Factors associated with routine childhood vaccine uptake and reasons for non-vaccination in India: 1998–2008
| Autor: | Mark Francis, J. Pekka Nuorti, Gagandeep Kang, Venkata Raghava Mohan, Hanna Nohynek, Heidi J. Larson, Vinohar Balraj |
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| Rok vydání: | 2018 |
| Předmět: |
Male
Parents Pediatrics medicine.medical_specialty Vaccination Coverage India Mothers 03 medical and health sciences 0302 clinical medicine Pregnancy Surveys and Questionnaires 030225 pediatrics Odds Ratio Prevalence Humans Medicine 030212 general & internal medicine Multinomial logistic regression Family Characteristics Government General Veterinary General Immunology and Microbiology Immunization Programs business.industry Tetanus Vaccination Public Health Environmental and Occupational Health Infant Prenatal Care Odds ratio Patient Acceptance of Health Care medicine.disease Educational attainment Social mobilization Logistic Models Infectious Diseases Socioeconomic Factors Molecular Medicine Female Residence business Demography |
| Zdroj: | Vaccine. 36:6559-6566 |
| ISSN: | 0264-410X |
| Popis: | Background Despite almost three decades of the Universal Immunization Program in India, a little more than half the children aged 12–23 months receive the full schedule of routine vaccinations. We examined socio-demographic factors associated with partial-vaccination and non-vaccination and the reasons for non-vaccination among Indian children during 1998 and 2008. Methods Data from three consecutive, nationally-representative, District Level Household and Facility Surveys (1998–99, 2002–04 and 2007–08) were pooled. Multinomial logistic regression was used to identify individual and household level socio-demographic variables associated with the child’s vaccination status. The mother’s reported reasons for non-vaccination were analyzed qualitatively, adapting from a previously published framework. Results The pooled dataset contained information on 178,473 children 12–23 months of age; 53%, 32% and 15% were fully vaccinated, partially vaccinated and unvaccinated respectively. Compared with the 1998–1999 survey, children in the 2007–2008 survey were less likely to be unvaccinated (Adjusted Prevalence Odds Ratio (aPOR): 0.92, 95%CI = 0.86–0.98) but more likely to be partially vaccinated (aPOR: 1.58, 95%CI = 1.52–1.65). Vaccination status was inversely associated with female gender, Muslim religion, lower caste, urban residence and maternal characteristics such as lower educational attainment, non-institutional delivery, fewer antenatal care visits and non-receipt of maternal tetanus vaccination. The mother’s reported reasons for non-vaccination indicated gaps in awareness, acceptance and affordability (financial and non-financial costs) related to routine vaccinations. Conclusions Persisting socio-demographic disparities related to partial-vaccination and non-vaccination were associated with important childhood, maternal and household characteristics. Further research investigating the causal pathways through which maternal and social characteristics influence decision-making for childhood vaccinations is needed to improve uptake of routine vaccination in India. Also, efforts to increase uptake should address parental fears related to vaccination to improve trust in government health services as part of ongoing social mobilization and communication strategies. |
| Databáze: | OpenAIRE |
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