Immunization statistics: Reality checkHow can governments hope to fulfil the needs of their children if they do not know precisely what those needs are? Participants at the 1990 World Summit for Children addressed this fundamental problem, calling for countries to establish mechanisms for the regular collection, analysis and publication of data concerning the well-being of their children. There is no better indicator of success in maintaining such information than a country's record on immunization, the most regularly collected and closely watched statistic. But assessing even these figures is a complicated process. Virtually every country maintains data on child immunizations. The most common record is the notation a health centre makes each time a child is immunized. The accuracy of these 'routine reports' can be flawed by the complexities of communicating the information up the chain of command from the local clinic to the health ministry. Routine reports are therefore periodically supplemented by surveys, which generally provide better data but are performed less frequently because of their expense. As a result, publications such as The Progress of Nations base their figures on a combination of the two. Working with these statistics reveals the complexities of data gathering. For instance, UNICEF figures reveal that, in 44 countries, routine clinic reports show immunization rates that are at least 10 percentage points higher than rates obtained from surveys. Elsewhere, this discrepancy is reversed: In 17 other countries, routine clinic reports give rates of coverage at least 10 percentage points lower than survey data. The implications of these variances are troubling. In India in 1992, for example, a survey found that 10 million fewer children under 1 had received the third dose of vaccine against diphtheria, pertussis and tetanus (DPT) than had been indicated in routine clinic reports. The opposite holds in Kenya. In 1996, the routine clinic reports showed that just 40% of children had received their third DPT shot, while survey records showed that 84% had -- a difference of about 500,000 children. If the 1996 immunization rates of the 40 largest countries were adjusted to account for the discrepancies between routine clinic reports and survey findings, worldwide coverage would be 10 percentage points less, or 70%. Thus, even the 'best' statistic available to measure children's well-being can be flawed if countries do not give it the priority it demands. Governments must devote more resources to data gathering if they are to meet children's right to health.
Immunization is the world's greatest health bargain: $15 to protect a child, including all costs of delivery.
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