Income-based inequality in full immunization coverage of children aged 12-23 months in Eastern India: A decomposition analysis

Abstract

Introduction: Notably, less than two-thirds of under-5 children received full immunization in 2016 in India. It is critical to understand the inequalities in access to immunization for determining an effective health policy agenda to ensure universal health coverage. Hence, we performed a study to assess the determinants of incomebased inequality in the full immunization of children aged 12-23 using Fairlie decomposition analysis. Methods: This cross-sectional study was a part of a community-based project that aimed to improve maternal and child health in the backward states of India, namely Bihar and Assam. The study was conducted in the rural and urban areas of Munger and Darrang districts of Bihar and Assam, respectively. The degree of income-related inequality in full immunization coverage was obtained through the concentration index. The Fairlie decomposition was employed to quantify the absolute contribution of socio-demographic factors explaining the group differences (higher or lower income) in the probability of having full immunization. Results: There were 73 fully and 82 non-fully immunized children. The concentration curve was lying above the line of equality, which implied that full immunization coverage was concentrated towards the lower-income group. Maternal education (7.5%) and place of residence (5.1%) widened the inequality gap, and caste (− 13.5%) and age of the child (− 2.5%) narrowed down the inequality gap for full immunization among lower and higher-income groups. Conclusions: The socio-economic inequalities in access to full immunization can be mitigated by multi-sectoral interventions with a focus on children with less-educated mothers and living in urban slums.

Decomposing the Gap in Contraceptive Use Among Female Adolescents and Young Women Aged 15-24 in India: An Analysis of Appended Datasets of NFHS-4 and 5

“…The results clearly showed that almost 96% of young women had knowledge about contraception. However, this knowledge of contraception did not articulate into use, as only 12% of the young women in age 15-24 used contraception, majorly among younger ages (15)(16)(17)(18)(19). This finding corroborates the findings found in a former study.…”

“…16 This method of decomposition permits us to compute the absolute contribution of factors explaining the group differences (over two groups) in the probability of using contraceptives among adolescents and young women. 17…”

A Decomposition Analysis to Understand the Wealth-Based Inequalities in Child Vaccination in Rural Southern Assam: A Cross-Sectional Study

“…[ 10 ] Evidence of differences in child vaccination in India based on wealth status has been widely overlooked. So far, just a few works have been carried out in India to address the issue, while a few[ 11 , 12 ] have addressed the issue nationally, the others are[ 13 , 14 ] area specific. But, these minimal studies have contributed significantly to the literature.…”

Differentials and Determinants of Immunization Coverage among Children aged 12-36 Months in India: Analysis of Nationally-Representative, Population-Based Survey Data

“…The Indian government's Universal Immunization Program (UIP), Reproductive, and Child Health Program (R&CHP) have improved childhood vaccination rates and minimised socioeconomic inequalities [17]. The Indian government funds all vaccine doses recommended in the UIP and provides them free of charge to all children in public healthcare facilities [18]. In low-income states, where more than half of India's children under the age of five live, the private health sector's contribution to childhood vaccination is limited, and the government administers the majority of vaccinations [19].…”