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Enhancing coverage and sustainability of vaccination programs: An explanatory framework with special reference to India

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  • Streefland, Pieter H.

Abstract

The article addresses the question in what form and under what conditions vaccination programs can be expected to continue once the 'take off' period is over. This matter is of great importance because of the need to continuously vaccinate new cohorts of children with a high degree of coverage and in an appropriate manner. Using data from India, where vaccination programs are integrated in regular health care delivery, an explanatory framework is presented which, first, analyses the vaccination program in terms of different levels, organizational cultures and inter-level linkages and, second, addresses the relation between the program and its socio-cultural context. The analysis provides starting points for changes that could enhance coverage and sustainability. Such changes include alterations in program design and adjustments in the views of different categories of program staff. The article discusses strategies directed at achieving such changes.

Suggested Citation

  • Streefland, Pieter H., 1995. "Enhancing coverage and sustainability of vaccination programs: An explanatory framework with special reference to India," Social Science & Medicine, Elsevier, vol. 41(5), pages 647-656, September.
    • Handle: RePEc:eee:socmed:v:41:y:1995:i:5:p:647-656
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    Cited by:

    1. de Timoteo Mavimbe, Joao Carlos & Muquingue, Humberto Nelson & Braa, Jorn & Bjune, Gunnar, 2006. "Immunization coverage in Mozambique: From concepts to decision-making," Health Policy, Elsevier, vol. 79(1), pages 92-100, November.
    2. Johnson, Knowlton & Hays, Carol & Center, Hayden & Daley, Charlotte, 2004. "Building capacity and sustainable prevention innovations: a sustainability planning model," Evaluation and Program Planning, Elsevier, vol. 27(2), pages 135-149, May.
    3. A. Emre Demirci, 2013. "Strategic Representation of an Abstract Reality: Spiraling Relations between Organizational Culture and Innovativeness," Journal of Management and Strategy, Journal of Management and Strategy, Sciedu Press, vol. 4(3), pages 39-55, August.
    4. Gauri, Varun & Khaleghian, Peyvand, 2002. "Immunization in Developing Countries: Its Political and Organizational Determinants," World Development, Elsevier, vol. 30(12), pages 2109-2132, December.
    5. 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.
    6. Streefland, Pieter H., 2001. "Public doubts about vaccination safety and resistance against vaccination," Health Policy, Elsevier, vol. 55(3), pages 159-172, March.

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