Timeliness in the uptake of hepatitis B birth dose among Indian children under age five: A population-based study

Abstract

ObjectiveTo assess the timeliness and risk factors for the delay in the uptake of the hepatitis B birth dose among Indian children aged 0–59 months. Information regarding whether the children received the birth dose and the time of receiving it was recorded based on the vaccination card available at the time of the National Family Health Survey (NFHS). MethodsUsing data from the fourth and fifth round of India’s National Family Health Survey (NFHS), the percentage of uptake and timely receipt of the hepatitis B birth dose were obtained by background characteristics and at the sub-national level (state). Multinomial logistic regression analysis was used to examine the risk factors. This study further performed a negative binomial regression estimation to predict the probability of receiving the birth dose at each day within a multivariable framework. ResultsIt was found that approximately 34 % of the children who received the birth dose and the timing of receiving the birth dose was made available through the vaccination card were administered the dose within 24-hours during 2015–16. However, the percentage increased to 51.91 % during 2019–21. During 2019–21, Ladakh had the highest proportion (85.03 %) of children receiving the dose within 24-hours, followed by Jammu & Kashmir with 78 %, and Arunachal Pradesh with 68 %. Mother’s education, economic status of the child’s family and region (children belong from) were found to be significant predictors in delay of receiving the birth dose within 24 hours. ConclusionResults indicated a need for targeted interventions to improve the coverage and timeliness in the uptake of this critical vaccine dose in the country. These interventions could include strategies such as strengthening the healthcare system, improving awareness among parents and healthcare providers, addressing logistical challenges in vaccine delivery, and promoting community engagement and education on importance of timely vaccination.