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Health Informatics Journal
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System dynamics approach to immunization healthcare issues in developing countries: a case study of Uganda

Agnes S. Rwashana

Faculty of Computing and Information Technology Makerere University PO Box 7062 Kampala, Uganda, asemwanga{at}cit.mak.ac.ug

Ddembe W. Williams

Faculty of Computing and Information Technology Makerere University PO Box 7062 Kampala, Uganda, d.williams{at}cit.mak.ac.ug

Stella Neema

Makerere Institute of Social Research Makerere University PO Box 16022 Kampala, Uganda, sheisim{at}yahoo.com

This article critically examines the challenges associated with demand for immunization, including the interplay of political, social, economic and technological forces that influence the level of immunization coverage. The article suggests a framework to capture the complex and dynamic nature of the immunization process and tests its effectiveness using a case study of Ugandan healthcare provision. Field study research methods and qualitative system dynamics, a feedback and control theory based modelling approach, are used to capture the complexity and dynamic nature of the immunization process, to enhance a deeper understanding of the immunization organizational environment. A model showing the dynamic influences associated with demand and provision of immunization services, with the aim of facilitating the decision making process as well as healthcare policy interventions, is presented.

Key Words: causal loop diagrams • healthcare services • immunization demand • immunization healthcare • system dynamics • Uganda

Health Informatics Journal, Vol. 15, No. 2, 95-107 (2009)
DOI: 10.1177/1460458209102971
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