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The Association between Childhood Immunization and Gender Inequality: A Multi-Country Ecological Analysis of Zero-Dose DTP Prevalence and DTP3 Immunization Coverage

This study explores the association between childhood immunization and gender inequality at the national level. Data for the study include annual country-level estimates of immunization among children aged 12–23 months, indicators of gender inequality, and associated factors for up to 165 countries...

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Autores principales: Vidal Fuertes, Cecilia, Johns, Nicole E., Goodman, Tracey S., Heidari, Shirin, Munro, Jean, Hosseinpoor, Ahmad Reza
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9317382/
https://www.ncbi.nlm.nih.gov/pubmed/35891196
http://dx.doi.org/10.3390/vaccines10071032
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author Vidal Fuertes, Cecilia
Johns, Nicole E.
Goodman, Tracey S.
Heidari, Shirin
Munro, Jean
Hosseinpoor, Ahmad Reza
author_facet Vidal Fuertes, Cecilia
Johns, Nicole E.
Goodman, Tracey S.
Heidari, Shirin
Munro, Jean
Hosseinpoor, Ahmad Reza
author_sort Vidal Fuertes, Cecilia
collection PubMed
description This study explores the association between childhood immunization and gender inequality at the national level. Data for the study include annual country-level estimates of immunization among children aged 12–23 months, indicators of gender inequality, and associated factors for up to 165 countries from 2010–2019. The study examined the association between gender inequality, as measured by the gender development index and the gender inequality index, and two key outcomes: prevalence of children who received no doses of the DTP vaccine (zero-dose children) and children who received the third dose of the DTP vaccine (DTP3 coverage). Unadjusted and adjusted fractional logit regression models were used to identify the association between immunization and gender inequality. Gender inequality, as measured by the Gender Development Index, was positively and significantly associated with the proportion of zero-dose children (high inequality AOR = 1.61, 95% CI: 1.13–2.30). Consistently, full DTP3 immunization was negatively and significantly associated with gender inequality (high inequality AOR = 0.63, 95% CI: 0.46–0.86). These associations were robust to the use of an alternative gender inequality measure (the Gender Inequality Index) and were consistent across a range of model specifications controlling for demographic, economic, education, and health-related factors. Gender inequality at the national level is predictive of childhood immunization coverage, highlighting that addressing gender barriers is imperative to achieve universal coverage in immunization and to ensure that no child is left behind in routine vaccination.
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spelling pubmed-93173822022-07-27 The Association between Childhood Immunization and Gender Inequality: A Multi-Country Ecological Analysis of Zero-Dose DTP Prevalence and DTP3 Immunization Coverage Vidal Fuertes, Cecilia Johns, Nicole E. Goodman, Tracey S. Heidari, Shirin Munro, Jean Hosseinpoor, Ahmad Reza Vaccines (Basel) Article This study explores the association between childhood immunization and gender inequality at the national level. Data for the study include annual country-level estimates of immunization among children aged 12–23 months, indicators of gender inequality, and associated factors for up to 165 countries from 2010–2019. The study examined the association between gender inequality, as measured by the gender development index and the gender inequality index, and two key outcomes: prevalence of children who received no doses of the DTP vaccine (zero-dose children) and children who received the third dose of the DTP vaccine (DTP3 coverage). Unadjusted and adjusted fractional logit regression models were used to identify the association between immunization and gender inequality. Gender inequality, as measured by the Gender Development Index, was positively and significantly associated with the proportion of zero-dose children (high inequality AOR = 1.61, 95% CI: 1.13–2.30). Consistently, full DTP3 immunization was negatively and significantly associated with gender inequality (high inequality AOR = 0.63, 95% CI: 0.46–0.86). These associations were robust to the use of an alternative gender inequality measure (the Gender Inequality Index) and were consistent across a range of model specifications controlling for demographic, economic, education, and health-related factors. Gender inequality at the national level is predictive of childhood immunization coverage, highlighting that addressing gender barriers is imperative to achieve universal coverage in immunization and to ensure that no child is left behind in routine vaccination. MDPI 2022-06-27 /pmc/articles/PMC9317382/ /pubmed/35891196 http://dx.doi.org/10.3390/vaccines10071032 Text en © World Health Organization 2022. https://creativecommons.org/licenses/by/3.0/igo/Licensee MDPI. This article is distributed under the terms of the Creative Commons Attribution IGO License (http://creativecommons.org/licenses/by/3.0/igo/ (https://creativecommons.org/licenses/by/3.0/igo/) ), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. In any reproduction of this article there should not be any suggestion that WHO or this article endorse any specific organization or products. The use of the WHO logo is not permitted. This notice should be preserved along with the article’s original URL.
spellingShingle Article
Vidal Fuertes, Cecilia
Johns, Nicole E.
Goodman, Tracey S.
Heidari, Shirin
Munro, Jean
Hosseinpoor, Ahmad Reza
The Association between Childhood Immunization and Gender Inequality: A Multi-Country Ecological Analysis of Zero-Dose DTP Prevalence and DTP3 Immunization Coverage
title The Association between Childhood Immunization and Gender Inequality: A Multi-Country Ecological Analysis of Zero-Dose DTP Prevalence and DTP3 Immunization Coverage
title_full The Association between Childhood Immunization and Gender Inequality: A Multi-Country Ecological Analysis of Zero-Dose DTP Prevalence and DTP3 Immunization Coverage
title_fullStr The Association between Childhood Immunization and Gender Inequality: A Multi-Country Ecological Analysis of Zero-Dose DTP Prevalence and DTP3 Immunization Coverage
title_full_unstemmed The Association between Childhood Immunization and Gender Inequality: A Multi-Country Ecological Analysis of Zero-Dose DTP Prevalence and DTP3 Immunization Coverage
title_short The Association between Childhood Immunization and Gender Inequality: A Multi-Country Ecological Analysis of Zero-Dose DTP Prevalence and DTP3 Immunization Coverage
title_sort association between childhood immunization and gender inequality: a multi-country ecological analysis of zero-dose dtp prevalence and dtp3 immunization coverage
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9317382/
https://www.ncbi.nlm.nih.gov/pubmed/35891196
http://dx.doi.org/10.3390/vaccines10071032
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