Gender inequity and age-appropriate immunization coverage in India from 1992 to 2006

Daniel J. Corsi · Diego G. Bassani · Rajesh Kumar · Shally Awasthi · Raju Jotkar · Prabhat Jha

127 citations0/0 files storedBMC International Health and Human Rights

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Vaccine Coverage and Hesitancy Global Maternal and Child Health Demographic Trends and Gender Preferences

Abstract

BACKGROUND: A variety of studies have considered the affects of India's son preference on gender differences in child mortality, sex ratio at birth, and access to health services. Less research has focused on the affects of son preference on gender inequities in immunization coverage and how this may have varied with time, and across regions and with sibling compositions. We present a systematic examination of trends in immunization coverage in India, with a focus on inequities in coverage by gender, birth order, year of birth, and state. METHODS: We analyzed data from three consecutive rounds of the Indian National Family Health Survey undertaken between 1992 and 2006. All children below five years of age with complete immunization histories were included in the analysis. Age-appropriate immunization coverage was determined for the following antigens: bacille Calmette-Guérin (BCG), oral polio (OPV), diphtheria, pertussis (whooping cough) and tetanus (DPT), and measles. RESULTS: Immunization coverage in India has increased since the early 1990s, but complete, age-appropriate coverage is still under 50% nationally. Girls were found to have significantly lower immunization coverage (p<0.001) than boys for BCG, DPT, and measles across all three surveys. By contrast, improved coverage of OPV suggests a narrowing of the gender differences in recent years. Girls with a surviving older sister were less likely to be immunized compared to boys, and a large proportion of all children were found to be immunized considerably later than recommended. CONCLUSIONS: Gender inequities in immunization coverage are prevalent in India. The low immunization coverage, the late immunization trends and the gender differences in coverage identified in our study suggest that risks of child mortality, especially for girls at higher birth orders, need to be addressed both socially and programmatically. ABSTRACT IN HINDI : See the full article online for a translation of this abstract in Hindi.

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2017Economic and Political Weekly 2006The World Health report 2006 1 : Working together for health 2 1983On Kinship Structure, Female Autonomy, and Demographic Behavior in India 1987Selective Discrimination against Female Children in Rural Punjab, India 2003Selective Gender Differences in Childhood Nutrition and Immunization in Rural India: The Role of Siblings 1998Son Preference, the Family-building Process and Child Mortality in India 2006Low male-to-female sex ratio of children born in India: national survey of 1·1 million households 1997Fertility Decline and Increased Manifestation of Sex Bias in India

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