Determinants of geographical inequalities for DTP3 vaccine coverage in sub-Saharan Africa.

Determinants of geographical inequalities for DTP3 vaccine coverage in sub-Saharan Africa. Vaccine. 2020 Mar 20;: Authors: Ikilezi G, Augusto OJ, Sbarra A, Sherr K, Dieleman JL, Lim SS Abstract Childhood immunization is one of the most effective health interventions, making it a key indicator of progress towards universal health coverage. In the last decade, improvements in coverage have been made globally, however, slow progress has been documented in sub-Saharan Africa with considerable subnational variations. We explore potential drivers of equitable immunization services based on subnational DTP3 coverage estimates. Using vaccine coverage at the 5 by 5 km area from 2000 to 2016, we quantify inequality using three measures. We assess the shortfall inequality which is the average deviation across subnational units from that with the highest coverage for each country. Secondly we estimate the threshold index, the proportion of children below a globally set subnational coverage target, and lastly, a Gini coefficient representing the within-country distribution of coverage. We use time series analyses to quantify associations with immunization expenditures controlling for country socio-economic and population characteristics. Development assistance, maternal education and governance were associated with reductions in inequality. Furthermore, high quality governance was associated with a stronger relationship between development assis...
Source: Vaccine - Category: Allergy & Immunology Authors: Tags: Vaccine Source Type: research