Political, Economic, and Social Determinants of the COVID-19 Vaccination Rate with Focus on Institutional Quality and Human Development: A Finite Mixture Approach
نویسندگان
1 Health Human Resources Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
2 tudent Research Committee, School of Health Management and Information Sciences, Shiraz University of Medical Sciences, Shiraz, Iran.
3 Department of Economics, Shiraz University, Shiraz, Iran.
doi
10.30476/jhmi.2025.109309.1327چکیده
Introduction: Although immunization against COVID-19 is one of the most effectivestrategies to control the pandemic, political, economic, and social determinants play a vital rolein improving vaccine access and vaccination rates across countries. The present study aimedto investigate the roles of political, economic, and social determinants in the performance ofcountries facing the COVID-19COVID-19 pandemic, focusing on institutional quality andhuman development.Methods: The required data were gathered from international organizations’ databases. Afterdescriptive and correlation analysis, finite mixture model (FMM) was used for estimationof the effect of institutional quality (IQ), human development index (HDI), and othercontrol variables (government health expenditure percentage of total health expenditure(GHE%THE), logarithmic gross domestic production (LGDP) and unemployment rate(UR)) on the covid-19 complete vaccination (CFV). The researchers’ assumption in usingFMM was that CFV had different dimensions and heterogeneity, and HDI had one observeddimension and several unobserved ones, which could better explain CFV heterogeneity thanother explanatory variables. Stata 17 was used for model estimation.Results: In the first class estimation of the FMM model, coefficients of IQ (γ1=0.1458, P=0.000),GHE%THE (μ1,1=0.2761, P=0.009), and LGDP (μ1,2=0.0586, P=0.014) were significantlypositive, and UR (μ1,3=-.0124, P=0.000) was significantly negative. Moreover, class-twoestimation showed a significant effect of HDI on CFV (δ2=63.0537, P=0.009). There is alsoa significant and positive relationship between CFV and IQ (γ2=0.1199, P=0.000), GHE%HE(μ2,1=0.27085, P=0.002), and LGDP (μ2,2=0.0559, P=0.000) and UR (μ2,3=0.0169, P=0.000).Conclusion: Countries with high human development and better institutional quality (voiceand accountability, control of corruption, political stability and absence of violence/terrorism,rule of law, regulatory quality, and government effectiveness) reported higher vaccinationrates. In other words, political, economic, and social determinants played a significant role inthe performance of health systems amid critical conditions, such as the pandemic, particularlyin access to vaccines and vaccination rates against COVID-19.
