Background Little attention has been paid to the comparison of COVID-19 pandemic responses and related factors in BRICS (Brazil, Russia, India, China, and South Africa) countries. We aimed at evaluating the association of daily new COVID-19 cases with socio-economic and demographic factors, health vulnerability, resources, and policy response in BRICS countries. Methods We conducted a cross-sectional study using data on the COVID-19 pandemic and other indicators of BRICS countries from February 26, 2020 to April 30, 2021. We compared COVID-19 epidemic in BRICS countries and analyzed related factors by log-linear Generalized Additive Model (GAM) models. Results In BRICS countries, India had the highest totally of confirmed cases with 18.76 million, followed by Brazil (14.45 million), Russia (4.81 million), and South Africa (1.58 million), while China (0.10 million) had the lowest figure. South Africa had the lowest rate of administered vaccine doses (0.18 million) among BRICS countries as of April 30, 2021. In the GAM model, a 1 unit increase in population density and policy stringency index was associated with a 5.17% and 1.95% growth in daily new COVID-19 cases (P < 0.001), respectively. Exposure–response curves for the effects of policy stringency index on daily new cases showed that there was a rapid surge in number of daily new COVID-19 cases when the index ranged from 0 to 45. The number of infections climbed slowly when the index ranged from 46 to 80, and decreased when the index was above 80 (P < 0.001). In addition, daily new COVID-19 cases (all P < 0.001) were also correlated with life expectancy at birth (-1.61%), extreme poverty (8.95%), human development index (-0.05%), GDP per capita (-0.18%), diabetes prevalence (0.66%), proportion of population aged 60 and above (2.23%), hospital beds per thousand people (-0.08%), proportion of people with access to improved drinking water (-7.40%), prevalence of open defecation (0.69%), and annual tourist/visitor arrivals (0.003%), after controlling other confounders. Different lag structures showed similar results in the sensitivity analysis. Conclusions Strong policy response is crucial to control the pandemic, such as effective containment and case management. Our findings also highlighted the importance of reducing socio-economic inequalities and strengthening the resilience of health systems to better respond to public health emergencies globally. Graphic abstract

Background Migrants account for a large part of China’s population. Many policies and inventions have been taken to improve access to public health services and the health of migrants. China’s Basic Public Health Services(BPHS) are a series of public health services in this policy domain, which aims at promoting the access of public health sevices and improve health equity of residents. The establishment of health records is the fundamental service of BPHS. However, there is little known about the establishment of health records among migrants in China, which hinders the more efficient provision of health services for migrants, and health equity is difficult to achieve. Based on the research gap, this study aims at showing the sociodemographic disparities in the establishment rate of health records, and identifying priorities and recommendations for promoting health equity of migrants in China. Methods This study used national data from China Migrants Dynamic Survey (CMDS) from 2014 to 2017 to evaluate the sociodemographic disparities in the establishment rate of health records and utilization of relevant public health services. The study included 539,926 respondents. Following the descriptive statistics of migrants, we showed the establishment rate of health records by sociodemographic characteristics and migrating related characteristics. Multivariate analysis was conducted to explore the associations between sociodemographic charicteristics, migrating related charicteristics and the establishment of health records. Results The establishment rate of health records among migrants in the sampled years were 22.99, 38.44, 27.29% respectively, and 29.18% in general, and there existed heterogeneity in the establishment rate of health records by sociodemographic charicteristics and migrating related charicteristics. Female migrants who were older, from middle age, married or living with partner, with higher educational attainment, with urban household registration, migrated for longer time, migrated for the reason of studying or family issues, migrated in province were more likely to establish health records. Conclusion There existed sociodemographic disparities in the establishment rate of health records and inequalities in the utilization of health records services among migrants in China. Migrating related characteristics also had impact on the establishment status. Policies should take both supply side and demand side of health services to improve the health equity of migrants, which means that relative departments should continue to invest in primary healthcare centers to improve their ability to provide services as well as migrants’ health literacy.

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Cross-sectional studies about the association between social integration, social exclusion, and vaccination behavior among internal migrants in China are lacking. In this study, we aimed to explore the association between the influenza vaccination behavior and social integration as well as social exclusion in China based on a cross-sectional study. We included 12,467 participants aged 15 years old or above from the 2017 Migrant Population Dynamic Monitoring Survey (MDMS). We used univariate analysis and logistic regression models to access the association between social integration, exclusion status, and influenza vaccination rates. Results suggested that the association between social integration and the vaccination rate was significantly positive. Moving between different districts impact on people’s mental health and their health performance. Significant association between influenza vaccination behavior and education attainment, income status, health record, and awareness of basic public health services program was reported. Therefore, in order to reduce the incidence of influenza disease and increase the vaccination rate, policymakers and the public should promote social integration for internal migrants. Meanwhile, our finding also implies possible strategies to promote COVID-19 vaccination.

Cross-sectional studies about association between awareness of basic public health services and vaccination rates among migrants were lacking. In this study, we aimed to explore the association between awareness of the BPHSs project and vaccination rates among the migrants in China. We included 10013 respondents aged 15 years old or above of eight provinces from 2017 Migrant Population Dynamic Monitoring Survey in China, a nationwide cross-sectional study. Multivariable logistic regressions were used to assess the association between awareness of basic public health services and vaccination rates. Among 10013 migrants, 76.48% were aware of the BPHSs project. Female, the middle-aged, married or having a relationship, the highly educated and the healthy population had higher awareness of this project than others. Multivariable logistic regressions showed that there were significant associations between the awareness of BPHSs project and vaccination rates of eight recommended vaccines (all p values <0.001), including HepA vaccine (OR: 1.54, 95%CI: 1.38-1.73), FIn vaccine (OR: 1.28, 95%CI: 1.13-1.44), JE vaccine (OR: 1.33, 95%CI: 1.14-1.54), TIG vaccine (OR: 1.28, 95%CI: 1.11-1.48), HepB vaccine (OR: 1.11, 95%CI: 1.01-1.22), DTaP vaccine (OR: 1.22, 95%CI: 1.05-1.43), MPSV vaccine (OR: 1.28, 95%CI: 1.08-1.51), HF vaccine (OR: 1.32, 95%CI: 1.03-1.70), except for JE vaccine. The results were robust in the sensitivity analysis. There was a strong relationship between the awareness rate of BPHSs project in the migrants and vaccination. Our findings indicated that the promotion of basic public health services had a beneficial effect on the national recommended vaccination coverage, especially for the migrants with relatively low vaccine coverage.