Decentralization and immunization program in a single-party state: the case of the Lao People’s Democratic Republic
Abstract Background The Lao People’s Democratic Republic (Lao PDR), a lower-middle-income country, lags behind other Southeast Asian countries in immunization coverage for children under two years of age. The organization of health services is a key determinant of the functionality of immunization p...
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ftdoajarticles:oai:doaj.org/article:92cd31b36efe490ca077fb46617e9d17 2024-09-09T19:27:30+00:00 Decentralization and immunization program in a single-party state: the case of the Lao People’s Democratic Republic Phonevilay Viphonephom Sengchanh Kounnavong Daniel Reinharz 2024-05-01T00:00:00Z https://doi.org/10.1186/s41182-024-00601-8 https://doaj.org/article/92cd31b36efe490ca077fb46617e9d17 EN eng BMC https://doi.org/10.1186/s41182-024-00601-8 https://doaj.org/toc/1349-4147 doi:10.1186/s41182-024-00601-8 1349-4147 https://doaj.org/article/92cd31b36efe490ca077fb46617e9d17 Tropical Medicine and Health, Vol 52, Iss 1, Pp 1-12 (2024) Decentralization Immunization program Neo-institutional theory Single-party state Lower-middle income country Lao PDR Arctic medicine. Tropical medicine RC955-962 article 2024 ftdoajarticles https://doi.org/10.1186/s41182-024-00601-8 2024-08-05T17:49:24Z Abstract Background The Lao People’s Democratic Republic (Lao PDR), a lower-middle-income country, lags behind other Southeast Asian countries in immunization coverage for children under two years of age. The organization of health services is a key determinant of the functionality of immunization programs. However, this aspect, and in particular its decentralization component of the healthcare system, has never been studied. Methods A case study in the Lao National Immunization Program was performed using a neo-institutional theory-based conceptual framework, highlighting the structure (rules, laws, resources, etc.) and interpretative schemes (dominant beliefs and ideas) that underlie the state of decentralization of the healthcare system that support the conduct of the immunization program. Twenty-two semi-structured interviews were conducted with representative actors from various government levels, external donors, and civil society, in four provinces. Data were complemented with information retrieved from relevant documents. Results The Lao healthcare system has a deconcentrated form of decentralization. It has a largely centralized structure, albeit with certain measures promoting the decentralization of its immunization programs. The structure underlying the state of centralization of immunization services provided is coherent with a shared dominant interpretive scheme. However, the rapid economic, technical, and educational changes affecting the country suggest that the coherence between structure and interpretative schemes is bound to change. Conclusion Unprecedented opportunities to access quality higher education and the use of social networks are factors in Lao PDR that could affect the distribution of responsibilities of the different levels of government for public health programs such as the National Immunization Program. Article in Journal/Newspaper Arctic Directory of Open Access Journals: DOAJ Articles Arctic Tropical Medicine and Health 52 1 |
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Directory of Open Access Journals: DOAJ Articles |
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ftdoajarticles |
language |
English |
topic |
Decentralization Immunization program Neo-institutional theory Single-party state Lower-middle income country Lao PDR Arctic medicine. Tropical medicine RC955-962 |
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Decentralization Immunization program Neo-institutional theory Single-party state Lower-middle income country Lao PDR Arctic medicine. Tropical medicine RC955-962 Phonevilay Viphonephom Sengchanh Kounnavong Daniel Reinharz Decentralization and immunization program in a single-party state: the case of the Lao People’s Democratic Republic |
topic_facet |
Decentralization Immunization program Neo-institutional theory Single-party state Lower-middle income country Lao PDR Arctic medicine. Tropical medicine RC955-962 |
description |
Abstract Background The Lao People’s Democratic Republic (Lao PDR), a lower-middle-income country, lags behind other Southeast Asian countries in immunization coverage for children under two years of age. The organization of health services is a key determinant of the functionality of immunization programs. However, this aspect, and in particular its decentralization component of the healthcare system, has never been studied. Methods A case study in the Lao National Immunization Program was performed using a neo-institutional theory-based conceptual framework, highlighting the structure (rules, laws, resources, etc.) and interpretative schemes (dominant beliefs and ideas) that underlie the state of decentralization of the healthcare system that support the conduct of the immunization program. Twenty-two semi-structured interviews were conducted with representative actors from various government levels, external donors, and civil society, in four provinces. Data were complemented with information retrieved from relevant documents. Results The Lao healthcare system has a deconcentrated form of decentralization. It has a largely centralized structure, albeit with certain measures promoting the decentralization of its immunization programs. The structure underlying the state of centralization of immunization services provided is coherent with a shared dominant interpretive scheme. However, the rapid economic, technical, and educational changes affecting the country suggest that the coherence between structure and interpretative schemes is bound to change. Conclusion Unprecedented opportunities to access quality higher education and the use of social networks are factors in Lao PDR that could affect the distribution of responsibilities of the different levels of government for public health programs such as the National Immunization Program. |
format |
Article in Journal/Newspaper |
author |
Phonevilay Viphonephom Sengchanh Kounnavong Daniel Reinharz |
author_facet |
Phonevilay Viphonephom Sengchanh Kounnavong Daniel Reinharz |
author_sort |
Phonevilay Viphonephom |
title |
Decentralization and immunization program in a single-party state: the case of the Lao People’s Democratic Republic |
title_short |
Decentralization and immunization program in a single-party state: the case of the Lao People’s Democratic Republic |
title_full |
Decentralization and immunization program in a single-party state: the case of the Lao People’s Democratic Republic |
title_fullStr |
Decentralization and immunization program in a single-party state: the case of the Lao People’s Democratic Republic |
title_full_unstemmed |
Decentralization and immunization program in a single-party state: the case of the Lao People’s Democratic Republic |
title_sort |
decentralization and immunization program in a single-party state: the case of the lao people’s democratic republic |
publisher |
BMC |
publishDate |
2024 |
url |
https://doi.org/10.1186/s41182-024-00601-8 https://doaj.org/article/92cd31b36efe490ca077fb46617e9d17 |
geographic |
Arctic |
geographic_facet |
Arctic |
genre |
Arctic |
genre_facet |
Arctic |
op_source |
Tropical Medicine and Health, Vol 52, Iss 1, Pp 1-12 (2024) |
op_relation |
https://doi.org/10.1186/s41182-024-00601-8 https://doaj.org/toc/1349-4147 doi:10.1186/s41182-024-00601-8 1349-4147 https://doaj.org/article/92cd31b36efe490ca077fb46617e9d17 |
op_doi |
https://doi.org/10.1186/s41182-024-00601-8 |
container_title |
Tropical Medicine and Health |
container_volume |
52 |
container_issue |
1 |
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1809896927427297280 |