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Inequities in Childhood Vaccination Coverage in Zhejiang, Province: Evidence from a Decomposition Analysis on Two-Round Surveys

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  • Yu Hu

    (Institute of Immunization and Prevention, Zhejiang Center for Disease Control and Prevention, Hangzhou 310000, China)

  • Hui Liang

    (Institute of Immunization and Prevention, Zhejiang Center for Disease Control and Prevention, Hangzhou 310000, China)

  • Ying Wang

    (Institute of Immunization and Prevention, Zhejiang Center for Disease Control and Prevention, Hangzhou 310000, China)

  • Yaping Chen

    (Institute of Immunization and Prevention, Zhejiang Center for Disease Control and Prevention, Hangzhou 310000, China)

Abstract

Objective : The objectives of this study were to determine the degree and risk factors of the inequity in the childhood coverage of full primary immunization (FPI) in Zhejiang province. Method : We used data from two rounds of vaccination coverage surveys among children aged 24–35 months conducted in 2014 and 2017, respectively. The household income per month was used as an index of socioeconomic status for the inequality analysis. The concentration index (CI) was used to quantify the degree of inequality, and the decomposition approach was applied to quantify the contributions from demographic factors to inequality in the coverage of FPI. Results : The coverage rates of FPI were 80.6%, with a CI value of 0.12028 for the 2014 survey, while the coverage rates of FPI were 85.2%, with a CI value of 0.10129 for the 2017 survey. The results of decomposition analysis suggested that 68.2% and 67.1% of the socioeconomic inequality in the coverage of FPI could be explained by the mother’s education level for the 2014 and 2017 survey, respectively. Other risk factors including birth order, ethnic group, mother’s age, maternal employment status, residence, immigration status, GDP per-capita, and the percentage of the total health spending allocated to public health could also explain this inequality. Conclusion : The socioeconomic inequity in the coverage of FPI still remained, although this gap was reduced between 2014 and 2017. Policy recommendations for health interventions on reducing the inequality in the coverage of FPI should be focused on eliminating poverty and women’s illiteracy.

Suggested Citation

  • Yu Hu & Hui Liang & Ying Wang & Yaping Chen, 2018. "Inequities in Childhood Vaccination Coverage in Zhejiang, Province: Evidence from a Decomposition Analysis on Two-Round Surveys," IJERPH, MDPI, vol. 15(9), pages 1-12, September.
    • Handle: RePEc:gam:jijerp:v:15:y:2018:i:9:p:2000-:d:169661
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    1. Hajizadeh, Mohammad & Hu, Min & Bombay, Amy & Asada, Yukiko, 2018. "Socioeconomic inequalities in health among Indigenous peoples living off-reserve in Canada: Trends and determinants," Health Policy, Elsevier, vol. 122(8), pages 854-865.
    2. Racine, Andrew D. & Joyce, Theodore J., 2007. "Maternal education, child immunizations, and public policy: Evidence from the US National Immunization Survey," Social Science & Medicine, Elsevier, vol. 65(8), pages 1765-1772, October.
    3. Mustafa Özer & Jan Fidrmuc & Mehmet Ali Eryurt, 2018. "Maternal education and childhood immunization in Turkey," Health Economics, John Wiley & Sons, Ltd., vol. 27(8), pages 1218-1229, August.
    4. Heckley, Gawain & Gerdtham, Ulf-G. & Kjellsson, Gustav, 2016. "A general method for decomposing the causes of socioeconomic inequality in health," Journal of Health Economics, Elsevier, vol. 48(C), pages 89-106.
    5. Qian Li & Yu Hu & Yanpeng Zhong & Yaping Chen & Xuewen Tang & Jing Guo & Lingzhi Shen, 2014. "Using the Immunization Information System to Determine Vaccination Coverage Rates among Children Aged 1–7 Years: A Report from Zhejiang Province, China," IJERPH, MDPI, vol. 11(3), pages 1-16, March.
    6. Wagstaff, Adam & Paci, Pierella & van Doorslaer, Eddy, 1991. "On the measurement of inequalities in health," Social Science & Medicine, Elsevier, vol. 33(5), pages 545-557, January.
    7. Rohini Pande, 2003. "Selective gender differences in childhood nutrition and immunization in rural India: The role of siblings," Demography, Springer;Population Association of America (PAA), vol. 40(3), pages 395-418, August.
    8. Jayanta Kumar Bora & Nandita Saikia, 2018. "Neonatal and under-five mortality rate in Indian districts with reference to Sustainable Development Goal 3: An analysis of the National Family Health Survey of India (NFHS), 2015–2016," PLOS ONE, Public Library of Science, vol. 13(7), pages 1-15, July.
    9. Yu Hu & Qian Li & Yaping Chen, 2017. "Timeliness of Childhood Primary Immunization and Risk Factors Related with Delays: Evidence from the 2014 Zhejiang Provincial Vaccination Coverage Survey," IJERPH, MDPI, vol. 14(9), pages 1-13, September.
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    Cited by:

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