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This chapter argues that neoliberal governmentality in immunization relocates the Turkish state's position regarding vaccine and immunization policies. Neoliberalism is often discussed in the context of privatization, performance, and effectiveness separately. However, more attention should be paid to the set of strategies that are employed in public policy processes to manage populations in terms of immunization, while intertwining power with knowledge. Following Foucault's concept of governmentality and taking it further within the context of biopolitics, this chapter focuses on different knowledge practices regarding vaccine and immunization policies in Turkey. In doing so, this case study applies a post-structural analysis to examine vaccine production, vaccine know-how, and immunization policies inscribed in policy documents as a form of knowledge practice. The analysis sheds light on the reflexive transformation of the concept of biopolitics, which is moving from state-oriented knowledge practices toward a neoliberal governmentality of immunization.

Child immunization is widely recognized as a cost-effective preventive medicine. Unfortunately, in India about 50% of the eligible children aged 12–23 months miss some essential vaccination. Though a positive association between maternal education and markers of child health like immunization has been long established, the literature has struggled to find a causal relationship, mainly because education is inextricably correlated with other socioeconomic variables like income. In this chapter, I propose a new instrument for women’s education in India using the following facts. First, due to lack of sanitary facilities in schools, particularly rural schools, large number of girls drop out of school once they reach puberty. Second, age at menarche is largely determined by biological factors and not social factors. Together, age at menarche can explain variations in schooling, yet be independent of outcome variables like child immunization. I find that additional years of maternal schooling (conditional on strictly positive years of schooling) do increase the probability of complete immunization of children.

Much of the discussion surrounding the antivaccine movement focuses on the decision of parents to not vaccinate their children and the resulting danger posed to others. However, the primary risk is borne by the child left unvaccinated. Although living in a developed country with high vaccination rates provides a certain amount of protection through population immunity, the unvaccinated child is still exposed to a considerably greater risk of preventable diseases than one who is vaccinated. I explore the tension between parental choice and the child’s right to be free of preventable diseases. The chapter’s goal is twofold: to advocate for moving from a dyadic framework – considering the interests of the parents against those of the state – to a triadic one, in which the interests of the child are given as much weight as those of the parent and the state; and to discuss which protections are available, and how they can be improved. Specific legal tools available to protect that child are examined, including tort liability of the parents to the child, whether and to what degree criminal law has a role, under what circumstances parental choice should be overridden, and the role of school immunization requirements in protecting the individual child.

Evaluating primary care for children has not before been undertaken on a national level, and only infrequently on an international level, an adult-focused perspective is the norm. The Models of Child Health Appraised (MOCHA) project explored the evaluation of quality of primary care for children in a nationally comparable way, which recognises the influence of all components of child well-being and well-becoming. Using adult-focused metrics fails to account for children’s physical and psycho-social development at different ages, differences in health and non-health determinants, patterns of disease and risk factors and the stages of the life course. To do this, we attempted to identify comparable measures of child health in the European Union and European Economic Area countries, we aimed to perform a structural equation modelling technique to identify causal effects of certain policies or procedures in children’s primary care and we aimed to identify and interrogate large datasets for key tracer conditions. We found that the creation of comparative data for children and child health services remains a low priority in Europe, and the largely unmet need for indicators covering all the healthcare dimensions hampers development of evidence-based policy. In terms of the MOCHA project objective of appraising models of child primary health care, the results of this specific work show that the means of appraisal of system and service quality are not yet agreed or mature, as well as having inadequate data to fuel them.

Purpose: We estimate national health expenditures on prevention using precise definitions, a transparent methodology, and a subdivision of the estimates into components to aid researchers in applying their own concepts of prevention activities.

Methodology/Approach: We supplemented the National Health Expenditure Accounts (NHEA) with additional data to identify national spending on primary and secondary prevention for each year from 1996 to 2004 across eight spending categories.

Findings: We estimate that NHEA expenditures devoted to prevention grew from $83.2 billion in 1996 to $159.8 billion in 2004, in current dollars. As a share of NHEA, this represents an increase from 7.8 percent in 1996 to 8.6 percent in 2004. This share peaked at 9 percent in 2002 and then declined due to reductions in public health spending as a percent of NHEA between 2002 and 2004. Primary prevention represents about half the expenditures, consisting largely of public health expenditures – the largest prevention element.

Originality/Value of Paper: Our 2004 estimate that 8.6 percent of NHEA goes to prevention is nearly three times as large as the commonly cited figure of 3 percent, but depends on the definitions used: our estimate falls to 8.1 percent when the research component is excluded, 5.1 percent when consideration is limited to primary prevention plus screening, 4.2 percent for primary prevention alone, and 2.8 percent if we count only public health expenditures. These findings should contribute to a more informed discussion of our nation's allocation of health care resources to prevention.

Using the duration measures defined by Bierwag (1996), we derive the formulae of duration far zero-coupon bonds, coupon bonds and bond portfolios under the Heath, Jarrow and Morton (1990) (HJM) term structure framework. The advantage in using Bierwag's duration measure is that it provides a one-to-one correspondence with the returns on interest rate sensitive securities. Hence, this duration measure can make the performance of risk management on interest rates better We also investigate the differences of duration for coupon bonds between our formula and the conventional Macaulay's measure. Finally, we show that the performance of dynamic immunization strategy is much better than that of static immunization strategy.

Information and communication technologies can transform how services can be and are delivered as has already happened in other arenas, such as civil aviation, financial services and retailing. Most modern health care is heavily dependent on e-health, including record keeping, targeted information sharing and digital diagnostic and imaging techniques. However, there remains little scientific knowledge base for optimal system content and function in primary health care, particularly for children. Models of Child Health Appraised (MOCHA) aimed to establish the current e-health situation in children’s primary care services. Electronic health records (EHRs) are in regular use in much of northern and western Europe and in some newer European Union Member States, but other countries lag behind. MOCHA investigated the use of unique identifiers, the use of case-based public health EHRs and the capability of record linkage, linkage of information with school health data and monitoring of social media influences, such as health websites and health apps. A widespread lack of standards underlined a lack of research enquiry into this issue in terms of children’s health data and health knowledge. Health websites and apps are a growing area of healthcare delivery, but there is a worrying lack of safeguards in place. The challenge for policy-makers and practitioners is to be aware and to lead on the innovative harnessing of new technologies, while protecting child users against new harms.

This study examined use of preventive health care services, for working-age adults with mobility limitations (uses mobility aids, has difficulty walking, difficulty standing for extended periods of time, or difficulty climbing steps) and for working-age adults reporting no mobility limitation, in order to identify similarities and disparities between the two populations. We analyzed data from the 1994 National Health Interview Survey Disability Supplement and NHIS Year 2000 file with cross-tabulation and logistic regression procedures to examine the relationship between mobility limitation and use of health screenings, immunizations, and health behavior counseling. Results were mixed, but disparities in preventive service use were identified.

Accredited Social Health Activists (ASHAs) are community health workers under the National Rural Health Mission of Government of India (NRHM). They have played a pivotal role during the COVID-19 pandemic in providing information and healthcare services to and from the remotest part of a village in India, working round the clock tracing patients and providing other COVID-19 related services along with fulfilling their basic duties of anti-natal care, immunization, sanitization, etc. The chapter seeks to understand the causative factors of invisibility and marginalization of ASHA workers. As most of them come from low-income and low-literacy background, they face discrimination and marginalization with long working hours, very low wages, and being treated as social pariah by the community they work in and work for. The study is particularly relevant because ASHA workers have worked as a communicating link between doctors, hospitals, and communities, and also through door-to-door survey, they have collected massive data during the pandemic, which has helped the governments to frame policies and take decisions. Both qualitative and quantitative methods have been used. I have interviewed some 55 ASHA workers (some of being my former students). I have used news clippings and government reports, regulations, directives and guidelines, survey reports of Thomas Reuters foundation, Amnesty International, Aziz Premji Foundation, as source material for information. There are certain gaps in policy making, social behavior, and attitude toward the ASHA workers, which need to be addressed.