Correction: Gender Based Within-Household Inequality in Childhood Immunization in India: Changes over Time and across Regions.
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ABSTRACT:
SUBMITTER: Singh A
PROVIDER: S-EPMC5336290 | biostudies-literature | 2017
REPOSITORIES: biostudies-literature
Publications
Correction: Gender Based Within-Household Inequality in Childhood Immunization in India: Changes over Time and across Regions.
PloS one 20170303 3
[This corrects the article DOI: 10.1371/journal.pone.0035045.]. ...[more]
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Project description:Background and objectivesDespite India's substantial economic growth in the past two decades, girls in India are discriminated against in access to preventive healthcare including immunizations. Surprisingly, no study has assessed the contribution of gender based within-household discrimination to the overall inequality in immunization status of Indian children. This study therefore has two objectives: to estimate the gender based within-household inequality (GWHI) in immunization status of Indian children and to examine the inter-regional and inter-temporal variations in the GWHI.Data and methodsThe present study used households with a pair of male-female siblings (aged 1-5 years) from two rounds of National Family Health Survey (NFHS, 1992-93 and 2005-06). The overall inequality in the immunization status (after controlling for age and birth order) of children was decomposed into within-households and between-households components using Mean log deviation to obtain the GWHI component. The analysis was conducted at the all-India level as well as for six specified geographical regions and at two time points (1992-93 and 2005-06). Household fixed-effects models for immunization status of children were also estimated.Results and conclusionsFindings from household fixed effects analysis indicated that the immunization scores of girls were significantly lower than that of boys. The inequality decompositions revealed that, at the all-India level, the absolute level of GWHI in immunization status decreased from 0.035 in 1992-93 to 0.023 in 2005-06. However, as a percentage of total inequality, it increased marginally (15.5% to 16.5%). In absolute terms, GWHI decreased in all the regions except in the North-East. But, as a percentage of total inequality it increased in the North-Eastern, Western and Southern regions. The main conclusions are the following: GWHI contributes substantially to the overall inequality in immunization status of Indian children; and though the overall inequality in immunization status declined in all the regions, the changes in GWHI were mixed.
| S-EPMC3324412 | biostudies-literature
Project description:BackgroundRecent evidence indicated that gender disparity in child health is minimal and narrowed over time in India. However, considering the geographical and socio-cultural diversity in India, the gender gap may persist across disaggregated socioeconomic context which may be masked by average level. This study examines the dynamics of gender disparity in childhood immunization across regions, residence, wealth, caste and religion in India during 1992-2006.MethodWe used multi-waves of the cross-sectional data of National Family Health Survey conducted in India between 1992-93 and 2005-06. Gender disparity ratio was used to measure the gender gap in childhood immunization across the selected socioeconomic characteristics. Multinomial regression analysis was used to examine the gender gap after accounting for other covariates.ResultResults indicate that, at aggregate level, gender disparity in full immunization is minimal and has stagnated during the study period. However, gender disparity--disfavouring female children--becomes apparent across the regions, poor households, and religion--particularly among Muslims. Adjusted gender disparity ratio indicates that, full immunization is lower among female than male children of the western region, poor household and among Muslims. Between 1992-93 and 2005-06, the disparity in full immunization had narrowed in the northern region whereas it had, astonishingly, increased in some of the western and southern states of the country.ConclusionOur findings emphasize the need to integrate gender issues in the ongoing immunization programme in India, with particular attention to urban areas, developed states, and to the Muslim community.
| S-EPMC4134226 | biostudies-literature
Project description:BACKGROUND:Childhood immunization is one of the most cost-effective interventions for child health. Still, many children are not able to receive completed immunization status. Wealth - related inequality in immunization is considered a major reason for equitable coverage of immunization in Pakistan. Therefore, we examine wealth-related inequality in completed childhood immunization and to assess achievement indices across geographical regions in Pakistan. METHODS:The analysis was based on a nationally representative demographic and health survey (DHS) of Pakistan, conducted in 2012-13. We examined completed childhood (12-23 months) immunization in the various regions of the country and we used concentration, extended concentration and achievement indices to demonstrate inequality across geographical regions in Pakistan. RESULTS:Inequality in completed childhood immunization was seen in Pakistan with concentration index (CI) of 0.181 (95% CI: 0.164-0.209). Regions with high average of complete immunization showed lower inequality except for Sindh. Despite having better average immunization coverage in Kyber Pakhtunkhwa, the relative change of 128% in concentration index (CI) from C2 (standard CI) to C5 (when poorer quantile received highest weights) shows this to be also the most inequitable regions. Four parameters of inequality aversion (v = 2, 3, 4 & 5) demonstrated that 'dis - achievement' in completed immunization is densely concentrated among the poorer regions. Balochistan, Sindh and Gilgit Baltistan exhibited broader inequality gaps (93.75%, 83.35%, and 54.93%, respectively) at higher aversion parameter. CONCLUSIONS:As hypothesized, achievement index uncovers 'penalized' immunization coverage amongst the poorest population. Thus any policy that stringently focuses on improving average immunization rate without any strategy to deal with inequality will only improve immunization rate within wealthier groups. Based on these results, it is advisable to public health policy makers to use both aspect of information: average and degree of inequality in immunization coverage.
| S-EPMC6098575 | biostudies-literature
Project description:This study explores the association between childhood immunization and gender inequality at the national level. Data for the study include annual country-level estimates of immunization among children aged 12-23 months, indicators of gender inequality, and associated factors for up to 165 countries from 2010-2019. The study examined the association between gender inequality, as measured by the gender development index and the gender inequality index, and two key outcomes: prevalence of children who received no doses of the DTP vaccine (zero-dose children) and children who received the third dose of the DTP vaccine (DTP3 coverage). Unadjusted and adjusted fractional logit regression models were used to identify the association between immunization and gender inequality. Gender inequality, as measured by the Gender Development Index, was positively and significantly associated with the proportion of zero-dose children (high inequality AOR = 1.61, 95% CI: 1.13-2.30). Consistently, full DTP3 immunization was negatively and significantly associated with gender inequality (high inequality AOR = 0.63, 95% CI: 0.46-0.86). These associations were robust to the use of an alternative gender inequality measure (the Gender Inequality Index) and were consistent across a range of model specifications controlling for demographic, economic, education, and health-related factors. Gender inequality at the national level is predictive of childhood immunization coverage, highlighting that addressing gender barriers is imperative to achieve universal coverage in immunization and to ensure that no child is left behind in routine vaccination.
| S-EPMC9317382 | biostudies-literature
Project description:The use of solid cooking fuels-wood, straw, crop residue, and cow-dung cakes-is associated with higher levels of environmental pollution and health burden. However, even in an era when incomes have grown and poverty has declined, the proportion of Indian households using clean cooking fuels such as kerosene or Liquefied Petroleum Gas (LPG) has increased only slightly. Even among the wealthiest quintile, only about 40 percent of the households rely solely on clean fuel. Since the chores of cooking and collection of fuel remain primarily the domain of women, we argue that intra-household gender inequalities play an important role in shaping the household decision to invest in clean fuel. Analyses using data from the India Human Development Survey (IHDS), a panel survey of over 41,000 households conducted in two waves in 2004-05 and 2011-12, respectively, show that women's access to salaried work and control over household expenditure decisions is associated with the use of clean fuel.
| S-EPMC7307322 | biostudies-literature
Project description:While correlations between maternal education and child health have been observed in diverse parts of the world, the causal pathways explaining how maternal education improves child health remain far from clear. Using data from the nationally representative India Human Development Survey of 2004-5, this analysis examines four possible pathways that may mediate the influence of maternal education on childhood immunization: greater human, social, and cultural capitals and more autonomy within the household. Data from 5287 households in India show the familiar positive relationship between maternal education and childhood immunization even after extensive controls for socio-demographic characteristics and village- and neighborhood-fixed effects. Two pathways are important: human capital (health knowledge) is an especially important advantage for mothers with primary education, and cultural capital (communication skills) is important for mothers with some secondary education and beyond.
| S-EPMC3495071 | biostudies-literature
Project description:The gender pay gap has been observed for decades, and still exists. Due to a life course perspective, gender differences in income are analyzed over a period of 24 years. Therefore, this study aims to investigate income trajectories and the differences regarding men and women. Moreover, the study examines how human capital determinants, occupational positions and factors that accumulate disadvantages over time contribute to the explanation of the GPG in Germany. Therefore, this study aims to contribute to a better understanding of the GPG over the life course. The data are based on the German cohort study lidA (living at work), which links survey data individually with employment register data. Based on social security data, the income of men and women over time are analyzed using a multilevel analysis. The results show that the GPG exists in Germany over the life course: men have a higher daily average income per year than women. In addition, the income developments of men rise more sharply than those of women over time. Moreover, even after controlling for factors potentially explaining the GPG like education, work experience, occupational status or unemployment episodes the GPG persists. Concluding, further research is required that covers additional factors like individual behavior or information about the labor market structure for a better understanding of the GPG.
| S-EPMC8733696 | biostudies-literature
Project description:BackgroundDespite the Indian government's Universal Immunization Program (UIP), the progress of full immunization coverage is plodding. The cost of delivering routine immunization varies widely across facilities within country and across country. However, the cost an individual bears on child immunization has not been focussed. In this context, this study tries to estimate the expenditure on immunization which an individual bears and the factors affecting immunization coverage at the regional level.MethodsUsing the 75th round of National Sample Survey Organization data, the present paper attempts to check the individual expenditure on immunization and the factors affecting immunization coverage at the regional level. Descriptive statistics and multivariate regression analysis were used to fulfil the study objectives. The two-part model has been employed to inspect the determinants of expenditure on immunization.ResultsThe overall prevalence of full immunization was 59.3 % in India. Full immunization was highest in Manipur (75.2 %) and lowest in Nagaland (12.8 %). The mean expenditure incurred on immunization varies from as low as Rs. 32.7 in Tripura to as high as Rs. 1008 in Delhi. Children belonging to the urban area [OR: 1.04; CI: 1.035, 1.037] and richer wealth quintile [OR: 1.14; CI: 1.134-1.137] had higher odds of getting immunization. Moreover, expenditure on immunization was high among children from the urban area [Rs. 273], rich wealth quintile [Rs. 297] and who got immunized in a private facility [Rs. 1656].ConclusionsThere exists regional inequality in immunization coverage as well as in expenditure incurred on immunization. Based on the findings, we suggest looking for the supply through follow-up and demand through spreading awareness through mass media for immunization.
| S-EPMC8459463 | biostudies-literature
Project description:The association between aerosol and lightning has been investigated with long-term decadal data (2005-2014) for lightning, aerosol optical depth (AOD), relative humidity, and effective cloud droplet size. To understand the complex relationship between aerosol and lightning, two different regions with different climatic and weather conditions, a humid region R1 (22°-29° N, 89°-92° E) and an arid region R2 (23°-28° N, 70°-76° E) of northern India, were chosen for the study domain. The results show that lightning activity was observed to occur more over the humid region R1, i.e., 1141 days (1/3 of total days), than over the arid region R2, i.e., 740 days (1/5 of total days). Also, over the humid region R1, the highest lightning flash density was recorded as nearly 4.6 × 10-4 flashes/km2/day observed for 18 days (1.5%); on the contrary, over the arid region R2, the maximum lightning flash density was observed to be 2.5 × 10-4 flashes/km2/day and occurred for about 22 days (2.9%). The analysis shows that a nonlinear relationship exists between aerosol and lightning with a highly associated influence of relative humidity. A very significant positive and negative co-relation that varies with relative humidity has been observed between AOD and lightning for both humid and arid regions. This shows relative humidity is the key factor in determining the increase or decrease of lightning activity. This study also shows that the larger the cloud droplet size, the higher the relative humidity and vice versa. This study emphasizes that aerosol concentration in the atmosphere influences cloud microphysics by modulating the size of cloud droplets and thereby regulating the lightning frequency. The atmospheric humidity is the driving factor in deciding the positive or negative co-relationship between aerosol and lightning.Supplementary informationThe online version contains supplementary material available at 10.1007/s00024-022-02981-6.
| S-EPMC8883017 | biostudies-literature
Project description:Immunization through vaccines among children has contributed to improved childhood survival and health outcomes globally. However, vaccine coverage among children is unevenly distributed across settings and populations. The measurement of inequalities is essential for understanding gaps in vaccine coverage affecting certain sub-populations and monitoring progress towards achieving equity. Our study aimed to characterize the methods of reporting inequalities in childhood vaccine coverage, inclusive of the settings, data source types, analytical methods, and reporting modalities used to quantify and communicate inequality. We conducted a scoping review of publications in academic journals which included analyses of inequalities in vaccination among children. Literature searches were conducted in PubMed and Web of Science and included relevant articles published between 8 December 2013 and 7 December 2023. Overall, 242 publications were identified, including 204 assessing inequalities in a single country and 38 assessing inequalities across more than one country. We observed that analyses on inequalities in childhood vaccine coverage rely heavily on Demographic Health Survey (DHS) or Multiple Indicator Cluster Surveys (MICS) data (39.3%), and papers leveraging these data had increased in the last decade. Additionally, about half of the single-country studies were conducted in low- and middle-income countries. We found that few studies analyzed and reported inequalities using summary measures of health inequality and largely used the odds ratio resulting from logistic regression models for analyses. The most analyzed dimensions of inequality were economic status and maternal education, and the most common vaccine outcome indicator was full vaccination with the recommended vaccine schedule. However, the definition and construction of both dimensions of inequality and vaccine coverage measures varied across studies, and a variety of approaches were used to study inequalities in vaccine coverage across contexts. Overall, harmonizing methods for selecting and categorizing dimensions of inequalities as well as methods for analyzing and reporting inequalities can improve our ability to assess the magnitude and patterns of inequality in vaccine coverage and compare those inequalities across settings and time.
| S-EPMC11360733 | biostudies-literature