Polio. Measles. Tuberculosis. Every country in the world administers a protocol of childhood immunizations to prevent devastating epidemics of diseases like these. Yet the distribution of social goods—collectively provided goods that have shared benefits—such as immunizations, is far from consistent. Global Policy Research Institute fellow and political science doctoral candidate Katie Cahill-Rincón hopes her research can help policymakers understand these different outcomes. “What can childhood immunizations tell us about the broader problems that developing states face in distributing basic goods and services, the different responses their governments take, and the role of international organizations in the decision process?”
India, the largest democracy in the world, has struggled with low immunization rates, while its politically unstable neighbor, Bangladesh, has an immunization rate nearly double that of India’s average. To understand this variation in immunization coverage, Cahill-Rincón compared the rates of child immunizations in 50 developing countries, along with case studies from Bangladesh and India. Her findings show that while democratic regimes such as India have a statistically greater likelihood of childhood immunizations, the effect is minor. Instead, other factors, including household determinants and the involvement of international organizations, are greater predictors of high immunization coverage.
To further explore this pattern, Cahill-Rincón spent six months in India in 2013, conducting interviews with leaders and policymakers and observing immunization rounds. She plans to travel to Bangladesh this summer to conduct similar research. In the course of her fieldwork, Cahill-Rincón has discovered that because of their stable cadre of experts and ability to focus on a narrower range of objectives, international organizations like UNICEF or the World Health Organization and its Expanded Program on Immunization can be very effective problem solvers. Additionally, these organizations offer resources to assist with the distribution of vital goods and services and can provide a form of accountability through intensive monitoring activities.
Cahill-Rincón says that her time in the field renewed her sense of purpose. “I realized that what was otherwise a row of zeroes and ones in my data set affects the health of real children and involves a deeply committed network of experts and volunteers.” It is this kind of outreach that Cahill-Rincón has witnessed firsthand at Purdue. “I think everyone benefits when academia combines the rigors of scientific inquiry with the ability to speak to practical concerns. At Purdue, I have been mentored by faculty whose work is able to accomplish just that.”
Cahill-Rincón hopes that her findings will influence decision makers as they set policy objectives and make budget decisions regarding foreign aid, so that children receive the basic goods they need to live healthy and productive lives. “If we can reach a child with a measles injection, can we use that same system to ensure that they have clean water and adequate nutrition? I hope that by understanding the challenges and solutions in the area of child immunizations that we can begin to improve a whole range of outcomes that promote social good.”
Could it be possible to transfer knowledge to our own disadvantaged in meaningful ways in poor areas of the United States? So many times a handout is not really helpful. We want what we do to be seen as a hand up, making people freer and more independent. Meeting basic needs is essential but taking it to the next step is equally important. Certainly we want to positively influence policy, but more important we want to give disadvantaged people the edge to step forward with confidence. Taking care of basic needs is step one, but not enough; we need to make sure that they become independent and self sufficient. The next steps are equally as important.