Kulkarni Shashwat, Thampi Varun, Deshmukh Devika, Gadhari Mangesh, Chandrasekar Rajeshwari, Phadke Mrudula
RJMC Health and Nutrition Mission, Department of Women and Child Development, Government of Maharashtra, Mumbai, India.
UNICEF Office for Maharashtra, Mumbai, Maharashtra, India.
Indian J Pediatr. 2023 Jan;90(1):38-48. doi: 10.1007/s12098-021-03843-0. Epub 2021 Sep 16.
To assess the gaps and trends in child immunization coverage among urban and rural areas in India, and compare the success of immunisation program in each.
PubMed, Scopus, and Crossref, and Google Scholar electronic databases were searched on October 9, 2019, and March 21, 2020, for studies that measured and reported immunization coverage indicators in India. Random-effects meta-analyses and meta-regressions were conducted.
The authors' search identified 545 studies, and 2 were obtained by expert suggestion. Among these 68 studies and 6 surveys were included. They found that full immunization coverage has grown yearly at 2.65% and 0.82% in rural and urban areas, respectively whereas partial immunization coverage declined by -2.44% and -0.69%, respectively. Percentage of nonimmunized children did not show a statistically significant trend in either.
While rural immunization coverage has seen a large increase over the past two decades, the progress in urban areas is weak and negligible. This was largely attributable to a focus on minimizing dropouts in rural areas. However, a lack of significant reduction in unimmunized children may indicate left-out children or pockets in both rural and urban areas. The poor performance of immunization programs in urban areas, coupled with a larger impact of COVID-19, warrants that India urgently adopts urban-sensitive and urban-focused policies and programs.
评估印度城乡儿童免疫接种覆盖率的差距和趋势，并比较各自免疫规划的成效。
于2019年10月9日和2020年3月21日检索了PubMed、Scopus、Crossref以及谷歌学术电子数据库，以查找衡量并报告印度免疫接种覆盖率指标的研究。进行了随机效应荟萃分析和荟萃回归分析。
作者的检索共识别出545项研究，通过专家建议又获得了2项研究。在这6项研究中，纳入了68项研究和6项调查。他们发现，农村和城市地区的全程免疫接种覆盖率分别以每年2.65%和0.82%的速度增长，而部分免疫接种覆盖率分别下降了-2.44%和-0.69%。未接种疫苗儿童的比例在两者中均未显示出统计学上的显著趋势。
虽然农村免疫接种覆盖率在过去二十年中有大幅提高，但城市地区的进展微弱且可忽略不计。这在很大程度上归因于对农村地区辍学率最小化的关注。然而，未接种疫苗儿童数量没有显著减少，这可能表明农村和城市地区都存在被遗漏的儿童或群体。城市地区免疫规划的不佳表现，再加上新冠疫情的更大影响，促使印度迫切需要采取对城市敏感且以城市为重点的政策和方案。
