ABSTRACT

Since the WHO Expanded Program on Immunization (EPI) was instituted in 1974, there has been a considerable increase in worldwide vaccination. Programmatic factors identified as important in achieving and maintaining high coverage include an adequate supply of vaccine (Cutts, Soares, et al., 1990; Subramanyam, 1989), accessibility of vaccination sites and convenient hours for vaccination (Belcher, Nicholas, Ofosu-Amaah, & Wurapa,

C H A P T E R

University of Pennsylvania

Cecelia C. Verzosa Academy for Educational Development, Washington, DC

José R. Hernandez Department of Health, San Lazaro Compound, Manila, Philippines

Department of Health, Manila, Philippines

1978; Cutts, Rodrigues, Colombo, & Bennett, 1989; Friede, Waternaux, Guyer, de Jesus, & Filipp, 1985), short waiting times (Cutts, Soares, et al., 1990a; Eng, Naimoli, Naimoli, Parker, & Lowenthal, 1991; Unger, 1991), and low rates of “missed opportunities” for vaccination (Cutts, Glik, et al., 1990; Cutts et al., 1989; Cutts, Soares, et al., 1990; Loevinsohn, 1989; Steinhoff, Cole, Cole, John, & Pereira, 1985).