Child health and immunisation - A macro-perspective

The purpose of this paper is to critically evaluate the immunisation progra mme in abroad macro-perspective on demographic trends and child health. We have collated data on 15 major Stares starting from the beginning of the 19 80s to mid-1990s, though observation on all variables uniformly over the pe riod could not be secured. our analysis suggests that there has been a slac kening of the initial thrust (1990-91): of the EPI, which is of some concer n from the point of vaccine preventable diseases (VPDs). Since the populati on of net infants is in the increasing phase in almost all states, the task of providing full coverage appears to be daunting given the present perfor mance level in the underperforming, states. Although the notion of 'herd im munity' is controversial, WE,my not be totally an the wrong a track in conc luding that though at the aggregate level VPD occurrence will go down the i ncidence of local 'epidemic' in some states cannot be ruled out. It is evid ent from our studies on immunisation,; that the programme lacks on both asp ects of incentive and management and :this is nor due to any shortage in. t he financial and physical resources devoted to it. This is also corroborate d by the better performances of politically better managed states as compar ed to states which suffered from inept political management and instability .