Institute of Immunization and Prevention, Zhejiang Center for Disease Control and Prevention, Hangzhou 310000, China.
Int J Environ Res Public Health. 2018 Sep 13;15(9):2000. doi: 10.3390/ijerph15092000.
: The objectives of this study were to determine the degree and risk factors of the inequity in the childhood coverage of full primary immunization (FPI) in Zhejiang province. : We used data from two rounds of vaccination coverage surveys among children aged 24⁻35 months conducted in 2014 and 2017, respectively. The household income per month was used as an index of socioeconomic status for the inequality analysis. The concentration index (CI) was used to quantify the degree of inequality, and the decomposition approach was applied to quantify the contributions from demographic factors to inequality in the coverage of FPI. : The coverage rates of FPI were 80.6%, with a CI value of 0.12028 for the 2014 survey, while the coverage rates of FPI were 85.2%, with a CI value of 0.10129 for the 2017 survey. The results of decomposition analysis suggested that 68.2% and 67.1% of the socioeconomic inequality in the coverage of FPI could be explained by the mother's education level for the 2014 and 2017 survey, respectively. Other risk factors including birth order, ethnic group, mother's age, maternal employment status, residence, immigration status, GDP per-capita, and the percentage of the total health spending allocated to public health could also explain this inequality. : The socioeconomic inequity in the coverage of FPI still remained, although this gap was reduced between 2014 and 2017. Policy recommendations for health interventions on reducing the inequality in the coverage of FPI should be focused on eliminating poverty and women's illiteracy.
: 本研究旨在确定浙江省儿童完全基础免疫(FPI)覆盖率的不平等程度和相关风险因素。 : 我们使用了分别于 2014 年和 2017 年进行的两轮 24-35 月龄儿童疫苗接种率调查的数据。家庭月收入用作社会经济地位不平等分析的指标。使用集中指数(CI)来量化不平等程度,并应用分解方法来量化人口因素对 FPI 覆盖率不平等的贡献。 : FPI 的覆盖率分别为 80.6%,2014 年调查的 CI 值为 0.12028,而 2017 年调查的 FPI 覆盖率为 85.2%,CI 值为 0.10129。分解分析的结果表明,2014 年和 2017 年,母亲教育水平分别可以解释 FPI 覆盖率社会经济不平等的 68.2%和 67.1%。其他风险因素,包括出生顺序、民族、母亲年龄、母亲就业状况、居住地、移民状况、人均国内生产总值和公共卫生总支出占比,也可以解释这种不平等。 : 尽管 2014 年至 2017 年间差距有所缩小,但 FPI 覆盖率仍存在社会经济不平等。针对减少 FPI 覆盖率不平等的卫生干预政策建议应侧重于消除贫困和妇女文盲。