ArticleEClinicalMedicine2021
Assessing the overlap between immunisation and other essential health interventions in 92 low- and middle-income countries using household surveys: opportunities for expanding immunisation and primary health care.
Article in EClinicalMedicine, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 25 papers, 1 of them a synthesis that pooled it.
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Who cites it
25 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Vaccination in Forcibly Displaced, Pediatric Populations: A Systematic Review and Meta-Analysis.JAMA network open · 2025Pooled it
- Urban-rural disparities in primary health care utilization in Indonesia: a cross-sectional study.Korean journal of family medicine · 2026Article
- Gavi's Zero-Dose Learning Hubs: enhanced approach for evidence generation and use from local to global.Health policy and planning · 2026Article
- Article
- Can unvaccinated children be reached through mobile phones? Analyses of national cross-sectional surveys from 70 countries.Journal of global health · 2025Article
- The Immunization Agenda 2030 Strategy to reach zero-dose children in low-income and middle-income countries: a scoping review.BMJ global health · 2025Article
- Multiple deprivations as drivers of suboptimal basic child vaccination in Latin America and the Caribbean: cross-sectional analysis of household survey data for 18,136 children across 211 regions in 15 countries.International journal for equity in health · 2025Article
- Exploring the attitudes of healthcare professionals towards primary healthcare in northwest Syria.BMC primary care · 2025Article
- Does unintended birth lead to zero dose of DPT vaccine among children aged 12-23 months in India?Human vaccines & immunotherapeutics · 2024Article
- Inequalities in ownership and availability of home-based vaccination records in 82 low- and middle-income countries.BMJ global health · 2024Article
- Prevalence and Trends of Not Receiving a Dose of DPT-Containing Vaccine Among Children 12-35 Months: An Analysis of 81 Low- And Middle-Income Countries.Journal of epidemiology and global health · 2024Article
- Article
- 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
- Assessing Geographic Overlap between Zero-Dose Diphtheria-Tetanus-Pertussis Vaccination Prevalence and Other Health Indicators.Vaccines · 2023Article
- Why Reaching Zero-Dose Children Holds the Key to Achieving the Sustainable Development Goals.Vaccines · 2023Article
- Article
- Mapping of Pro-Equity Interventions Proposed by Immunisation Programs in Gavi Health Systems Strengthening Grants.Vaccines · 2023Article
- Article
- Article
- Essential childhood immunization in 43 low- and middle-income countries: Analysis of spatial trends and socioeconomic inequalities in vaccine coverage.PLoS medicine · 2023Article
Corrections and comments
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Authors and funding
6 authors.
Funding
Abstract
backgroundUnvaccinated children may live in households with limited access to other primary health care (PHC) services, and routine vaccination services may provide the opportunity to bring caregivers into contact with the health system. We aimed to investigate the overlap between not being vaccinated and failing to receive other PHC services in low- and middle-income countries (LMICs).
methodsUsing Demographic and Health Surveys (DHS) and Multiple Indicator Cluster Surveys (MICS) data between 2010-2019 from 92 LMICs, we analysed six vaccination indicators based on the bacille Calmette-Guérin (BCG), polio, diphtheria-pertussis-tetanus (DPT) and measles vaccines and their overlap with four other PHC indicators - at least four antenatal care (ANC) visits, institutional delivery, careseeking for common childhood illnesses or symptoms and place for handwashing in the home - in 211,141 children aged 12-23 months. Analyses were stratified according to wealth quintiles and World Bank income levels.
findingsUnvaccinated children and their mothers were systematically less likely to receive the other PHC interventions. These associations were particularly marked for 4+ ANC visits and institutional delivery and modest for careseeking behaviour. Our stratified analyses confirm a systematic disadvantage of unvaccinated children and their families with respect to obtaining other health services in all levels of household wealth and country income.
interpretationWe suggested that lack of vaccination goes hand in hand with missing out on other health interventions. This represents an opportunity for integrated delivery strategies that may more efficiently reduce inequalities in health service coverage.
fundingBill & Melinda Gates Foundation, Gavi, the Vaccine Alliance, The Wellcome Trust, Associação Brasileira de Saúde Coletiva and Coordenação de Aperfeiçoamento de Pessoal de Nível Superior.
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