Socioeconomic inequalities in non- coverage of full vaccination among children in Bangladesh: a comparative study of Demographic and Health Surveys, 2007 and 2017–18

Abstract

Background Vaccination is considered as a powerful and cost-effective weapon against many communicable diseases. An increase in full vaccination among the most vulnerable populations in Bangladesh was observed in the last decade. This study aimed to capture the socioeconomic inequalities in non-coverage of full vaccination among children aged 12–23 months using the nationally representative data from the Bangladesh Demographic and Health Surveys (BDHS). Methods Data for this study have been drawn from the 2007 and 2017–18 BDHS, which covered 10,996 and 20,127 ever-married women aged 15–49 years in 2007 and 2017–18, respectively. Binary logistic regression analysis was performed to find the factors associated with children who did not receive full vaccination. Further, the concentration index was used to observe the socioeconomic inequality for the outcome variable. Results The proportion of children who did not get fully vaccinated decreased by more than 6 points (18.2 percent to 11.8 percent) between the years 2007 and 2017–18. In 2017–18, the odds of children who were not fully vaccinated were 58 percent and 53 percent less among mothers who had primary education in 2007 [adjusted odds ratio (AOR): 0.42; confidence interval (CI): 0.24–0.73] and 2017–18 [AOR: 0.47; CI: 0.23–0.94] respectively, compared to mothers with no education. The inequality for children who were not fully vaccinated had declined between two survey periods [concentration index (CCI) value of − 0.13 in 2007 and -0.08 in 2017–18]. The concentration of inequality in children with higher parity who did not receive full vaccination had increased from 5 percent in 2007 to 16.9 percent in 2017–18. There was a drastic increase in the socioeconomic inequality contributed by place of delivery from 2.9 percent (2007) to 60.5 percent (2017–18) among children who did not receive full vaccination. Conclusions The present study provide eminent evidence that non-coverage of full vaccination is more prevalent among children from poor households in Bangladesh, which is mainly associated with factors like mother’s education, father’s education and working status and household wealth index across the two rounds. These factors suggest multifaceted pro-poor interventions that will protect them from hardship and reduce their socioeconomic inequalities in coverage of full vaccination.

High prevalence of zero-dose children in underserved and special setting populations in Ethiopia using a generalize estimating equation and concentration index analysis

“…Underserved and special setting populations receive fewer healthcare services, including immunization services; face economic constraints to bring their children to vaccination services areas; face cultural and/or linguistic barriers to accessing immunization healthcare services; lack familiarity with the healthcare delivery system and; live in locations where providers aren't readily available or physically accessible, such as pastoralist regions (1), developing regions (Afar, Somali, Gambella, and BG), newlyestablished regions of Sidama and South West Ethiopia Peoples' Region regions, con ict-affected areas (27), underserved urban population including slum areas (2), hard-to-reach areas in agrarian regions (Amhara, Oromia, and SNNP regions) (2), IDPs, and refugees.…”

“…The curves show that whether the socio-economic status related inequality in the outcome variable (on x-axis) prevails or not (27,32). If the curve is above the line of equality that means the index value is negative; hence it shows that the outcome variable is disproportionally concentrated among the poor and vice-versa (27,32). The concentration index is de ned as twice the area between the concentration curve and the line of equality.…”

Risk factors for COVID-19 mortality among telehealth patients in Bangladesh: A prospective cohort study

“…Our results are generalizable to unvaccinated patients in Bangladesh and other low resource settings, as most of the Bangladeshi population was unvaccinated during the period of telehealth services. Although, current vaccination coverage is high in Bangladesh, coverage among vulnerable poor and elderly in rural areas are still low and the provision of boosters is inadequate now [ 51 , 52 ].…”

Determinants of Full Vaccination Coverage among Children Aged 12-23 Months in Bangladesh: A Comparison between High- and Low-Performing Divisions

“…Compared to other South Asian countries, the vaccination coverage for children is the highest in Bangladesh [ 11 ]. Childhood vaccination prevents roughly 200,000 deaths in Bangladesh each year [ 12 ].…”

“…This reinforced the importance of a multisectoral approach in designing policies to achieve health-related sustainable development goals and universal immunization coverage in low- and middle-income countries. Several studies have been conducted in Bangladesh and other South Asian countries which identified sex of children [ 22 ], mother's age [ 5 , 11 ], mother's education [ 2 , 4 ], mother's employment status [ 5 ], mother's number of antenatal care visits [ 23 ], whether the delivery of child was at health facility [ 5 , 11 , 23 ], wealth status of household [ 2 , 13 , 24 ], household's size [ 2 , 5 ], and region of residence [ 4 ] as the influential factors behind childhood immunization. Although there are various studies in Bangladesh and other similar contexts vary, few studies focused on full vaccination of children from the age group 12-23 months.…”