Abstract
BackgroundDespite the Indian government’s Universal Immunization Program (UIP), the progress of full immunization coverage is plodding. The cost of delivering routine immunization varies widely across facilities within country and across country. However, the cost an individual bears on child immunization has not been focussed. In this context, this study tries to estimate the expenditure on immunization which an individual bears and the factors affecting immunization coverage at the regional level.MethodsUsing the 75th round of National Sample Survey Organization data, the present paper attempts to check the individual expenditure on immunization and the factors affecting immunization coverage at the regional level. Descriptive statistics and multivariate regression analysis were used to fulfil the study objectives. The two-part model has been employed to inspect the determinants of expenditure on immunization.ResultsThe overall prevalence of full immunization was 59.3 % in India. Full immunization was highest in Manipur (75.2 %) and lowest in Nagaland (12.8 %). The mean expenditure incurred on immunization varies from as low as Rs. 32.7 in Tripura to as high as Rs. 1008 in Delhi. Children belonging to the urban area [OR: 1.04; CI: 1.035, 1.037] and richer wealth quintile [OR: 1.14; CI: 1.134–1.137] had higher odds of getting immunization. Moreover, expenditure on immunization was high among children from the urban area [Rs. 273], rich wealth quintile [Rs. 297] and who got immunized in a private facility [Rs. 1656].ConclusionsThere exists regional inequality in immunization coverage as well as in expenditure incurred on immunization. Based on the findings, we suggest looking for the supply through follow-up and demand through spreading awareness through mass media for immunization.
Highlights
Despite the Indian government’s Universal Immunization Program (UIP), the progress of full immunization coverage is plodding
The recent estimates on immunization coverage by World Health Organization (WHO) and UNICEF report that globally 19.5 million infants missed the routine immunization services, and 60 % of these children reside in developing countries which include India, Pakistan, Indonesia, Angola, Brazil, Srivastava et al BMC Health Services Research (2021) 21:1001 the Democratic Republic of the Congo, Ethiopia, Iraq, Nigeria, and South Africa [3]
From each stratum/ sub-stratum, first stage units (FSU) have been selected by Probability Proportional to Size With Replacement (PPSWR), size being the number of households of the Urban Frame Survey (UFS) Block
Summary
Despite the Indian government’s Universal Immunization Program (UIP), the progress of full immunization coverage is plodding. The cost an individual bears on child immunization has not been focussed In this context, this study tries to estimate the expenditure on immunization which an individual bears and the factors affecting immunization coverage at the regional level. The recent estimates on immunization coverage by WHO and UNICEF report that globally 19.5 million infants missed the routine immunization services, and 60 % of these children reside in developing countries which include India, Pakistan, Indonesia, Angola, Brazil, Srivastava et al BMC Health Services Research (2021) 21:1001 the Democratic Republic of the Congo, Ethiopia, Iraq, Nigeria, and South Africa [3]. Previous studies have highlighted individual predictive factors for vaccination, including gender, age, birth order, and other household factors such as family size, number of children below age 3 years, household wealth, caste, and maternal education [7,8,9]. Regress log coef. (95 % CI) Predicted mean health expenditure (in Rupees)
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