PMID- 17332655
OWN - NLM
STAT- MEDLINE
DCOM- 20070911
LR  - 20181201
IS  - 0971-5916 (Print)
IS  - 0971-5916 (Linking)
VI  - 125
IP  - 1
DP  - 2007 Jan
TI  - Health infrastructure & immunization coverage in rural India.
PG  - 31-42
AB  - BACKGROUND & OBJECTIVE: Immunization coverage in India is far from complete with 
      a disproportionately large number of rural children not being immunized. We 
      carried out this study to examine the role of health infrastructure and community 
      health workers in expanding immunization coverage in rural India. METHODS: The 
      sample consisted of 43,416 children aged 2-35 months residing in rural India from 
      the National Family Health Surveys (NFHS) conducted in 1993 and 1998. We 
      estimated separate multinomial logit regression models for polio and non polio 
      vaccines that estimated the probability that a child would receive "no cover," 
      "some cover" or "full age-appropriate cover." The key measure of health 
      infrastructure was a hierarchical variable that assigned each child to categories 
      (no facility, dispensary or clinic, sub-centre, primary health care centre, and 
      hospital) based on the best health facility available in the child's village. We 
      also included variables capturing the availability of various types of community 
      health workers in the village and other health infrastructure. RESULTS: While 
      there was under-provision of rural health infrastructure, our results showed that 
      the availability of health infrastructure had only a modest effect on 
      immunization coverage. Larger and better-equipped facilities had bigger effects 
      on immunization coverage. The presence of community health workers in the village 
      was not associated with increased immunization coverage. INTERPRETATION & 
      CONCLUSION: Our findings suggest that expanding the availability of fixed health 
      infrastructure is unlikely to achieve the goal of universal coverage. Reforming 
      community outreach programmes might be better strategy for increasing 
      immunization coverage.
FAU - Datar, Ashlesha
AU  - Datar A
AD  - Economics & Statistics Group, RAND Corporation, Santa Monica, CA 90407, USA.
FAU - Mukherji, Arnab
AU  - Mukherji A
FAU - Sood, Neeraj
AU  - Sood N
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - India
TA  - Indian J Med Res
JT  - The Indian journal of medical research
JID - 0374701
SB  - IM
CIN - Indian J Med Res. 2007 Jan;125(1):13-6. PMID: 17332652
MH  - Child, Preschool
MH  - Female
MH  - Health Services Accessibility
MH  - Humans
MH  - Immunization Programs/*organization & administration/*statistics & numerical data
MH  - India
MH  - Infant
MH  - Male
MH  - National Health Programs/*organization & administration
MH  - Rural Population
EDAT- 2007/03/03 09:00
MHDA- 2007/09/12 09:00
CRDT- 2007/03/03 09:00
PHST- 2007/03/03 09:00 [pubmed]
PHST- 2007/09/12 09:00 [medline]
PHST- 2007/03/03 09:00 [entrez]
PST - ppublish
SO  - Indian J Med Res. 2007 Jan;125(1):31-42.