Department of Social Welfare, Keimyung University, Daegu 42601, Republic of Korea.
Department of Social Welfare, Yonsei University, Seoul 03722, Republic of Korea.
Int J Environ Res Public Health. 2023 Jan 18;20(3):1755. doi: 10.3390/ijerph20031755.
Identifying the inequalities associated with immunisation coverage among children is crucial. We investigated the factors associated with complete immunisation among 12- to 23-month-old children in five South Asian countries: Afghanistan, Bangladesh, India, Nepal, and Pakistan, using nationally representative data sets from the Demographic and Health Survey (DHS). Descriptive statistics, bivariate association, and logistic regression analyses were employed to identify the prevalence and the factors in each country that affect the likelihood of full childhood immunisation coverage. The complete childhood immunisation coverage varied significantly within each country in South Asia. Afghanistan had the lowest immunisation rates (42.6%), whereas Bangladesh ranked the highest in complete childhood immunisation rates, at 88.2%. Similarly, 77.1% of Indian children, 79.2% of Nepali children, and 62.2% of Pakistani children were completely immunised. Household wealth status strongly correlated with full childhood immunisation in Afghanistan, India, and Pakistan at the bivariate level. The results from the logistic regression showed that a higher maternal educational level had a statistically significant association with complete childhood immunisation in all countries compared to mothers who did not attend any school. In conclusion, the study revealed the inequalities of complete childhood immunisation within South Asia. Governments must be proactive in their endeavours to address universal and equitable vaccine coverage in collaboration with national and international stakeholders and in line with the relevant Sustainable Development Goals.
确定儿童免疫覆盖率相关的不平等现象至关重要。我们使用来自人口与健康调查（DHS）的具有全国代表性的数据集，调查了五个南亚国家（阿富汗、孟加拉国、印度、尼泊尔和巴基斯坦）12 至 23 个月大儿童完全免疫的相关因素。采用描述性统计、双变量关联和逻辑回归分析来确定每个国家的流行情况和影响儿童完全免疫覆盖率的因素。完全儿童免疫覆盖率在南亚每个国家内部存在显著差异。阿富汗的免疫率最低（42.6%），而孟加拉国的完全儿童免疫率最高，达到 88.2%。同样，77.1%的印度儿童、79.2%的尼泊尔儿童和 62.2%的巴基斯坦儿童完全免疫。家庭财富状况在双变量水平上与阿富汗、印度和巴基斯坦的完全儿童免疫密切相关。逻辑回归的结果表明，与未接受任何学校教育的母亲相比，所有国家中母亲教育程度较高与完全儿童免疫之间存在统计学上的显著关联。总之，该研究揭示了南亚内部完全儿童免疫的不平等现象。政府必须积极努力，与国家和国际利益相关者合作，根据相关可持续发展目标，实现普遍和公平的疫苗覆盖。
