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

Health Informatics J. 2009 Jun;15(2):95-107. doi: 10.1177/1460458209102971.


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.

MeSH terms

  • Decision Making
  • Developing Countries*
  • Health Education*
  • Health Knowledge, Attitudes, Practice*
  • Health Policy
  • Health Services Needs and Demand
  • Humans
  • Mass Vaccination*
  • Models, Organizational
  • Patient Acceptance of Health Care
  • Qualitative Research
  • Systems Analysis*
  • Uganda