Immunization in Developing Countries : Its Political and Organizational Determinants

Gauri, Varun ; Khaleghian, Peyvand

World Bank, Washington, DC

关键词: ADVERTISING;    AGENTS;    ASSURANCE;    AUTISM;    BUREAUCRACIES;   

DOI  :  10.1596/1813-9450-2769
RP-ID  :  WPS2769

学科分类：社会科学、人文和艺术（综合）

来源: World Bank Open Knowledge Repository

【 摘 要 】

The authors use cross-national social,political, economic, and institutional data to explain whysome countries have stronger immunization programs thanothers, as measured by diphtheria-tetanus-pertussis (DTP)and measles vaccine coverage rates and the adoption of thehepatitis B vaccine. After reveiwing the existing literatureon demand- and supply-side side factors that affectimmunization programs, the authors find that the elementsthat most affect immunization programs in low- andmiddle-income countries involve broad changes in the globalpolicy environment and contact with international agencies.Democracies tend to have lower coverage rates thanautocracies, perhaps because bureaucratic elites have anaffinity for immunization programs and are granted moreautonomy in autocracies, althought this effect is notvisible in low-income countries. The authors also find thatthe quality of a nation's institutions and its level ofdevelopment are strongly related to immunization ratecoverage and vaccine adoption, and that coverage rates arein general more a function of supply-side than demandeffects. there is no evidence that epidemics or polioeradication campaigns affect immunization rates one way oranother, or that average immunization rates increasefollowing outbreaks of diphtheria, pertussis, or measles.