WEALTH-BASED INEQUALITY IN CHILD IMMUNIZATION IN INDIA: A DECOMPOSITION APPROACH

2017 ◽  
Vol 50 (3) ◽  
pp. 312-325 ◽  
Author(s):  
Avijit Debnath ◽  
Nairita Bhattacharjee
Keyword(s):  
Immunization Coverage ◽  
Decomposition Approach ◽  
Child Immunization ◽  
Vaccine Preventable Diseases ◽  
Modified Method ◽  
Socioeconomic Strata ◽  
Unequal Access ◽  
Facility Survey ◽  
Remarkable Progress ◽  
Main Factor

SummaryDespite years of health and medical advancement, children still suffer from infectious diseases that are vaccine preventable. India reacted in 1978 by launching the Expanded Programme on Immunization in an attempt to reduce the incidence of vaccine-preventable diseases (VPDs). Although the nation has made remarkable progress over the years, there is significant variation in immunization coverage across different socioeconomic strata. This study attempted to identify the determinants of wealth-based inequality in child immunization using a new, modified method. The present study was based on 11,001 eligible ever-married women aged 15–49 and their children aged 12–23 months. Data were from the third District Level Household and Facility Survey (DLHS-3) of India, 2007–08. Using an approximation of Erreyger’s decomposition technique, the study identified unequal access to antenatal care as the main factor associated with inequality in immunization coverage in India.

Antenatal Care and Provision of Basic Immunization in Children Aged 12-23 Months: Meta-Analysis

2020 ◽  
Author(s):  
◽  
Vitri Widyaningsih ◽  
Bhisma Murti ◽  
◽  
Keyword(s):  
Antenatal Care ◽  
English Language ◽  
Meta Analysis ◽  
Immunization Coverage ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Middle Income ◽  
Child Immunization ◽  
Vaccine Preventable Diseases ◽  
Central Java

ABSTRACT Background: Among the leading causes of global child morbidity and mortality are vaccine-preventable diseases, especially in low-and middle-income countries (LMICs). A complete basic immunization for children contains one BCG, three DPT-HB-Hib immunizations, four polio immunizations, and one measles immunizations. Antenatal care visit contributes an important to complete the basic immunization. This study aimed to estimate the effect of antenatal care on the completeness of basic immunization in children aged 12-23 months in Africa using meta-analysis. Subjects and Method: A meta-analysis and systematic review was conducted to examine the effect of antenatal care on the basic immunization completeness in children aged 12-23 months. Published articles in 2015-2020 were collected from PubMed and Google Scholar databases. Keywords used “immunization coverage” OR “vaccination coverage” OR “complete immunization” OR “complete vaccination” OR “full immunization” OR “full vaccination” AND children OR “child immunization” OR “child immunization coverage” NOT “incomplete immunization” OR “incomplete vaccination”. The inclusion criteria were full text, in English language, and using cross-sectional study design. The selected articles were analyzed by Revman 5.3. Results:6 studies from Senegal, Nigeria, Ethiopia, and South Africa showed that antenatal care increased basic immunization completeness in children aged 12-23 months (aOR=1.19; 95% CI= 1.06 to 1.36; p<0.001) with I2 = 95%). Conclusion: Antenatal care increases basic immunization completeness in children aged 12-23 months. Keywords: basic immunization, antenatal care, children aged 12-23 months Correspondence: Farida. Masters Program in Public Health, Universitas Sebelas Maret. Jl. Ir. Sutarmi 36A, Surakarta 57126, Central Java. Email: [email protected]. Mobile: 085654415292 DOI: https://doi.org/10.26911/the7thicph.03.125

Understanding inequalities in child immunization in India: a decomposition approach

2021 ◽  
pp. 1-13
Author(s):  
Vinod Joseph Kannankeril Joseph
Keyword(s):  
Socioeconomic Factors ◽  
Low Socioeconomic Status ◽  
Concentration Index ◽  
Immunization Coverage ◽  
Household Wealth ◽  
Child Growth ◽  
Care Utilization ◽  
Decomposition Approach ◽  
Child Immunization ◽  
Full Immunization

Abstract The importance of childhood immunization for healthy child growth and development is well recognized and is considered to be the best and most cost-effective lifesaver. Low socioeconomic status has been shown to be associated with low child immunization and health care utilization, but the inequalities in immunization coverage due to social and economic factors are poorly understood. This study aimed to explore the association between child immunization coverage and various socioeconomic factors and to quantify their contributions to generating inequalities in immunization coverage in India. The study data are from the National Family Health Survey-4 conducted in 2015–16. The association between socioeconomic determinants and child full immunization coverage was estimated using the χ2 test and binary logistic regression. Concentration indices were estimated to measure the magnitude of inequality, and these were further decomposed to explain the contribution of different socioeconomic factors to the total disparity in full immunization coverage. The results showed that the uptake of immunization in 2015–16 was highly associated with mother’s educational status and household wealth. The concentration index decomposition revealed that inequality (immunization disadvantage) was highest among poorer economic groups and among children whose mothers were illiterate. The overall concentration index value indicates that the weaker socioeconomic groups in India are more disadvantaged in terms of immunization interventions. The results offer insight into the dynamics of the variation in immunization coverage in India and help identify vulnerable populations that should be targeted to decrease socioeconomic inequalities in the country.

scholarly journals An epidemiological investigation of the 2019 suspected pertussis outbreak in northwestern Nigeria

2021 ◽  
Vol 9 ◽  
pp. 205031212110083
Author(s):  
Omoleke Semeeh ◽  
Biniam Getachew ◽  
Yusuf Taofik ◽  
Lukman Surajudeen ◽  
Assad Hassan ◽  
...  
Keyword(s):  
Confidence Interval ◽  
Disease Transmission ◽  
Attack Rate ◽  
Odds Ratio ◽  
Case Fatality Rate ◽  
Adjusted Odds Ratio ◽  
Case Fatality ◽  
Immunization Coverage ◽  
Fatality Rate ◽  
Vaccine Preventable Diseases

Introduction: In 2019, we investigated the profile of the cases and controls and the determinants of pertussis transmission in Kebbi State, Northwestern Nigeria, to inform better immunization and surveillance strategies. Methods: Community-based unmatched case–control study and review of the 2019 pertussis routine surveillance data in the affected settlements in the state were conducted. A total of 52 suspected cases of pertussis and 107 control from two local government areas in Kebbi State were recruited. Data were analyzed using descriptive and inferential statistics. Results: The highest attack rate was observed among between 1- and 4-year age group followed by children less than 1-year old, and the least attack rate was among those above 15 years. The overall attack rate and the case fatality rate were 2.10% and 0.10%, respectively. A higher attack rate was observed among women, whereas the case fatality rate was more among males. From the community survey, we observed that the cases were less likely to have pertussis vaccination history (adjusted odds ratio = 0.28, 95% confidence interval = 0.11–0.74) compared with the controls. Knowing pertussis prevention methods were found protective for pertussis transmission (adjusted odds ratio = 0.14, 95% confidence interval = 0.04–0.45). Conclusion: This study showed the vulnerability of children under 5 years, especially under 1 year, to vaccine-preventable diseases in rural populations, where “real” immunization coverage is sub-optimal, and the dominant socio-demographic factors are supportive of disease transmission. We found immunization and knowledge of the preventive measures to be protective against pertussis outbreaks. Therefore, routine immunization services must be intensified to improve coverage and prevent future pertussis outbreak(s).

scholarly journals Child Immunization Coverage – A Critical Review

2016 ◽  
Vol 18 (05) ◽  
pp. 48-53
Author(s):  
Sourabh Shastri ◽  
Anand Sharma ◽  
Prof. Vibhakar Mansotra
Keyword(s):  
Critical Review ◽  
Immunization Coverage ◽  
Child Immunization

scholarly journals Do the dynamics of vaccine programs improve the full immunization of children under the age of five in Cameroon?

2020 ◽  
Author(s):  
Rodrigue NDA'CHI DEFFO ◽  
Benjamin FOMBA KAMGA
Keyword(s):  
Infant Mortality ◽  
Birth Order ◽  
Immunization Coverage ◽  
Developed Countries ◽  
Demographic And Health Surveys ◽  
Least Developed Countries ◽  
Vaccine Preventable Diseases ◽  
Development Goals ◽  
Mother’S Age ◽  
The Impact

Abstract Background: Among the eight Millennium Development Goals (MDGs), three were devoted to health. Two amongst which MDG4 in relation to the reduction of infant mortality has not been achieved in Least Developed Countries (LDC). In Africa, a significant part of infant mortality is due to vaccine-preventable diseases administered free of charge by the Extended Program on Immunization (EPI). As such, in the "social equity" pillar of Sustainable Development Goals (SDG), the MDGs related to health have yet been taken into account. The achievement of these objectives requires an understanding of the immunization behavior of children under five years of age through an analysis of immunization dynamics between 1991 and 2011.Methods: We use data from Demographic and Health Surveys (DHS) of 1991, 1998, 2004 and 2011 carried out by the National Institute of Statistics (NIS). The module concerning EPI vaccines was administered to 3350, 2317, 8125 and 25524 under 5 in 1991, 1998, 2004 and 2011 respectively. The Immunization analysis was made from the logistic model for complete immunization and the Oaxaca's decomposition to assess the contribution of the unexplained part, which is that of the strategies/programs implemented between 1991 and 2011 by the EPI to improve immunization.Results: In general, children with vaccination card are more than 7 times likely to be fully immunized than their counterparts who do not have any. This result was higher in 1991 (approximately 57) and lowest in 2011 (5). In addition, the child's birth order reduces his/her probability of being fully immunized and the impact increases with the latter's birth order. On the other hand, the mother's age as well as her level of education increase the child's likelihood of receiving all basic vaccines. Moreover, the contributions of EPI partners in terms of immunization support as well as strategies to promote immunization through communication for development are of a particular importance in increasing immunization coverage. They significantly explain 67.62% of the 0.105 gain recorded within the 2011-2004 period and 72.46% of the 0.069 gain recorded within the 2004-1998 period.Conclusion: The contribution of EPI partner organizations is fundamental for the achievement of EPI objectives. Since they contribute to increase the likelihood of fully immunized children. The link with child immunization is done through the specific characteristics to the mother.

Two-way assessment of key performance indicators to vaccine supply chain system in India

2019 ◽  
Vol 68 (1) ◽  
pp. 194-230 ◽  
Author(s):  
Dheeraj Chandra ◽  
Dinesh Kumar
Keyword(s):  
Supply Chain ◽  
Performance Improvement ◽  
Performance Indicators ◽  
Immunization Coverage ◽  
Decision Makers ◽  
Supply Chain Performance ◽  
Child Immunization ◽  
Content Type ◽  
Internal Process ◽  
Delivery Performance

PurposeThe purpose of this paper is to identify the key performance indicators (KPIs) of vaccine supply chain of Universal Immunization Program (UIP) India, and measure their impact on vaccine supply chain performance improvement, so that results of this study can help the decision makers manage the activity and effectiveness of their resources in order to improve vaccine delivery performance and child immunization coverage.Design/methodology/approachThe 41 KPIs in terms of four dimension of the balanced scorecard (BSC), i.e. financial, customer, internal process and learning and growth have been identified and validated from the literature and expert’s opinions. Further, the impact of internal process and learning and growth performance indicators on the vaccine supply chain performance improvement have been evaluated using two-way assessment. The rankings obtained using two-way assessment are then compared to DEMATEL approach to validate the results.FindingsThe results from the analysis reveal that “Enhancement in employee work satisfaction” (LG3=10.08 percent), “Enhancement in professional vaccine supply chain managers and leaders” (LG2 = 6.70 percent) “Improvement in planning and coordination in the supply chain” (LG9 = 6.57 percent) are the three critical performance indicators having maximum impact on vaccine supply chain performance improvement. The decision makers should give priority to these performance indicators to improve delivery performance and immunization coverage.Social implicationsThis study focuses on the improvement in vaccine delivery performance, therefore, analysis and findings can be useful to government immunization programs of India to other developing nations to improve child immunization coverage.Originality/valueTo our knowledge, this paper is first to attempt to provide a direction to improve immunization coverage through vaccine supply chain performance indicators.

scholarly journals Preventing epidemics in a community of households

1996 ◽  
Vol 117 (3) ◽  
pp. 443-455 ◽  
Author(s):  
R. Hall ◽  
N. G. Becker
Keyword(s):  
School Children ◽  
Immunization Coverage ◽  
Household Structure ◽  
Community Effects ◽  
Vaccine Preventable Diseases ◽  
Susceptibility To Infection ◽  
Immunization Strategies ◽  
Or Groups ◽  
Different Types ◽  
Random Mixing

SummaryThe occurrence of epidemics of vaccine-preventable diseases, and the immunization coverage required to prevent them, is affected by the presence of households and heterogeneity in the community. We consider a community where individuals live in households and are of different types, according to infectivity and/or susceptibility to infection. We describe a method for computing the critical immunization coverage to prevent epidemics in such communities and discuss the effectiveness of immunization strategies. In a heterogeneous community where individuals live in households several immunization strategies are possible and we examine strategies targeting households, randomly selected individuals, or groups with highly intense transmission, such as school children. We compare estimates of the critical immunization coverage if we assume that disease is spread solely by random mixing with estimates which result if we assume the effects of the household structure. Estimates made under these two sets of assumptions differ. The results provide insights into the community effects of vaccination, and the household structure of the community should be taken into account when designing immunization policies.

scholarly journals Analisis Data Riskesdas 2007/2008: Kontribusi Karakteristik Ibu terhadap Status Imunisasi Anak di Indonesia

2009 ◽  
Vol 4 (2) ◽  
pp. 91 ◽  
Author(s):  
Sutanto Priyo Hastono
Keyword(s):  
Health Care ◽  
Multivariate Analysis ◽  
Multilevel Analysis ◽  
Immunization Coverage ◽  
Orientation Program ◽  
Child Immunization ◽  
Immunization Status ◽  
Immunization Services ◽  
Multi Level

Cakupan imunisasi terbukti dapat menurunkan secara signifikan kejadian kesakitan dan kematian yang diakibatkan penyakit tersebut, tetapi di Indonesia cakupan tersebut tergolong rendah.Tujuan penelitian adalah mengetahui hubungan karakteristik ibu dengan status imunisasi anak di Indonesia. Disain yang digunakan dalam penelitian adalah potong lintang dengan sampel anak yang berumur antara 1-2 tahun yang tinggal di wilayah Indonesia. Sumber data sekunder yang digunakan adalah Riskesdas Depkes tahun 2007/08. Proporsi anak usia 12-24 bulan yang mendapat imunisasi lengkap adalah 56,2 % (95% CI :55,1-57,3). Pendidikan ibu dan pendidikan suami ditemukan berhubungan secara bermakna dengan status imunisasi dasar pada anak. Hasil analisis multi-level menemukan bahwa kontribusi variabel level kabupaten (92,5 %) jauh lebih besar daripada level individu (7,5 %). Disarankan pemerintah bersama masyarakat berupaya untuk meningkatkan pendidikan. Departemen Kesehatan dan sektor terkait disarankan menyusun pedoman upaya memobilisasi imunisa-si dengan sasaran penyuluhan dan kampanye imunisasi secara tepat.Kata kunci: Perilaku, status imunisasi anak, analisis multilevel.AbstractThe escalation on the immunization coverage has been proved to significantly reduce the morbidity and mortality of the immunized diseases. However, in Indonesia the coverage of immunization is still low. The research purpose is to understand the role of mother’s characteristics to child immunization status in Indonesia. This is an advance analysis of Riskesdas data 2007/2008. Sample of the research is children age 12-24 months. The results showed that only56.2% children had had complete immunization. Multivariate analysis shows that characteristic factors, such as mother’s and husband’s education are sig-nificant to child immunization status. The result of Multilevel Analysis shows that the role of characteristic factors to child immunization status is 7.5% and the role of district level is 92.5%. Based on this result research, it is important for government to continuously improving education, immunization knowledge and encourage the utilization of health care especially immunization services. Ministry of Health and related sectors are supposed to arrange orientation program for immunization mobilization.Keywords: Behavior, child immunization status, multilevel analysis.

scholarly journals Immunization coverage under universal immunization programme in Kozhikode district, Kerala

2019 ◽  
Vol 6 (9) ◽  
pp. 3667
Author(s):  
Sreedevi C.
Keyword(s):  
Immunization Coverage ◽  
Sampling Technique ◽  
Cost Effective ◽  
Dropout Rate ◽  
Cross Sectional Study ◽  
Cluster Sampling ◽  
Cross Sectional ◽  
Vaccine Preventable Diseases ◽  
Immunization Programme ◽  
Multi Stage

Background: Immunization is an important cost effective tool for preventing the morbidities and mortalities caused by vaccine preventable diseases. The objectives of this study were to assess the universal immunization programme coverage of children of 12–23 months of age in Kozhikode district and to study the factors associated with immunization coverage.Methods: A cross sectional study was conducted in 30 randomly selected electoral wards of Kozhikode district which were selected using multi stage cluster sampling technique during April 2013 to May 2014.Results: 469 children were studied from 30 clusters. 75.5% was fully immunized while 1.5% was unimmunized. Dropout rate for DPT 3 to Measles was the highest accounting to 20.2%. Most common reason for failure of immunization among unimmunized was that the parents didn’t feel the need (57.1%) and for partially immunized was the illness of the child (27.8%) followed by lack of awareness of the time of immunization (22.2%). Religion, early age of the mother at marriage and first delivery and high birth order were significantly associated with a higher proportion of partially immunized while higher education of the parents (>12th standard), health worker’s home visit in the first year of the child and presence of immunization card were significantly associated with a high full immunization coverage (p<0.05).Conclusions: Immunization coverage of 75.5% is far behind the target to be achieved. 1.5% of the children didn’t get any of the vaccinations. It is very important to increases the coverage to prevent the re-emergence of vaccine preventable diseases.

scholarly journals Impact of COVID-19 pandemic on routine childhood immunisation services post lockdown in a tertiary care centre in Meerut district of western U.P.

2021 ◽  
Vol 8 (2) ◽  
pp. 219
Author(s):  
Archana D. Agrawal ◽  
Gaurav Gupta ◽  
Ashu Bhasin ◽  
Abhishek Singh ◽  
Alpa Rathi
Keyword(s):  
Public Health ◽  
Tertiary Care ◽  
Immunization Coverage ◽  
Routine Immunization ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Vaccine Preventable Diseases ◽  
Number Of Children ◽  
Birth Dose ◽  
The Impact

Background: The severe acute respiratory syndrome corona virus-2 (SARS CoV-2) disease pandemic has been a threat to public health and health care system world-wide including routine immunization which has been greatly disrupted putting children at risk for vaccine-preventable diseases (VPDs). A study with an aim to analyse the impact of COVID-19 pandemic on routine immunization coverage post lockdown at a tertiary care centre of western UP.Methods: A retrospective analytical study was conducted at LLRM Medical College, Meerut comparing 3 periods of year 2020, each of 4 weeks viz: 1-28th of February, 1-28 of August and 1-28 of December.Results: Total number of vaccine beneficiaries decreased significantly post lockdown from 646 in February to 275 and 419 in August and December respectively. The percent reduction was maximally seen in booster vaccines while birth dose group was least affected. There was 76.2% and 39.3% reduction in number of children receiving primary doses of combination vaccines in August and December period respectively as compared to February 2020. We found 68.42% and 54.39 % reduction in MR-1 beneficiaries in August and December respectively as compared to February 2020.Conclusions: Significant reduction is found in total number of children receiving immunization during un-lockdown period, compared to pre-COVID level. This difference was more significant in booster doses compared to birth doses. We did not find any significant catch up in vaccine beneficiaries by December 2020 despite 7 months of un-lockdown raising significant concern for public health.

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