PMID- 22484740
OWN - NLM
STAT- MEDLINE
DCOM- 20121002
LR  - 20220408
IS  - 0974-7559 (Electronic)
IS  - 0019-6061 (Linking)
VI  - 49
IP  - 3
DP  - 2012 Mar
TI  - Inequity in childhood immunization in India: a systematic review.
PG  - 203-23
AB  - BACKGROUND: Despite a reduction in disease burden of vaccine preventable diseases 
      through childhood immunization, considerable progress needs to be made in terms 
      of ensuring efficiency and equity of vaccination coverage. OBJECTIVE: To conduct 
      a systematic review to identify and explore factors associated with inequities in 
      routine vaccination of children in India. METHODS: Publications reporting 
      vaccination inequity were retrieved through a systematic search of Medline and 
      websites of the WHO, UNICEF and demographic health surveys in India. No 
      restrictions were applied in terms of study designs. The primary outcome measure 
      was complete vaccination or immunization defined as per the standard WHO 
      definition. RESULTS: There were three nationwide data sets viz. the three 
      National Family Health Surveys (NFHS), a research study conducted by the Indian 
      Council of Medical Research (ICMR) and a UNICEF coverage evaluation survey. In 
      addition, several publications representing different population groups or 
      geographic regions were available. A small number of publications were reanalyses 
      of data from the NFHS series. There is considerable inequity in vaccination 
      coverage in different states. Within states, traditionally poor performing states 
      have greater inequities, although there are significant inequities even within 
      better performing states. There are significant inequities in childhood 
      vaccination based on various factors related to individual (gender, birth order), 
      family (area of residence, wealth, parental education), demography (religion, 
      caste), and the society (access to health-care, community literacy level) 
      characteristics. Girls fare uniformly worse than boys and higher birth order 
      infants have lower vaccination coverage. Urban infants have higher coverage than 
      rural infants and those living in urban slums. There is an almost direct 
      relationship between household wealth and vaccination rates. The vaccination 
      rates are lower among infants with mothers having no or low literacy, and 
      families with insufficient empowerment of women. Paternal literacy has an 
      inconsistent positive relationship with infant vaccination. There is a 
      relationship between religion and caste and childhood vaccination. Access to 
      health services and other infrastructure, is associated with better vaccination 
      coverage of infants. The precise impact of specific risk factors operating singly 
      or in combination cannot be calculated from this systematic review. CONCLUSION: 
      This systematic review identifies and explores factors associated with inequity 
      in childhood immunization in India; and provides information for urgent action to 
      redress the imbalances.
FAU - Mathew, Joseph L
AU  - Mathew JL
AD  - Advanced Pediatrics Centre, PGIMER, Chandigarh, India. 
      dr.joseph.l.mathew@gmail.com
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PT  - Review
PT  - Systematic Review
PL  - India
TA  - Indian Pediatr
JT  - Indian pediatrics
JID - 2985062R
SB  - IM
CIN - Indian Pediatr. 2012 Jul;49(7):592-3. PMID: 22885451
MH  - Child, Preschool
MH  - Female
MH  - Health Care Surveys
MH  - Healthcare Disparities/*statistics & numerical data
MH  - Humans
MH  - India/epidemiology
MH  - Infant
MH  - Infant, Newborn
MH  - Male
MH  - Socioeconomic Factors
MH  - United Nations
MH  - Vaccination/*statistics & numerical data
EDAT- 2012/04/10 06:00
MHDA- 2012/10/04 06:00
CRDT- 2012/04/10 06:00
PHST- 2012/04/10 06:00 [entrez]
PHST- 2012/04/10 06:00 [pubmed]
PHST- 2012/10/04 06:00 [medline]
AID - 10.1007/s13312-012-0063-z [doi]
PST - ppublish
SO  - Indian Pediatr. 2012 Mar;49(3):203-23. doi: 10.1007/s13312-012-0063-z.