Evidence map›Paper›PMID 33933038›Full record

ArticleBMC public health2021

Change in full immunization inequalities in Indian children 12-23 months: an analysis of household survey data.

Brian Wahl, Madhu Gupta, Daniel J Erchick, Bryan N Patenaude, Taylor A Holroyd, Molly Sauer, Madeleine Blunt, Mathuram Santosham, Rupali Jayant Limaye

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in BMC public health, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
21citing papers in PubMed, 1 pooled it
2.5field-weighted citation impact, top 9% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

21 citing papers in PubMed, 1 synthesis or guideline pooled it, 29 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 2 institutions in 2 countries.

Brian Wahl *Department of International Health, Johns Hopkins Bloomberg School of Public Health, 415 N Washington Street, Floor 5, Baltimore, MD, 21231, USA. bwahl@jhu.edu.
Madhu Gupta *Department of Community Medicine and School of Public Health, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
Daniel J ErchickDepartment of International Health, Johns Hopkins Bloomberg School of Public Health, 415 N Washington Street, Floor 5, Baltimore, MD, 21231, USA.
Bryan N PatenaudeDepartment of International Health, Johns Hopkins Bloomberg School of Public Health, 415 N Washington Street, Floor 5, Baltimore, MD, 21231, USA.
Taylor A HolroydDepartment of International Health, Johns Hopkins Bloomberg School of Public Health, 415 N Washington Street, Floor 5, Baltimore, MD, 21231, USA.
Molly SauerDepartment of International Health, Johns Hopkins Bloomberg School of Public Health, 415 N Washington Street, Floor 5, Baltimore, MD, 21231, USA.
Madeleine BluntDepartment of International Health, Johns Hopkins Bloomberg School of Public Health, 415 N Washington Street, Floor 5, Baltimore, MD, 21231, USA.
Mathuram SantoshamDepartment of International Health, Johns Hopkins Bloomberg School of Public Health, 415 N Washington Street, Floor 5, Baltimore, MD, 21231, USA.
Rupali Jayant LimayeDepartment of International Health, Johns Hopkins Bloomberg School of Public Health, 415 N Washington Street, Floor 5, Baltimore, MD, 21231, USA.
Johns Hopkins University · USPost Graduate Institute of Medical Education and Research · IN

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundIndia has made substantial progress in improving child health in recent years. However, the country continues to account for a large number of vaccine preventable child deaths. We estimated wealth-related full immunization inequalities in India. We also calculated the degree to which predisposing, reinforcing, and enabling factors contribute to these inequalities.

methodsWe used data from the two rounds of a large nationally representative survey done in all states in India in 2005-06 (n = 9582) and 2015-16 (n = 49,284). Full immunization status was defined as three doses of diphtheria-tetanus-pertussis vaccine, three doses of polio vaccine, one dose of Bacillus Calmette-Guérin vaccine, and one dose of measles vaccine in children 12-23 months. We compared full immunization coverage by wealth quintiles using descriptive statistics. We calculated concentration indices for full immunization coverage at the national and state levels. Using predisposing, reinforcing, and enabling factors associated with full immunization status identified from the literature, we applied a generalized linear model (GLM) framework with a binomial distribution and an identity link to decompose the concentration index.

resultsNational full immunization coverage increased from 43.65% in 2005-06 to 62.46% in 2015-16. Overall, full immunization coverage in both 2005-06 and 2015-16 in all states was lowest in children from poorer households and improved with increasing socioeconomic status. The national concentration index decreased from 0.36 to 0.13 between the two study periods, indicating a reduction in poor-rich inequality. Similar reductions were observed for most states, except in states where inequalities were already minimal (i.e., Tamil Nadu) and in some northeastern states (i.e., Meghalaya and Manipur). In 2005-06, the contributors to wealth-related full immunization inequality were antenatal care, maternal education, and socioeconomic status. The same factors contributed to full immunization inequality in 2015-16 in addition to difficulty reaching a health facility.

conclusionsImmunization coverage and wealth-related equality have improved nationally and in most states over the last decade in India. Targeted, context-specific interventions could help address overall wealth-related full immunization inequalities. Intensified government efforts could help in this regard, particularly in high-focus states where child mortality remains high.

Indexed as

VaccinationVaccination CoverageChildFemaleHumansImmunizationImmunization ProgramsIndiaInfantPregnancySocioeconomic FactorsChild healthImmunizationIndiaInequalities

Identifiers

PMID33933038
PMCPMC8088616
OpenAlexW3159576248

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.