy, Elsevier, vol. 70(3), pages 327-345, December.
    7. RyokoSato & Yoshito Takasaki, 2016. "Peer Effects on Vaccination: Experimental Evidence from Rural Nigeria," CIRJE F-Series CIRJE-F-1002, CIRJE, Faculty of Economics, University of Tokyo.
    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. Xie, Jipan & Dow, William H., 2005. "Longitudinal study of child immunization determinants in China," Social Science & Medicine, Elsevier, vol. 61(3), pages 601-611, August.
    10. Masayuki Kudamatsu, 2012. "Has Democratization Reduced Infant Mortality In Sub-Saharan Africa? Evidence From Micro Data," Journal of the European Economic Association, European Economic Association, vol. 10(6), pages 1294-1317, December.
    11. Khaleghian, Peyvand, 2003. "Decentralization and public services : the case of immunization," Policy Research Working Paper Series 2989, The World Bank.
    12. World Bank, 2005. "Benchmarking Immunization Program Performance in the Africa Region," World Bank Other Operational Studies 8619, The World Bank.
    13. repec:eee:socmed:v:190:y:2017:i:c:p:237-246 is not listed on IDEAS
    14. Elizabeth Crouch & Lori Dickes, 2015. "A Prediction Model of Childhood Immunization Rates," Applied Health Economics and Health Policy, Springer, vol. 13(2), pages 243-251, April.
    15. Mani, Anandi & Mukand, Sharun, 2007. "Democracy, visibility and public good provision," Journal of Development Economics, Elsevier, vol. 83(2), pages 506-529, July.
    16. 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.
    17. Timothy Besley & Masayuki Kudamatsu, 2006. "Health and Democracy," American Economic Review, American Economic Association, vol. 96(2), pages 313-318, May.
    18. 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).
    19. Eggen, Andrea & Bezemer, Dirk J, 2007. "Do Poverty Reduction Strategies Help Achieve The Millennium Development Goals?," MPRA Paper 7030, University Library of Munich, Germany.
    20. Satis Devkota & Christopher Butler, 2016. "Caste-ethnic disparity in vaccine use among 0- to 5-year-old children in Nepal: a decomposition analysis," International Journal of Public Health, Springer;Swiss School of Public Health (SSPH+), vol. 61(6), pages 693-699, July.
    21. Raut, Nirmal Kumar & Shrestha, Devendra Prasad, 2011. "Why Low Adult Immunization? An inquiry into the case of Hepatitis B Vaccine in the Peri-Urban Areas of Kathmandu Valley," MPRA Paper 61711, University Library of Munich, Germany, revised Jan 2015.

    More about this item

    JEL classification:

    • C72 - Mathematical and Quantitative Methods - - Game Theory and Bargaining Theory - - - Noncooperative Games
    • D82 - Microeconomics - - Information, Knowledge, and Uncertainty - - - Asymmetric and Private Information; Mechanism Design
    • L14 - Industrial Organization - - Market Structure, Firm Strategy, and Market Performance - - - Transactional Relationships; Contracts and Reputation

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