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Immunization Gender Inequity in Pakistan: An Analysis of 6.2 Million Children Born from 2019 to 2022 and Enrolled in the Sindh Electronic Immunization Registry

Gender-based inequities in immunization impede the universal coverage of childhood vaccines. Leveraging data from the Government of Sindh’s Electronic Immunization Registry (SEIR), we estimated inequalities in immunization for males and females from the 2019–2022 birth cohorts in Pakistan. We comput...

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Autores principales: Siddiqi, Danya Arif, Iftikhar, Sundus, Siddique, Muhammad, Mehmood, Mariam, Dharma, Vijay Kumar, Shah, Mubarak Taighoon, Setayesh, Hamidreza, Chandir, Subhash
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10059986/
https://www.ncbi.nlm.nih.gov/pubmed/36992269
http://dx.doi.org/10.3390/vaccines11030685
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author Siddiqi, Danya Arif
Iftikhar, Sundus
Siddique, Muhammad
Mehmood, Mariam
Dharma, Vijay Kumar
Shah, Mubarak Taighoon
Setayesh, Hamidreza
Chandir, Subhash
author_facet Siddiqi, Danya Arif
Iftikhar, Sundus
Siddique, Muhammad
Mehmood, Mariam
Dharma, Vijay Kumar
Shah, Mubarak Taighoon
Setayesh, Hamidreza
Chandir, Subhash
author_sort Siddiqi, Danya Arif
collection PubMed
description Gender-based inequities in immunization impede the universal coverage of childhood vaccines. Leveraging data from the Government of Sindh’s Electronic Immunization Registry (SEIR), we estimated inequalities in immunization for males and females from the 2019–2022 birth cohorts in Pakistan. We computed male-to-female (M:F) and gender inequality ratios (GIR) Tfor enrollment, vaccine coverage, and timeliness. We also explored the inequities by maternal literacy, geographic location, mode of vaccination delivery, and gender of vaccinators. Between 1 January 2019, and 31 December 2022, 6,235,305 children were enrolled in the SEIR, 52.2% males and 47.8% females. We observed a median M:F ratio of 1.03 at enrollment and at Penta-1, Penta-3, and Measles-1 vaccinations, indicating more males were enrolled in the immunization system than females. Once enrolled, a median GIR of 1.00 indicated similar coverage for females and males over time; however, females experienced a delay in their vaccination timeliness. Low maternal education; residing in remote-rural, rural, and slum regions; and receiving vaccines at fixed sites, as compared to outreach, were associated with fewer females being vaccinated, as compared to males. Our findings suggeste the need to tailor and implement gender-sensitive policies and strategies for improving equity in immunization, especially in vulnerable geographies with persistently high inequalities.
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spelling pubmed-100599862023-03-30 Immunization Gender Inequity in Pakistan: An Analysis of 6.2 Million Children Born from 2019 to 2022 and Enrolled in the Sindh Electronic Immunization Registry Siddiqi, Danya Arif Iftikhar, Sundus Siddique, Muhammad Mehmood, Mariam Dharma, Vijay Kumar Shah, Mubarak Taighoon Setayesh, Hamidreza Chandir, Subhash Vaccines (Basel) Article Gender-based inequities in immunization impede the universal coverage of childhood vaccines. Leveraging data from the Government of Sindh’s Electronic Immunization Registry (SEIR), we estimated inequalities in immunization for males and females from the 2019–2022 birth cohorts in Pakistan. We computed male-to-female (M:F) and gender inequality ratios (GIR) Tfor enrollment, vaccine coverage, and timeliness. We also explored the inequities by maternal literacy, geographic location, mode of vaccination delivery, and gender of vaccinators. Between 1 January 2019, and 31 December 2022, 6,235,305 children were enrolled in the SEIR, 52.2% males and 47.8% females. We observed a median M:F ratio of 1.03 at enrollment and at Penta-1, Penta-3, and Measles-1 vaccinations, indicating more males were enrolled in the immunization system than females. Once enrolled, a median GIR of 1.00 indicated similar coverage for females and males over time; however, females experienced a delay in their vaccination timeliness. Low maternal education; residing in remote-rural, rural, and slum regions; and receiving vaccines at fixed sites, as compared to outreach, were associated with fewer females being vaccinated, as compared to males. Our findings suggeste the need to tailor and implement gender-sensitive policies and strategies for improving equity in immunization, especially in vulnerable geographies with persistently high inequalities. MDPI 2023-03-17 /pmc/articles/PMC10059986/ /pubmed/36992269 http://dx.doi.org/10.3390/vaccines11030685 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Siddiqi, Danya Arif
Iftikhar, Sundus
Siddique, Muhammad
Mehmood, Mariam
Dharma, Vijay Kumar
Shah, Mubarak Taighoon
Setayesh, Hamidreza
Chandir, Subhash
Immunization Gender Inequity in Pakistan: An Analysis of 6.2 Million Children Born from 2019 to 2022 and Enrolled in the Sindh Electronic Immunization Registry
title Immunization Gender Inequity in Pakistan: An Analysis of 6.2 Million Children Born from 2019 to 2022 and Enrolled in the Sindh Electronic Immunization Registry
title_full Immunization Gender Inequity in Pakistan: An Analysis of 6.2 Million Children Born from 2019 to 2022 and Enrolled in the Sindh Electronic Immunization Registry
title_fullStr Immunization Gender Inequity in Pakistan: An Analysis of 6.2 Million Children Born from 2019 to 2022 and Enrolled in the Sindh Electronic Immunization Registry
title_full_unstemmed Immunization Gender Inequity in Pakistan: An Analysis of 6.2 Million Children Born from 2019 to 2022 and Enrolled in the Sindh Electronic Immunization Registry
title_short Immunization Gender Inequity in Pakistan: An Analysis of 6.2 Million Children Born from 2019 to 2022 and Enrolled in the Sindh Electronic Immunization Registry
title_sort immunization gender inequity in pakistan: an analysis of 6.2 million children born from 2019 to 2022 and enrolled in the sindh electronic immunization registry
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10059986/
https://www.ncbi.nlm.nih.gov/pubmed/36992269
http://dx.doi.org/10.3390/vaccines11030685
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