Immunization in
S. Gaudin
Abstract:
Previously
published evidence from the 1992-93 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 (1998-99), we take a new snapshot of the
situation and compare it to 1992-93, 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 seventeen largest Indian states. Comparing 1992-93 to 1998-99
achievements using different degrees of “inequality aversion” provides no
evidence that distributional improvements occur at the expense of overall
performance.