|Status and determinants of child immunisation coverage in three South Asian countries, India, Bangladesh and Nepal: Evidence from the Demographic and Health Survey|
||Illias Kanchan Sk, Firoz Sk, Prashika Rajendra Kurlikar, Mithlesh Chourase, Rajaram Yadav, and Abhijit Basu Biswas
||Sri Lanka Journal of Child Health, 47(1): 56-63
Multiple Asian Countries
||Background: Vaccination is the most cost-effective intervention to improve health and reduce morbidity and mortality due to vaccine-preventable diseases in the child population. The South Asian region was home to 1.8 of the 6 million babies who died within twenty-eight days of birth in 2015.
Objective: To describe the status and its determinants of immunisation coverage in three South Asian countries, India, Bangladesh and Nepal.
Method: The study utilized data from the Demographic Health Surveys of India, Bangladesh and Nepal. We used the principal component analysis (PCA) to compute the wealth index. Descriptive statistics, bivariate analysis and multivariate logistic regression model were utilised to access the status and factors associated with immunisation coverage.
Results:The study found increasing trends in immunisation coverage in India, Bangladesh and Nepal. More than 85% of children from Nepal and Bangladesh were fully immunised in contrast to 43.6% from India. There was a wide variation in child immunisation coverage in terms of socioeconomic and demographic factors. Multivariate logistic regression revealed that factors like mother’s age, residence, birth order and religion had minimal impact on complete immunisation coverage. However, mother’s education and wealth index appeared as the significant confounding factors of full immunization coverage. Children belonging to the higher educated and rich families were more likely to be fully immunised. Maximum impact of education (AOR=9.833; p<0.01) and wealth index (AOR=8.105; p<0.01) were observed in 2006 and 2011 respectively in Nepal.
Conclusions: More than 85% of children from Nepal and Bangladesh were fully immunised in contrast to 43.6% from India. Mother’s education and wealth index appeared to have a significant impact on full immunization coverage.