Inequalities in full immunization coverage: Trends in low-and middle-income countries

María Clara Restrepo-Méndez, Aluísio J D Barros, Kerry L M Wong, Hope L. Johnson, George Pariyo, Giovanny V A França, Fernando C. Wehrmeister, Cesar G. Victora

Research output: Contribution to journalArticle

Abstract

Objective To investigate disparities in full immunization coverage across and within 86 low- and middle-income countries. Methods In May 2015, using data from the most recent Demographic and Health Surveys and Multiple Indicator Cluster Surveys, we investigated inequalities in full immunization coverage i.e. one dose of bacille Calmette-Guérin vaccine, one dose of measles vaccine, three doses of vaccine against diphtheria, pertussis and tetanus and three doses of polio vaccine in 86 low- or middle-income countries. We then investigated temporal trends in the level and inequality of such coverage in eight of the countries. Findings In each of the World Health Organizations regions, it appeared that about 56-69% of eligible children in the low- and middle-income countries had received full immunization. However, within each region, the mean recorded level of such coverage varied greatly. In the African Region, for example, it varied from 11.4% in Chad to 90.3% in Rwanda. We detected pro-rich inequality in such coverage in 45 of the 83 countries for which the relevant data were available and pro-urban inequality in 35 of the 86 study countries. Among the countries in which we investigated coverage trends, Madagascar and Mozambique appeared to have made the greatest progress in improving levels of full immunization coverage over the last two decades, particularly among the poorest quintiles of their populations. Conclusion Most low-and middle - income countries are affected by pro-rich and pro-urban inequalities in full immunization coverage that are not apparent when only national mean values of such coverage are reported.

Original languageEnglish (US)
Pages (from-to)794-805A
JournalBulletin of the World Health Organization
Volume94
Issue number11
DOIs
StatePublished - Nov 1 2016

Fingerprint

Immunization
Chad
Diphtheria-Tetanus-Pertussis Vaccine
Rwanda
Mozambique
Measles Vaccine
BCG Vaccine
Madagascar
Poliomyelitis
Vaccines
Demography
Population

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health

Cite this

Restrepo-Méndez, M. C., Barros, A. J. D., Wong, K. L. M., Johnson, H. L., Pariyo, G., França, G. V. A., ... Victora, C. G. (2016). Inequalities in full immunization coverage: Trends in low-and middle-income countries. Bulletin of the World Health Organization, 94(11), 794-805A. https://doi.org/10.2471/BLT.15.162172

Inequalities in full immunization coverage : Trends in low-and middle-income countries. / Restrepo-Méndez, María Clara; Barros, Aluísio J D; Wong, Kerry L M; Johnson, Hope L.; Pariyo, George; França, Giovanny V A; Wehrmeister, Fernando C.; Victora, Cesar G.

In: Bulletin of the World Health Organization, Vol. 94, No. 11, 01.11.2016, p. 794-805A.

Research output: Contribution to journalArticle

Restrepo-Méndez, MC, Barros, AJD, Wong, KLM, Johnson, HL, Pariyo, G, França, GVA, Wehrmeister, FC & Victora, CG 2016, 'Inequalities in full immunization coverage: Trends in low-and middle-income countries', Bulletin of the World Health Organization, vol. 94, no. 11, pp. 794-805A. https://doi.org/10.2471/BLT.15.162172
Restrepo-Méndez, María Clara ; Barros, Aluísio J D ; Wong, Kerry L M ; Johnson, Hope L. ; Pariyo, George ; França, Giovanny V A ; Wehrmeister, Fernando C. ; Victora, Cesar G. / Inequalities in full immunization coverage : Trends in low-and middle-income countries. In: Bulletin of the World Health Organization. 2016 ; Vol. 94, No. 11. pp. 794-805A.
@article{6b1ffc55d6f0452c84df0de3f4888549,
title = "Inequalities in full immunization coverage: Trends in low-and middle-income countries",
abstract = "Objective To investigate disparities in full immunization coverage across and within 86 low- and middle-income countries. Methods In May 2015, using data from the most recent Demographic and Health Surveys and Multiple Indicator Cluster Surveys, we investigated inequalities in full immunization coverage i.e. one dose of bacille Calmette-Gu{\'e}rin vaccine, one dose of measles vaccine, three doses of vaccine against diphtheria, pertussis and tetanus and three doses of polio vaccine in 86 low- or middle-income countries. We then investigated temporal trends in the level and inequality of such coverage in eight of the countries. Findings In each of the World Health Organizations regions, it appeared that about 56-69{\%} of eligible children in the low- and middle-income countries had received full immunization. However, within each region, the mean recorded level of such coverage varied greatly. In the African Region, for example, it varied from 11.4{\%} in Chad to 90.3{\%} in Rwanda. We detected pro-rich inequality in such coverage in 45 of the 83 countries for which the relevant data were available and pro-urban inequality in 35 of the 86 study countries. Among the countries in which we investigated coverage trends, Madagascar and Mozambique appeared to have made the greatest progress in improving levels of full immunization coverage over the last two decades, particularly among the poorest quintiles of their populations. Conclusion Most low-and middle - income countries are affected by pro-rich and pro-urban inequalities in full immunization coverage that are not apparent when only national mean values of such coverage are reported.",
author = "Restrepo-M{\'e}ndez, {Mar{\'i}a Clara} and Barros, {Alu{\'i}sio J D} and Wong, {Kerry L M} and Johnson, {Hope L.} and George Pariyo and Fran{\cc}a, {Giovanny V A} and Wehrmeister, {Fernando C.} and Victora, {Cesar G.}",
year = "2016",
month = "11",
day = "1",
doi = "10.2471/BLT.15.162172",
language = "English (US)",
volume = "94",
pages = "794--805A",
journal = "Bulletin of the World Health Organization",
issn = "0042-9686",
publisher = "World Health Organization",
number = "11",

}

TY - JOUR

T1 - Inequalities in full immunization coverage

T2 - Trends in low-and middle-income countries

AU - Restrepo-Méndez, María Clara

AU - Barros, Aluísio J D

AU - Wong, Kerry L M

AU - Johnson, Hope L.

AU - Pariyo, George

AU - França, Giovanny V A

AU - Wehrmeister, Fernando C.

AU - Victora, Cesar G.

PY - 2016/11/1

Y1 - 2016/11/1

N2 - Objective To investigate disparities in full immunization coverage across and within 86 low- and middle-income countries. Methods In May 2015, using data from the most recent Demographic and Health Surveys and Multiple Indicator Cluster Surveys, we investigated inequalities in full immunization coverage i.e. one dose of bacille Calmette-Guérin vaccine, one dose of measles vaccine, three doses of vaccine against diphtheria, pertussis and tetanus and three doses of polio vaccine in 86 low- or middle-income countries. We then investigated temporal trends in the level and inequality of such coverage in eight of the countries. Findings In each of the World Health Organizations regions, it appeared that about 56-69% of eligible children in the low- and middle-income countries had received full immunization. However, within each region, the mean recorded level of such coverage varied greatly. In the African Region, for example, it varied from 11.4% in Chad to 90.3% in Rwanda. We detected pro-rich inequality in such coverage in 45 of the 83 countries for which the relevant data were available and pro-urban inequality in 35 of the 86 study countries. Among the countries in which we investigated coverage trends, Madagascar and Mozambique appeared to have made the greatest progress in improving levels of full immunization coverage over the last two decades, particularly among the poorest quintiles of their populations. Conclusion Most low-and middle - income countries are affected by pro-rich and pro-urban inequalities in full immunization coverage that are not apparent when only national mean values of such coverage are reported.

AB - Objective To investigate disparities in full immunization coverage across and within 86 low- and middle-income countries. Methods In May 2015, using data from the most recent Demographic and Health Surveys and Multiple Indicator Cluster Surveys, we investigated inequalities in full immunization coverage i.e. one dose of bacille Calmette-Guérin vaccine, one dose of measles vaccine, three doses of vaccine against diphtheria, pertussis and tetanus and three doses of polio vaccine in 86 low- or middle-income countries. We then investigated temporal trends in the level and inequality of such coverage in eight of the countries. Findings In each of the World Health Organizations regions, it appeared that about 56-69% of eligible children in the low- and middle-income countries had received full immunization. However, within each region, the mean recorded level of such coverage varied greatly. In the African Region, for example, it varied from 11.4% in Chad to 90.3% in Rwanda. We detected pro-rich inequality in such coverage in 45 of the 83 countries for which the relevant data were available and pro-urban inequality in 35 of the 86 study countries. Among the countries in which we investigated coverage trends, Madagascar and Mozambique appeared to have made the greatest progress in improving levels of full immunization coverage over the last two decades, particularly among the poorest quintiles of their populations. Conclusion Most low-and middle - income countries are affected by pro-rich and pro-urban inequalities in full immunization coverage that are not apparent when only national mean values of such coverage are reported.

UR - http://www.scopus.com/inward/record.url?scp=84994583216&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84994583216&partnerID=8YFLogxK

U2 - 10.2471/BLT.15.162172

DO - 10.2471/BLT.15.162172

M3 - Article

C2 - 27821882

AN - SCOPUS:84994583216

VL - 94

SP - 794-805A

JO - Bulletin of the World Health Organization

JF - Bulletin of the World Health Organization

SN - 0042-9686

IS - 11

ER -