scholarly journals Household expenditure for immunization among children in India: a two-part model approach

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Shobhit Srivastava ◽  
Pradeep Kumar ◽  
Shekhar Chauhan ◽  
Adrita Banerjee
Keyword(s):  
Urban Area ◽  
Immunization Coverage ◽  
Wealth Quintile ◽  
Regional Level ◽  
Sample Survey ◽  
Factors Affecting ◽  
Universal Immunization Program ◽  
The Cost ◽  
Full Immunization ◽  
Part Model

Abstract Background Despite the Indian government’s Universal Immunization Program (UIP), the progress of full immunization coverage is plodding. The cost of delivering routine immunization varies widely across facilities within country and across country. However, the cost an individual bears on child immunization has not been focussed. In this context, this study tries to estimate the expenditure on immunization which an individual bears and the factors affecting immunization coverage at the regional level. Methods Using the 75th round of National Sample Survey Organization data, the present paper attempts to check the individual expenditure on immunization and the factors affecting immunization coverage at the regional level. Descriptive statistics and multivariate regression analysis were used to fulfil the study objectives. The two-part model has been employed to inspect the determinants of expenditure on immunization. Results The overall prevalence of full immunization was 59.3 % in India. Full immunization was highest in Manipur (75.2 %) and lowest in Nagaland (12.8 %). The mean expenditure incurred on immunization varies from as low as Rs. 32.7 in Tripura to as high as Rs. 1008 in Delhi. Children belonging to the urban area [OR: 1.04; CI: 1.035, 1.037] and richer wealth quintile [OR: 1.14; CI: 1.134–1.137] had higher odds of getting immunization. Moreover, expenditure on immunization was high among children from the urban area [Rs. 273], rich wealth quintile [Rs. 297] and who got immunized in a private facility [Rs. 1656]. Conclusions There exists regional inequality in immunization coverage as well as in expenditure incurred on immunization. Based on the findings, we suggest looking for the supply through follow-up and demand through spreading awareness through mass media for immunization.

scholarly journals Gender discrimination and other factors affecting Full Immunization Coverage (FIC) in 59 low performing blocks of Bihar

2020 ◽  
Vol 32 (1) ◽  
pp. 101-107
Author(s):  
C M Singh ◽  
Abhishek Mishra ◽  
Neeraj Agarwal ◽  
Arshad Ayub ◽  
Shradha Mishra ◽  
...  
Keyword(s):  
Data Collection ◽  
Gender Discrimination ◽  
Associated Factors ◽  
Care Facility ◽  
Health Care Facility ◽  
Immunization Coverage ◽  
Cluster Sampling ◽  
Factors Affecting ◽  
Coverage Ratio ◽  
Full Immunization

Background: Routine childhood immunization has proven to be among the most practical and most cost-effective health interventions. The full immunization coverage (FIC) has increased, still it is less. Especially in  the low performing blocks of Bihar ,it is less than 70 %.There are various factors responsible for less FIC including gender discrimination also which is still hidden in the society. Hence this study was done to find out the FIC in Bihar with associated factors including gender discrimination. Objectives: To find out the various associated factors affecting FIC and to find out gender discrimination (if any) in FIC in different districts of Bihar. Methodology: Two stage cluster sampling with Probability Proportional to size Sampling (PPS) was used as per Study protocol. The study was conducted in 59 low- performing blocks of Bihar where the full immunization coverage was less than 70%. The survey was conducted in 59 blocks. From each block, 30 clusters (Villages) were selected. As a convention, 7 children of age group 12- 23 months were selected from each cluster. Thus, data collection was done for a total of 12,390 children.A structured questionnaire was formulated on the basis of WHO coverage evaluation format. Web based Application SDRC kit was used for data collection while SPSS v. 20 was used for analysis. Results: FIC was found to be 60.81% , it was higher for the rural clusters, general caste, Hindus when compared to urban clusters , SC and other castes, and Muslim religion respectively. For 1st child FIC was highest (66.8%) and was lesser for females. A coverage ratio (female to male) was found to be less than 1 for most of the districts. Conclusion: There are considerable inequities in full immunization by various individual (birth order, gender, birth weight), social (religion, caste), and societal (health care facility and cluster type) characteristics. In general, the ratio (female/male) remains less than 1 for most of the districts.

scholarly journals Determinants of Immunization Coverage and Associated Factors among Children aged under Two-Year-Old in the National Immunization Program of Mewat district, Haryana (2019-2020)

2021 ◽  
Vol 9 (1) ◽  
pp. 176-196
Author(s):  
Vishesh Kumar
Keyword(s):  
Immunization Coverage ◽  
Cost Effective ◽  
Cross Sectional Study ◽  
Vaccine Hesitancy ◽  
Immunization Program ◽  
Cross Sectional ◽  
Universal Immunization Program ◽  
Vaccine Preventable Diseases ◽  
Related Data ◽  
Full Immunization

Background: Vaccination against childhood communicable diseases through Expanded Program on Immunization is one of the most cost-effective public health interventions. Additional 1.5 million child deaths can be prevented if global vaccination coverage is improved. Mewat district has one of India’s lowest immunization rates despite a long-standing Universal Immunization Program and continues to sustain a high prevalence of vaccine-preventable diseases. This study investigates determinants of immunization status among children aged 0-23 months. Methods: A community-based cross-sectional study was conducted from December 2019 to June 2020, among 800 children aged 0-23months, randomly selected in one rural and one urban ward each from all 4 blocks of Mewat. Socio-demographic conditions and vaccine-related data were collected using a semi-structured questionnaire. Immunization was assessed by vaccination card and by mother’s recall where the card was unavailable. Results:Mewat has increased full immunization coverage from 13.1% in 2015-16 to 59.4%. Immunization card was available with 68.5% (292/426) beneficiaries. Dropout rates for Pentavalent1 to Pentavalent3 was 27.5% and 54% for Bacillus Calmette-Guerin to measles. After adjusting for the state of residence, religion, gender, paternal education, health professional presence during birth, place of vaccination and knowledge of mother on due dose were significantly associated with full immunization. Awareness gap and fear of side effects for vaccines were main reasons of vaccine hesitancy. Conclusion: Full immunization coverage in the district is sub optimal and behind the desired coverage goal, mainly due to vaccine hesitancy. Enhancing community knowledge about the benefits of vaccination is recommended.

scholarly journals Monitoring inequality changes in full immunization coverage in infants in Latin America and the Caribbean

2020 ◽  
Vol 44 ◽  
pp. 1
Author(s):  
Manuel Colomé-Hidalgo ◽  
Juan Donado Campos ◽  
Ángel Gil de Miguel
Keyword(s):  
Income Inequality ◽  
Latin American ◽  
Health Surveys ◽  
Immunization Coverage ◽  
Wealth Quintile ◽  
Income Quintile ◽  
Demographic And Health Surveys ◽  
Time Points ◽  
Absolute And Relative Inequalities ◽  
Full Immunization

Objective. To compare inequalities in full infant vaccination coverage at two different time points between 1992 and 2016 in Latin American and Caribbean countries. Methods. Analysis is based on recent available data from Demographic and Health Surveys, Multiple Indicator Cluster Surveys, and Reproductive Health Surveys conducted in 18 countries between 1992 and 2016. Full immunization data from children 12–23 months of age were disaggregated by wealth quintile. Absolute and relative inequalities between the richest and the poorest quintile were measured. Differences were measured for 14 countries with data available for two time points. Significance was determined using 95% confidence intervals. Results. The overall median full immunization coverage was 69.9%. Approximately one-third of the countries have a high-income inequality gap, with a median difference of 5.6 percentage points in 8 of 18 countries. Bolivia, Colombia, El Salvador, and Peru have achieved the greatest progress in improving coverage among the poorest quintiles of their population in recent years. Conclusion. Full immunization coverage in the countries in the study shows higher-income inequality gaps that are not seen by observing national coverage only, but these differences appear to be reduced over time. Actions monitoring immunization coverage based on income inequalities should be considered for inclusion in the assessment of public health policies to appropriately reduce the gaps in immunization for infants in the lowest-income quintile.

The Cost of Being ‘Backward’ in India: Socio-religious Discrimination in the Labour Market

2021 ◽  
pp. 097370302110296
Author(s):  
Soumyajit Chakraborty ◽  
Alok K. Bohara
Keyword(s):  
Labour Market ◽  
Economic Cost ◽  
National Sample ◽  
Sample Survey ◽  
Religious Discrimination ◽  
Capital Endowment ◽  
Scheduled Castes ◽  
Sample Survey Data ◽  
The Cost ◽  
Human Capital Endowment

Being from backward castes, classes and Muslims in India has an economic cost associated with the nature of institutional discrimination. Using the 2011–2012 National Sample Survey data, this study identifies that caste and religion still rule the modern Indian labour market. We find that discrimination is evident in the socio-religious earnings gaps. While the parametric decompositions suggest that most of these gaps are due to differential human capital endowment, the nonparametric method almost evenly attributes inequality to discrimination and endowment. The results presented in this study suggest that discrimination against Scheduled Castes and Scheduled Tribes, Muslims and Other Backward Classes should be included in policy designs to promote equity in the Indian labour market.

scholarly journals Factors Affecting the Rate of Fuel Consumption in Aircrafts

2021 ◽  
Vol 13 (14) ◽  
pp. 8066
Author(s):  
Thowayeb H. Hassan ◽  
Abu Elnasr E. Sobaih ◽  
Amany E. Salem
Keyword(s):  
Fuel Consumption ◽  
Positive Association ◽  
Pollutant Emissions ◽  
Aviation Industry ◽  
Factors Affecting ◽  
Fuel Flow ◽  
Homogeneity Of Variance ◽  
Strong Positive Association ◽  
Ground Distance ◽  
The Cost

The cost of fuel and its availability are among the most major concerns for aircrafts and the aviation industry overall. Environmental difficulties with chemical pollutant emissions emitted by aviation machines are also connected to fuel consumption. As a result, it is crucial to examine factors that affect the overall fuel usage and consumption in the airport-based aviation industry. Several variables were investigated related to the total fuel consumed, such as dry operating weight (DOW) (KG), zero-fuel weight (ZFW), take-off weight (TOW), air distance (AIR DIST) (KM), and ground distance (GDN DIST). Analysis of the correlation between total fuel consumed as well as the extra fuel and selected variables was conducted. The results showed that the most positively associated factors with the total used fuel were the air distance (r2 = 0.86, p < 0.01), ground distance (r2 = 0.78, p < 0.01), TOW (r2 = 0.68, p < 0.01), and flight time (r2 = 0.68, p < 0.01). There was also a strong positive association between the average fuel flow (FF) and actual TOW (r2 = 0.74, p < 0.01) as well as ZFW (r2 = 0.61, p < 0.01). The generalized linear model (GLM) was utilized to assess the predictions of total energy usage after evaluating important outliers, stability of the homogeneity of variance, and the normalization of the parameter estimation. The results of multiple linear regression revealed that the most significant predictors of the total consumed fuel were the actual ZFW (p < 0.01), actual TOW (p < 0.01), and actual average FF (p < 0.05). The results interestingly confirmed that wind speed has some consequences and effects on arrival fuel usage. The result reflects that thermal and hydrodynamic economies impact on the flying fuel economy. The research has various implications for both scholars and practitioners of aviation industry.

scholarly journals Combining regional to local restoration goals in the Brazilian Atlantic forest

2021 ◽  
Vol 21 (3) ◽  
Author(s):  
Cassia M.G. Lemos ◽  
Pedro R. Andrade ◽  
Ricardo R. Rodrigues ◽  
Leticia Hissa ◽  
Ana P. D. Aguiar
Keyword(s):  
Cost Effectiveness ◽  
Atlantic Forest ◽  
Natural Regeneration ◽  
Regional Level ◽  
Target Area ◽  
Brazilian Atlantic Forest ◽  
Regeneration Potential ◽  
Allocation Model ◽  
Alternative Scenarios ◽  
The Cost

AbstractTo achieve regional and international large-scale restoration goals with minimum costs, several restoration commitments rely on natural regeneration, a passive and inexpensive strategy. However, natural regeneration potential may vary within the landscape, mainly due to its historical context. In this work, we use spatially explicit restoration scenarios to explore how and where, within a given region, multiple restoration commitments could be combined to achieve cost-effectiveness outcomes. Our goal is to facilitate the elaboration of forest restoration plans at the regional level, taking into consideration the costs for active and passive restoration methods. The approach includes (1) a statistical analysis to estimate the natural regeneration potential for a given area based on alternative sets of biophysical, land cover, and/or socioeconomic factors and (2) the use of a land change allocation model to explore the cost-effectiveness of combining multiple restoration commitments in a given area through alternative scenarios. We test our approach in a strategic region in the Brazilian Atlantic Forest Biome, the Paraiba Valley in São Paulo State. Using the available data for 2011, calibrated for 2015, we build alternative scenarios for allocating natural regeneration until 2025. Our models indicate that the natural regeneration potential of the region is actually very low, and the cost-effectiveness outcomes are similar for all scenarios. We believe our approach can be used to support the regional-level decision-making about the implementation of multiple commitments aiming at the same target area. It can also be combined with other approaches for more refined analysis (e.g., optimization models).

scholarly journals Economic burden of childhood diarrhea in Burundi

2021 ◽  
Vol 6 (1) ◽  
Author(s):  
Fulgence Niyibitegeka ◽  
Arthorn Riewpaiboon ◽  
Sitaporn Youngkong ◽  
Montarat Thavorncharoensap
Keyword(s):  
Economic Burden ◽  
Cost Model ◽  
Primary Treatment ◽  
Management Program ◽  
Community Based ◽  
Factors Affecting ◽  
Hospitalization Costs ◽  
Illness Study ◽  
The Cost ◽  
Substantial Economic Burden

Abstract Background In 2016, diarrhea killed around 7 children aged under 5 years per 1000 live births in Burundi. The objective of this study was to estimate the economic burden associated with diarrhea in Burundi and to examine factors affecting the cost to provide economic evidence useful for the policymaking about clinical management of diarrhea. Methods The study was designed as a prospective cost-of-illness study using an incidence-based approach from the societal perspective. The study included patients aged under 5 years with acute non-bloody diarrhea who visited Buyenzi health center and Prince Regent Charles hospital from November to December 2019. Data were collected through interviews with patients’ caregivers and review of patients’ medical and financial records. Multiple linear regression was performed to identify factors affecting cost, and a cost model was used to generate predictions of various clinical and care management costs. All costs were converted into international dollars for the year 2019. Results One hundred thirty-eight patients with an average age of 14.45 months were included in this study. Twenty-one percent of the total patients included were admitted. The average total cost per episode of diarrhea was Int$109.01. Outpatient visit and hospitalization costs per episode of diarrhea were Int$59.87 and Int$292, respectively. The costs were significantly affected by the health facility type, patient type, health insurance scheme, complications with dehydration, and duration of the episode before consultation. Our model indicates that the prevention of one case of dehydration results in savings of Int$16.81, accounting for approximately 11 times of the primary treatment cost of one case of diarrhea in the community-based management program for diarrhea in Burundi. Conclusion Diarrhea is associated with a substantial economic burden to society. Evidence from this study provides useful information to support health interventions aimed at prevention of diarrhea and dehydration related to diarrhea in Burundi. Appropriate and timely care provided to patients with diarrhea in their communities and primary health centers can significantly reduce the economic burden of diarrhea. Implementing a health policy to provide inexpensive treatment to prevent dehydration can save significant amount of health expenditure.

Factors affecting the future of the Scottish hydrometric network

1987 ◽  
Vol 78 (4) ◽  
pp. 269-274 ◽  
Author(s):  
T. Poodle
Keyword(s):  
Data Acquisition ◽  
Computer Systems ◽  
Economic Recession ◽  
Data Standards ◽  
Factors Affecting ◽  
Economic Climate ◽  
A Minor ◽  
The Cost ◽  
Minor Extent

ABSTRACTThe Scottish Hydrometric Network consists of a number of river gauging stations which have been located at sites considered suitable to provide long term flow records. Economic recession has placed some stress on the gauging programme, and has given rise to extensive closures of gauging stations in England and, to a minor extent so far, in Scotland. The way in which the network became established provides a mixture of strengths and weaknesses which could have unpredictable consequences in an adverse economic climate. Changing technology provides some opportunity to reduce the cost of data acquisition and improve the deployment of manpower, while maintaining data standards. In these changing circumstances, particularly with extensive use of computer systems, it is important that standards are established for data returned to the Water Archive and that the network is not allowed to degenerate by default.

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