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Inequalities in full vaccination coverage based on maternal education and wealth quintiles among children aged 12–23 months: further analysis of national cross-sectional surveys of six South Asian countries

OBJECTIVE: This study was conducted to compare full vaccination coverage and its inequalities (by maternal education and household wealth quintile). DESIGN: This further analysis was based on the data from national-level cross-sectional Demographic and Health Survey (DHS) from six countries in South...

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Autores principales: Acharya, Kiran, Dharel, Dinesh, Subedi, Raj Kumar, Bhattarai, Asmita, Paudel, Yuba Raj
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8823194/
https://www.ncbi.nlm.nih.gov/pubmed/35131811
http://dx.doi.org/10.1136/bmjopen-2020-046971
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author Acharya, Kiran
Dharel, Dinesh
Subedi, Raj Kumar
Bhattarai, Asmita
Paudel, Yuba Raj
author_facet Acharya, Kiran
Dharel, Dinesh
Subedi, Raj Kumar
Bhattarai, Asmita
Paudel, Yuba Raj
author_sort Acharya, Kiran
collection PubMed
description OBJECTIVE: This study was conducted to compare full vaccination coverage and its inequalities (by maternal education and household wealth quintile). DESIGN: This further analysis was based on the data from national-level cross-sectional Demographic and Health Survey (DHS) from six countries in South Asia. SETTING: We used most recent DHS data from six South Asian countries: Nepal, India, Pakistan, Bangladesh, Afghanistan and the Maldives. The sample size of children aged 12–23 months ranged from 6697 in the Maldives to 628 900 in India. PRIMARY AND SECONDARY OUTCOME MEASURES: To measure absolute and relative inequalities of vaccination coverage, we used regression-based inequality measures, slope index of inequality (SII) and the relative index of inequality (RII), respectively, by maternal education and wealth quintile. RESULTS: Full vaccination coverage was the highest in Bangladesh (84%) and the lowest in Afghanistan (46%), with an average of 61.5% for six countries. Pakistan had the largest inequalities in coverage both by maternal education (SII: −50.0, RII: 0.4) and household wealth quintile (SII: −47.1, RII: 0.5). Absolute inequalities were larger by maternal education compared with wealth quintile in four of the six countries. The relative index of inequality by maternal education was lower in Pakistan (0.5) and Afghanistan (0.5) compared with Nepal (0.7), India (0.7) and Bangladesh (0.7) compared with rest of the countries. By wealth quintiles, RII was lower in Pakistan (0.5) and Afghanistan (0.6) and higher in Nepal (0.9) and Maldives (0.9). CONCLUSIONS: The full vaccination coverage in 12–23 months old children was below 85% in all six countries. Inequalities by maternal education were more profound than household wealth-based inequalities in four of six countries studied, supporting the benefits of maternal education to improve child health outcome.
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spelling pubmed-88231942022-02-17 Inequalities in full vaccination coverage based on maternal education and wealth quintiles among children aged 12–23 months: further analysis of national cross-sectional surveys of six South Asian countries Acharya, Kiran Dharel, Dinesh Subedi, Raj Kumar Bhattarai, Asmita Paudel, Yuba Raj BMJ Open Public Health OBJECTIVE: This study was conducted to compare full vaccination coverage and its inequalities (by maternal education and household wealth quintile). DESIGN: This further analysis was based on the data from national-level cross-sectional Demographic and Health Survey (DHS) from six countries in South Asia. SETTING: We used most recent DHS data from six South Asian countries: Nepal, India, Pakistan, Bangladesh, Afghanistan and the Maldives. The sample size of children aged 12–23 months ranged from 6697 in the Maldives to 628 900 in India. PRIMARY AND SECONDARY OUTCOME MEASURES: To measure absolute and relative inequalities of vaccination coverage, we used regression-based inequality measures, slope index of inequality (SII) and the relative index of inequality (RII), respectively, by maternal education and wealth quintile. RESULTS: Full vaccination coverage was the highest in Bangladesh (84%) and the lowest in Afghanistan (46%), with an average of 61.5% for six countries. Pakistan had the largest inequalities in coverage both by maternal education (SII: −50.0, RII: 0.4) and household wealth quintile (SII: −47.1, RII: 0.5). Absolute inequalities were larger by maternal education compared with wealth quintile in four of the six countries. The relative index of inequality by maternal education was lower in Pakistan (0.5) and Afghanistan (0.5) compared with Nepal (0.7), India (0.7) and Bangladesh (0.7) compared with rest of the countries. By wealth quintiles, RII was lower in Pakistan (0.5) and Afghanistan (0.6) and higher in Nepal (0.9) and Maldives (0.9). CONCLUSIONS: The full vaccination coverage in 12–23 months old children was below 85% in all six countries. Inequalities by maternal education were more profound than household wealth-based inequalities in four of six countries studied, supporting the benefits of maternal education to improve child health outcome. BMJ Publishing Group 2022-02-07 /pmc/articles/PMC8823194/ /pubmed/35131811 http://dx.doi.org/10.1136/bmjopen-2020-046971 Text en © Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. https://creativecommons.org/licenses/by-nc/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) .
spellingShingle Public Health
Acharya, Kiran
Dharel, Dinesh
Subedi, Raj Kumar
Bhattarai, Asmita
Paudel, Yuba Raj
Inequalities in full vaccination coverage based on maternal education and wealth quintiles among children aged 12–23 months: further analysis of national cross-sectional surveys of six South Asian countries
title Inequalities in full vaccination coverage based on maternal education and wealth quintiles among children aged 12–23 months: further analysis of national cross-sectional surveys of six South Asian countries
title_full Inequalities in full vaccination coverage based on maternal education and wealth quintiles among children aged 12–23 months: further analysis of national cross-sectional surveys of six South Asian countries
title_fullStr Inequalities in full vaccination coverage based on maternal education and wealth quintiles among children aged 12–23 months: further analysis of national cross-sectional surveys of six South Asian countries
title_full_unstemmed Inequalities in full vaccination coverage based on maternal education and wealth quintiles among children aged 12–23 months: further analysis of national cross-sectional surveys of six South Asian countries
title_short Inequalities in full vaccination coverage based on maternal education and wealth quintiles among children aged 12–23 months: further analysis of national cross-sectional surveys of six South Asian countries
title_sort inequalities in full vaccination coverage based on maternal education and wealth quintiles among children aged 12–23 months: further analysis of national cross-sectional surveys of six south asian countries
topic Public Health
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8823194/
https://www.ncbi.nlm.nih.gov/pubmed/35131811
http://dx.doi.org/10.1136/bmjopen-2020-046971
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