Immunization in developing countries: Its political and organizational determinants

The factors that most affect immunization coverage involve the global policy environment and contact with international agencies. Except in very poor countries, democracies have lower coverage rates than autocracies. The quality of a country's institutions and its level of development are also strongly related to immunization rate coverage and vaccine adoption. There is no evidence that disease outbreaks or polio eradication campaigns affect immunization rates. In the current structure of immunization programs, coverage rates respond more to supply-side than demand effects. (C) 2002 Elsevier Science Ltd. All rights reserved.