Abstract
BackgroundVaccination is considered as a powerful and cost-effective weapon against many communicable diseases. An increase in full vaccination among the most vulnerable populations in Bangladesh was observed in the last decade. This study aimed to capture the socioeconomic inequalities in non-coverage of full vaccination among children aged 12–23 months using the nationally representative data from the Bangladesh Demographic and Health Surveys (BDHS).MethodsData for this study have been drawn from the 2007 and 2017–18 BDHS, which covered 10,996 and 20,127 ever-married women aged 15–49 years in 2007 and 2017–18, respectively. Binary logistic regression analysis was performed to find the factors associated with children who did not receive full vaccination. Further, the concentration index was used to observe the socioeconomic inequality for the outcome variable.ResultsThe proportion of children who did not get fully vaccinated decreased by more than 6 points (18.2 percent to 11.8 percent) between the years 2007 and 2017–18. In 2017–18, the odds of children who were not fully vaccinated were 58 percent and 53 percent less among mothers who had primary education in 2007 [adjusted odds ratio (AOR): 0.42; confidence interval (CI): 0.24–0.73] and 2017–18 [AOR: 0.47; CI: 0.23–0.94] respectively, compared to mothers with no education. The inequality for children who were not fully vaccinated had declined between two survey periods [concentration index (CCI) value of − 0.13 in 2007 and -0.08 in 2017–18]. The concentration of inequality in children with higher parity who did not receive full vaccination had increased from 5 percent in 2007 to 16.9 percent in 2017–18. There was a drastic increase in the socioeconomic inequality contributed by place of delivery from 2.9 percent (2007) to 60.5 percent (2017–18) among children who did not receive full vaccination.ConclusionsThe present study provide eminent evidence that non-coverage of full vaccination is more prevalent among children from poor households in Bangladesh, which is mainly associated with factors like mother’s education, father’s education and working status and household wealth index across the two rounds. These factors suggest multifaceted pro-poor interventions that will protect them from hardship and reduce their socioeconomic inequalities in coverage of full vaccination.
Highlights
Vaccination is considered as a powerful and cost-effective weapon against many communicable diseases
This study aimed to capture the socioeconomic inequalities in non-coverage of full vaccination status among children aged 12–23 months using the nationally representative Demographic and Health Surveys (DHS) datasets
Using two rounds of Bangladesh Demographic and Health Surveys (BDHS), our study revealed that most of the non-coverage in full vaccination occurs in poor households over time
Summary
Vaccination is considered as a powerful and cost-effective weapon against many communicable diseases. This study aimed to capture the socioeconomic inequalities in non-coverage of full vaccination among children aged 12–23 months using the nationally representative data from the Bangladesh Demographic and Health Surveys (BDHS). Studies showed an absolute inequality in childhood vaccination coverage which is advantageous for male and urban residing children in the south and southeast regions [9,10,11]. Factors that hinder achieving complete childhood vaccination coverage include inadequacy of health services, lack of parental education, poverty, and traditional beliefs in society [12,13,14]. Evidence suggests that parental education, work status and household economic status are the most influential factors in reducing childhood vaccination inequality in poor societies [15,16,17].
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