Joe William
Institute of Economic Growth, University of Delhi Enclave, North Campus, Delhi 110007, India
Health Policy Plan. 2015 May;30(4):407-22. doi: 10.1093/heapol/czu023. Epub 2014 Apr 16.
Immunization in India is marked with stark disparities across gender, caste, wealth and place of residence with severe shortfalls among those disadvantaged in more than one dimension. In this regard, an explicit recognition of intersectionality and intersectional inequalities has 2-fold relevance; one, being the pathway of health inequality and the other being its role as a deterrent of progress particularly at higher (better) levels of health. Against this backdrop, this study examines intersectional inequalities in immunization in India and also suggests a level-sensitive progress assessment method. The study uses group analogue of Gini coefficient for highlighting the magnitude of intersectional inequality and for comprehending its association with immunization level. The results unravel the plight of vulnerable intersectional groups and draw attention to disquieting shortfalls among female SCST (scheduled castes and tribes) children from rural areas. There is also some evidence to indicate leveraging among rural males in matters of immunization and it is further discerned that such gender advantage is greater among rural non-SCST community than the rural SCST group. In concluding, the study calls for intensive immunization planning to improve coverage among vulnerable communities in both rural and urban areas.
印度的免疫接种存在明显的性别、种姓、财富和居住地点差异，在多个方面处于劣势的人群存在严重不足。在这方面，明确认识交叉性和交叉不平等具有两方面的相关性；其一，是健康不平等的途径；其二，是其作为进步阻碍的作用，尤其是在较高（更好）健康水平上。在此背景下，本研究考察了印度免疫接种中的交叉不平等，并提出了一种基于水平的进展评估方法。该研究使用基尼系数的群体类似物来突出交叉不平等的程度，并理解其与免疫接种水平的关联。结果揭示了弱势交叉群体的困境，并提请人们注意农村地区女性在册种姓和在册部落儿童令人不安的不足。也有一些证据表明农村男性在免疫接种方面存在优势，并且进一步发现这种性别优势在农村非在册种姓和在册部落社区比农村在册种姓和在册部落群体更大。总之，该研究呼吁进行密集的免疫接种规划，以提高农村和城市弱势社区的覆盖率。
