Advancing the application of systems thinking in health: understanding the growing complexity governing immunization services in Kerala, India

Governing immunization services in a way that achieves and maintains desired population coverage levels is complex as it involves interactions of multiple actors and contexts. In Kerala, India after routine immunization had reached high coverage in the late 1990s, it started to decline in some of the districts. This paper describes an application of complex adaptive systems theory and methods to understand and explain the phenomena underlying unexpected changes in vaccination coverage.

a:1:{i:0;s:39:"https://doi.org/10.1186/1478-4505-12-44";}

Varghese J, Kutty VR, Paina L, Adam T. Advancing the application of systems thinking in health: understanding the growing complexity governing immunization services in Kerala, India. Health Research Policy and Systems. 2014;12(47). doi:10.1186/1478-4505-12-44