ArticleVaccine2017
Demand- and supply-side determinants of diphtheria-pertussis-tetanus nonvaccination and dropout in rural India.
Article in Vaccine, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 30 papers.
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Who cites it
30 citing papers in PubMed, 53 citations in OpenAlex.
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- Vaccination coverage and its associated factors among children under-5 in Somalia.BMC public health · 2025Article
- A qualitative process evaluation of community-based participatory research and human-centered design in the 'Let's talk about vaccines' approach in Mozambique and Malawi.Research involvement and engagement · 2025Article
- Path to full immunisation coverage, role of each vaccine and their importance in the immunisation programme: a cross-sectional analytical study of India.BMJ public health · 2025Article
- Zero-dose children and the extended immunisation cascade: Understanding the path to full immunisation with six childhood vaccines in 43 countries.Journal of global health · 2024Article
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- Determinants and prevalence of zero-dose children in Somalia: Analysis of the 2020 Health Demographic Survey data.PLOS global public health · 2024Article
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- Determinants of Full Vaccination Coverage among Children Aged 12-23 Months in Bangladesh: A Comparison between High- and Low-Performing Divisions.International journal of pediatrics · 2024Article
- Exploring the Pattern of Immunization Dropout among Children in India: A District-Level Comparative Analysis.Vaccines · 2023Article
- Patterns in the Prevalence of Unvaccinated Children Across 36 States and Union Territories in India, 1993-2021.JAMA network open · 2023Article
- Observational
- Vaccination dropout and wealth related inequality among children aged 12-35 months in remote and underserved settings of Ethiopia: a cross-sectional evaluation survey.Frontiers in pediatrics · 2023Article
- Improving routine childhood immunisation outcomes in low-income and middle-income countries: an evidence gap map.BMJ open · 2022Review
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- Public health facility quality and child immunization outcomes in rural India: A decomposition analysis.Vaccine · 2022Article
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Authors and funding
2 authors at 2 institutions in 2 countries.
Funding
Abstract
backgroundAlthough 93% of 12- to 23-month-old children in India receive at least one vaccine, typically Bacillus Calmette-Guérin, only 75% complete the recommended three doses of diphtheria-pertussis-tetanus (DPT, also referred to as DTP) vaccine. Determinants can be different for nonvaccination and dropout but have not been examined in earlier studies. We use the three-dose DPT series as a proxy for the full sequence of recommended childhood vaccines and examine the determinants of DPT nonvaccination and dropout between doses 1 and 3.
methodsWe analyzed data on 75,728 6- to 23-month-old children in villages across India to study demand- and supply-side factors determining nonvaccination with DPT and dropout between DPT doses 1 and 3, using a multilevel approach. Data come from the District Level Household and Facility Survey 3 (2007-08).
resultsIndividual- and household-level factors were associated with both DPT nonvaccination and dropout between doses 1 and 3. Children whose mothers had no schooling were 2.3 times more likely not to receive any DPT vaccination and 1.5 times more likely to drop out between DPT doses 1 and 3, compared with children whose mothers had 10 or more years of schooling. Although supply-side factors related to availability of public health facilities and immunization-related health workers in villages were not correlated with dropout between DPT doses 1 and 3, children in districts where 46% or more villages had a healthcare subcentre were 1.5 times more likely to receive at least one dose of DPT vaccine compared with children in districts where 30% or fewer villages had subcentres.
conclusionsNonvaccination with DPT in India is influenced by village- and district-level contextual factors over and above individuals' background characteristics. Dropout between DPT doses 1 and 3 is associated more strongly with demand-side factors than with village- and district-level supply-side factors.
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