PMID- 24023816
OWN - NLM
STAT- MEDLINE
DCOM- 20140408
LR  - 20231106
IS  - 1932-6203 (Electronic)
IS  - 1932-6203 (Linking)
VI  - 8
IP  - 9
DP  - 2013
TI  - Trends in child immunization across geographical regions in India: focus on 
      urban-rural and gender differentials.
PG  - e73102
LID - 10.1371/journal.pone.0073102 [doi]
LID - e73102
AB  - BACKGROUND: Although child immunization is regarded as a highly cost-effective 
      lifesaver, about fifty percent of the eligible children aged 12-23 months in 
      India are without essential immunization coverage. Despite several programmatic 
      initiatives, urban-rural and gender difference in child immunization pose an 
      intimidating challenge to India's public health agenda. This study assesses the 
      urban-rural and gender difference in child immunization coverage during 1992-2006 
      across six major geographical regions in India. DATA AND METHODS: Three rounds of 
      the National Family Health Survey (NFHS) conducted during 1992-93, 1998-99 and 
      2005-06 were analyzed. Bivariate analyses, urban-rural and gender inequality 
      ratios, and the multivariate-pooled logistic regression model were applied to 
      examine the trends and patterns of inequalities over time. KEY FINDINGS: The 
      analysis of change over one and half decades (1992-2006) shows considerable 
      variations in child immunization coverage across six geographical regions in 
      India. Despite a decline in urban-rural and gender differences over time, 
      children residing in rural areas and girls remained disadvantaged. Moreover, 
      northeast, west and south regions, which had the lowest gender inequality in 1992 
      observed an increase in gender difference over time. Similarly, urban-rural 
      inequality increased in the west region during 1992-2006. CONCLUSION: This study 
      suggests periodic evaluation of the health care system is vital to assess the 
      between and within group difference beyond average improvement. It is essential 
      to integrate strong immunization systems with broad health systems and coordinate 
      with other primary health care delivery programs to augment immunization 
      coverage.
FAU - Singh, Prashant Kumar
AU  - Singh PK
AD  - International Institute for Population Sciences, Mumbai, India.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20130904
PL  - United States
TA  - PLoS One
JT  - PloS one
JID - 101285081
SB  - IM
MH  - Adolescent
MH  - Cities/*statistics & numerical data
MH  - Female
MH  - Geography/*statistics & numerical data
MH  - Humans
MH  - Immunization/*trends
MH  - India
MH  - Infant
MH  - Male
MH  - Rural Population/*statistics & numerical data
MH  - Sex Distribution
PMC - PMC3762848
COIS- Competing Interests: The author has declared that no competing interests exist.
EDAT- 2013/09/12 06:00
MHDA- 2014/04/09 06:00
PMCR- 2013/09/04
CRDT- 2013/09/12 06:00
PHST- 2013/03/06 00:00 [received]
PHST- 2013/07/17 00:00 [accepted]
PHST- 2013/09/12 06:00 [entrez]
PHST- 2013/09/12 06:00 [pubmed]
PHST- 2014/04/09 06:00 [medline]
PHST- 2013/09/04 00:00 [pmc-release]
AID - PONE-D-13-09982 [pii]
AID - 10.1371/journal.pone.0073102 [doi]
PST - epublish
SO  - PLoS One. 2013 Sep 4;8(9):e73102. doi: 10.1371/journal.pone.0073102. eCollection 
      2013.