ArticleIndian journal of pediatrics2026
Decomposition of Wealth-Related Inequality in Child Immunization Among Aspirational and Non-Aspirational Districts in India.
Article in Indian journal of pediatrics, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectivesTo determine the change in inequalities in full immunization coverage among children aged 12-23 mo in aspirational districts (ADs) and non-aspirational districts (NADs) in India from 2015-16 to 2019-2021 and decompose its causes.
methodsThe authors used the National Family Health Survey (NFHS-4 and NFHS-5) data for the analysis. The two-sample proportions test and linear probability model were used. Further, the corrected concentration index (CCI) was used to measure inequality, and Wagstaff’s decomposition analysis was used to decompose the inequality.
resultsFull immunization coverage among Indian children increased from 60.91% (NFHS-4) to 75.97% (NFHS-5) in NADs, and from 57.93% to 74.73% in ADs. The study shows an important finding of convergence of immunization estimates among ADs and NADS during NFHS-5. Inequality in child immunization, measured by CCI, decreased from NFHS-4 to NFHS-5 but remained higher in ADs. Mother’s education, healthcare utilization variables, residence, and region are the key contributors to immunization inequality.
conclusionsThe findings suggest that the focus should be on improving mothers’ education, providing health cards, and antenatal care visits, and reducing the distance to health facilities. Improving the provision of healthcare utilization variables can help mitigate inequalities in full immunization coverage, especially in ADs, thereby reducing inequalities between ADs and NADs.
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