Economic-Related Inequalities in Zero-Dose Children: A Study of Non-Receipt of Diphtheria–Tetanus–Pertussis Immunization Using Household Health Survey Data from 89 Low- and Middle-Income Countries
Despite advances in scaling up new vaccines in low- and middle-income countries, the global number of unvaccinated children has remained high over the past decade. We used 2000–2019 household survey data from 154 surveys representing 89 low- and middle-income countries to assess within-country, econ...
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| Format: | Article |
| Language: | English |
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MDPI AG
2022-04-01
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| Series: | Vaccines |
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| Online Access: | https://www.mdpi.com/2076-393X/10/4/633 |
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| author | Nicole Bergen Bianca O. Cata-Preta Anne Schlotheuber Thiago M. Santos M. Carolina Danovaro-Holliday Tewodaj Mengistu Samir V. Sodha Daniel R. Hogan Aluisio J. D. Barros Ahmad Reza Hosseinpoor |
| author_facet | Nicole Bergen Bianca O. Cata-Preta Anne Schlotheuber Thiago M. Santos M. Carolina Danovaro-Holliday Tewodaj Mengistu Samir V. Sodha Daniel R. Hogan Aluisio J. D. Barros Ahmad Reza Hosseinpoor |
| author_sort | Nicole Bergen |
| collection | DOAJ |
| description | Despite advances in scaling up new vaccines in low- and middle-income countries, the global number of unvaccinated children has remained high over the past decade. We used 2000–2019 household survey data from 154 surveys representing 89 low- and middle-income countries to assess within-country, economic-related inequality in the prevalence of one-year-old children with zero doses of diphtheria–tetanus–pertussis (DTP) vaccine. Zero-dose DTP prevalence data were disaggregated by household wealth quintile. Difference, ratio, slope index of inequality, concentration index, and excess change measures were calculated to assess the latest situation and change over time, by country income grouping for 17 countries with high zero-dose DTP numbers and prevalence. Across 89 countries, the median prevalence of zero-dose DTP was 7.6%. Within-country inequalities mostly favored the richest quintile, with 19 of 89 countries reporting a rich–poor gap of ≥20.0 percentage points. Low-income countries had higher inequality than lower–middle-income countries and upper–middle-income countries (difference between the median prevalence in the poorest and richest quintiles: 14.4, 8.9, and 2.7 percentage points, respectively). Zero-dose DTP prevalence among the poorest households of low-income countries declined between 2000 and 2009 and between 2010 and 2019, yet economic-related inequality remained high in many countries. Widespread economic-related inequalities in zero-dose DTP prevalence are particularly pronounced in low-income countries and have remained high over the previous decade. |
| first_indexed | 2024-03-09T10:28:41Z |
| format | Article |
| id | doaj.art-edc99afcb8e64e368863c4192257d346 |
| institution | Directory Open Access Journal |
| issn | 2076-393X |
| language | English |
| last_indexed | 2024-03-09T10:28:41Z |
| publishDate | 2022-04-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Vaccines |
| spelling | doaj.art-edc99afcb8e64e368863c4192257d3462023-12-01T21:31:22ZengMDPI AGVaccines2076-393X2022-04-0110463310.3390/vaccines10040633Economic-Related Inequalities in Zero-Dose Children: A Study of Non-Receipt of Diphtheria–Tetanus–Pertussis Immunization Using Household Health Survey Data from 89 Low- and Middle-Income CountriesNicole Bergen0Bianca O. Cata-Preta1Anne Schlotheuber2Thiago M. Santos3M. Carolina Danovaro-Holliday4Tewodaj Mengistu5Samir V. Sodha6Daniel R. Hogan7Aluisio J. D. Barros8Ahmad Reza Hosseinpoor9Department of Data and Analytics, World Health Organization, 20 Avenue Appia, 1211 Geneva, SwitzerlandInternational Center for Equity in Health, Federal University of Pelotas, Rua Mal Deodoro 1160, Pelotas 96020-220, BrazilDepartment of Data and Analytics, World Health Organization, 20 Avenue Appia, 1211 Geneva, SwitzerlandInternational Center for Equity in Health, Federal University of Pelotas, Rua Mal Deodoro 1160, Pelotas 96020-220, BrazilDepartment of Immunization, Vaccines and Biologicals, World Health Organization, 20 Avenue Appia, 1211 Geneva, SwitzerlandGavi, The Vaccine Alliance, 40 Chemin du Pommier, 1218 Geneva, SwitzerlandDepartment of Immunization, Vaccines and Biologicals, World Health Organization, 20 Avenue Appia, 1211 Geneva, SwitzerlandGavi, The Vaccine Alliance, 40 Chemin du Pommier, 1218 Geneva, SwitzerlandInternational Center for Equity in Health, Federal University of Pelotas, Rua Mal Deodoro 1160, Pelotas 96020-220, BrazilDepartment of Data and Analytics, World Health Organization, 20 Avenue Appia, 1211 Geneva, SwitzerlandDespite advances in scaling up new vaccines in low- and middle-income countries, the global number of unvaccinated children has remained high over the past decade. We used 2000–2019 household survey data from 154 surveys representing 89 low- and middle-income countries to assess within-country, economic-related inequality in the prevalence of one-year-old children with zero doses of diphtheria–tetanus–pertussis (DTP) vaccine. Zero-dose DTP prevalence data were disaggregated by household wealth quintile. Difference, ratio, slope index of inequality, concentration index, and excess change measures were calculated to assess the latest situation and change over time, by country income grouping for 17 countries with high zero-dose DTP numbers and prevalence. Across 89 countries, the median prevalence of zero-dose DTP was 7.6%. Within-country inequalities mostly favored the richest quintile, with 19 of 89 countries reporting a rich–poor gap of ≥20.0 percentage points. Low-income countries had higher inequality than lower–middle-income countries and upper–middle-income countries (difference between the median prevalence in the poorest and richest quintiles: 14.4, 8.9, and 2.7 percentage points, respectively). Zero-dose DTP prevalence among the poorest households of low-income countries declined between 2000 and 2009 and between 2010 and 2019, yet economic-related inequality remained high in many countries. Widespread economic-related inequalities in zero-dose DTP prevalence are particularly pronounced in low-income countries and have remained high over the previous decade.https://www.mdpi.com/2076-393X/10/4/633inequalitysocioeconomic factorsvaccinationimmunizationglobal healthdiphtheria–tetanus–pertussis (DTP) vaccine |
| spellingShingle | Nicole Bergen Bianca O. Cata-Preta Anne Schlotheuber Thiago M. Santos M. Carolina Danovaro-Holliday Tewodaj Mengistu Samir V. Sodha Daniel R. Hogan Aluisio J. D. Barros Ahmad Reza Hosseinpoor Economic-Related Inequalities in Zero-Dose Children: A Study of Non-Receipt of Diphtheria–Tetanus–Pertussis Immunization Using Household Health Survey Data from 89 Low- and Middle-Income Countries Vaccines inequality socioeconomic factors vaccination immunization global health diphtheria–tetanus–pertussis (DTP) vaccine |
| title | Economic-Related Inequalities in Zero-Dose Children: A Study of Non-Receipt of Diphtheria–Tetanus–Pertussis Immunization Using Household Health Survey Data from 89 Low- and Middle-Income Countries |
| title_full | Economic-Related Inequalities in Zero-Dose Children: A Study of Non-Receipt of Diphtheria–Tetanus–Pertussis Immunization Using Household Health Survey Data from 89 Low- and Middle-Income Countries |
| title_fullStr | Economic-Related Inequalities in Zero-Dose Children: A Study of Non-Receipt of Diphtheria–Tetanus–Pertussis Immunization Using Household Health Survey Data from 89 Low- and Middle-Income Countries |
| title_full_unstemmed | Economic-Related Inequalities in Zero-Dose Children: A Study of Non-Receipt of Diphtheria–Tetanus–Pertussis Immunization Using Household Health Survey Data from 89 Low- and Middle-Income Countries |
| title_short | Economic-Related Inequalities in Zero-Dose Children: A Study of Non-Receipt of Diphtheria–Tetanus–Pertussis Immunization Using Household Health Survey Data from 89 Low- and Middle-Income Countries |
| title_sort | economic related inequalities in zero dose children a study of non receipt of diphtheria tetanus pertussis immunization using household health survey data from 89 low and middle income countries |
| topic | inequality socioeconomic factors vaccination immunization global health diphtheria–tetanus–pertussis (DTP) vaccine |
| url | https://www.mdpi.com/2076-393X/10/4/633 |
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