Inequality in childhood immunization in India: a national level analysis of policy concerns

Amrita Gupta, International Institute for Population Sciences (IIPS)
T.V. Sekher, International Institute for Population Sciences (IIPS)

Immunization has revolutionized child health care throughout the world, preventing millions of deaths every year in addition to reducing the risk of disability caused by infectious diseases and stands as the greatest public health achievement of the 20th century. However, the wider benefits of immunization are not reaching all children of the world in an equitable manner especially in the developing countries like India, reflecting the inherent inequality in access to basic health service which is free of cost. In India in spite of a longstanding national program on immunization the coverage is only 54 percent by 2007-08. Apart from it there are large scale inequalities in immunization with respect to gender, wealth and the place of residence. Given this context, the paper tries to examine the inequalities in immunization, with respect to wealth, gender variables and the place of residence. Recent data from a national survey (2007-08) covering 7, 00,000 households were analyzed employing concentration index, rich-poor ratio and gender ratio. The study reveals that, in spite of health benefits of immunization and generous funding and campaign by the government, the outcomes are far from satisfactory both at the national and state levels. Another major problem is the drop-outs in multiple vaccines of DPT and Polio which has brought down the overall coverage of immunization. Children from poor households, rural areas and girls are less likely to be fully immunized. Mother’s education and religion had significant influence on immunization coverage. At the national level and even among the better performing states the inequality in immunization with respect to wealth, gender and place of residence is widespread. Program need to specifically address the widening inequality in immunization in India specifically with respect to wealth, gender and place of residence in order to improve the coverage achieve the set goals.