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Comprehensive & Cost Effective Laboratory Monitoring of HIV/AIDS: an African Role Model

Comprehensive & Cost Effective Laboratory Monitoring of HIV/AIDS: an African Role Model

Published on: October 31, 2010

Health workers and vaccination coverage in developing countries: an econometric analysis.

Sudhir Anand¹, Till Bärnighausen²

¹University of Oxford, Department of Economics, Oxford, UK; Harvard University, Global Equity Initiative, Cambridge, MA, USA.

Lancet (London, England)

|April 17, 2007

Summary

Higher nurse density significantly improves childhood vaccination coverage in developing nations, demonstrating that health workers are crucial for vaccine access. National income did not impact immunisation rates.

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Area of Science:

Global Health
Epidemiology
Health Services Research

Background:

Vaccine-preventable diseases cause over 1 million child deaths annually in developing countries.
Human resources for health are critical for vaccination but their population-level impact is understudied.

Purpose of the Study:

To investigate the association between health worker density and childhood vaccination coverage in developing countries.

Main Methods:

Cross-country multiple regression analyses were performed.
Dependent variables included coverage for measles-containing vaccine (MCV), diphtheria-tetanus-pertussis (DTP3), and poliomyelitis (polio3).
Independent variables were aggregate health worker density, and separately, doctor and nurse densities, controlling for income, literacy, and land area.

Main Results:

Aggregate health worker density positively correlated with coverage for all three vaccines.
Nurse density showed a significant positive association with MCV, DTP3, and polio3 coverage.
Doctor density was not significantly associated with any of the vaccination coverages; higher female adult literacy and smaller land area were also associated with increased coverage.

Conclusions:

Increased density of nurses enhances vaccination service availability, improving child immunisation rates.
National income is not a determinant of immunisation coverage.
Health worker availability, particularly nurses, is a key factor influencing vaccination coverage in developing countries.