Inequalities in complete childhood immunisation in Nepal: results from a population-based cross-sectional study
Objective To investigate the effect of different aspects of inequality on childhood immunisation rates in Nepal. The study hypothesised that social inequality factors (eg, gender of a child, age of mother, caste/ethnic affiliation, mother’s socioeconomic status, place of residence and other structur...
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BMJ Publishing Group
2020-09-01
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| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/10/9/e037646.full |
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| author | In Han Song Elizabeth Palley Madhu Sudhan Atteraya |
| author_facet | In Han Song Elizabeth Palley Madhu Sudhan Atteraya |
| author_sort | In Han Song |
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| description | Objective To investigate the effect of different aspects of inequality on childhood immunisation rates in Nepal. The study hypothesised that social inequality factors (eg, gender of a child, age of mother, caste/ethnic affiliation, mother’s socioeconomic status, place of residence and other structural barrier factors such as living in extreme poverty and distance to health facility) affect the likelihood of children being immunised.Design Using gender of a child, age of mother, caste/ethnic affiliation, mother’s socioeconomic status, place of residence and other structural barrier factors such as living in extreme poverty and distance to health facility as independent variables, we performed bivariate and multivariate logistic regression analyses.Setting This study used data from the most recent nationally representative cross-sectional Nepal Demographic and Health Survey in 2016.Participants The analysis reviewed data from 1025 children aged 12–23 months old.Outcome measures The main outcome variable was childhood immunisation.Results Only 79.2% of children were fully immunised. The complete vaccination rate of ethnic/caste subpopulations ranged from 66.4% to 85.2%. Similarly, multivariate analysis revealed that children from the previously untouchable caste (OR 0.58; CI 0.33 to 0.99) and the Terai caste (OR 0.54; CI 0.29 to 0.99) were less likely to be fully immunised than children from the high Hindu caste.Conclusion Given Nepal’s limited resources, we suggest that programmes that target the families of children who are least likely to be fully immunised, specifically those who are not only poor but also in financial crises and ‘underprivileged’ caste families, might be an effective strategy to improve Nepal’s childhood immunisation rates. |
| format | Article |
| id | doaj-art-a8ab5316d1a64fb09cfaec6379b6634c |
| institution | Kabale University |
| issn | 2044-6055 |
| language | English |
| publishDate | 2020-09-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open |
| spelling | doaj-art-a8ab5316d1a64fb09cfaec6379b6634c2025-01-08T13:20:08ZengBMJ Publishing GroupBMJ Open2044-60552020-09-0110910.1136/bmjopen-2020-037646Inequalities in complete childhood immunisation in Nepal: results from a population-based cross-sectional studyIn Han Song0Elizabeth Palley1Madhu Sudhan Atteraya2Graduate School of Social Welfare, Yonsei University, Seoul, The Republic of KoreaSchool of Social Work, Adelphi University, Garden City, New York, USADepartment of Social Welfare, Keimyung University, Daegu, The Republic of KoreaObjective To investigate the effect of different aspects of inequality on childhood immunisation rates in Nepal. The study hypothesised that social inequality factors (eg, gender of a child, age of mother, caste/ethnic affiliation, mother’s socioeconomic status, place of residence and other structural barrier factors such as living in extreme poverty and distance to health facility) affect the likelihood of children being immunised.Design Using gender of a child, age of mother, caste/ethnic affiliation, mother’s socioeconomic status, place of residence and other structural barrier factors such as living in extreme poverty and distance to health facility as independent variables, we performed bivariate and multivariate logistic regression analyses.Setting This study used data from the most recent nationally representative cross-sectional Nepal Demographic and Health Survey in 2016.Participants The analysis reviewed data from 1025 children aged 12–23 months old.Outcome measures The main outcome variable was childhood immunisation.Results Only 79.2% of children were fully immunised. The complete vaccination rate of ethnic/caste subpopulations ranged from 66.4% to 85.2%. Similarly, multivariate analysis revealed that children from the previously untouchable caste (OR 0.58; CI 0.33 to 0.99) and the Terai caste (OR 0.54; CI 0.29 to 0.99) were less likely to be fully immunised than children from the high Hindu caste.Conclusion Given Nepal’s limited resources, we suggest that programmes that target the families of children who are least likely to be fully immunised, specifically those who are not only poor but also in financial crises and ‘underprivileged’ caste families, might be an effective strategy to improve Nepal’s childhood immunisation rates.https://bmjopen.bmj.com/content/10/9/e037646.full |
| spellingShingle | In Han Song Elizabeth Palley Madhu Sudhan Atteraya Inequalities in complete childhood immunisation in Nepal: results from a population-based cross-sectional study BMJ Open |
| title | Inequalities in complete childhood immunisation in Nepal: results from a population-based cross-sectional study |
| title_full | Inequalities in complete childhood immunisation in Nepal: results from a population-based cross-sectional study |
| title_fullStr | Inequalities in complete childhood immunisation in Nepal: results from a population-based cross-sectional study |
| title_full_unstemmed | Inequalities in complete childhood immunisation in Nepal: results from a population-based cross-sectional study |
| title_short | Inequalities in complete childhood immunisation in Nepal: results from a population-based cross-sectional study |
| title_sort | inequalities in complete childhood immunisation in nepal results from a population based cross sectional study |
| url | https://bmjopen.bmj.com/content/10/9/e037646.full |
| work_keys_str_mv | AT inhansong inequalitiesincompletechildhoodimmunisationinnepalresultsfromapopulationbasedcrosssectionalstudy AT elizabethpalley inequalitiesincompletechildhoodimmunisationinnepalresultsfromapopulationbasedcrosssectionalstudy AT madhusudhanatteraya inequalitiesincompletechildhoodimmunisationinnepalresultsfromapopulationbasedcrosssectionalstudy |