International Journal of Medical and Health Research

International Journal of Medical and Health Research


International Journal of Medical and Health Research
International Journal of Medical and Health Research
Vol. 5, Issue 8 (2019)

Measles Vaccination Coverage in Northeastern States, India: Inequality and Spatial Distribution Perspective


KH Jitenkumar Singh, Vinod Joseph KJ, Subhash Gautam, Sunita Sharma, Jeetendra Yadav

Background: Measles is a highly contagious viral disease which remains a major cause of death among young children globally, despite the availability of a safe and effective vaccine. It is among the major cause of child death which can be prevented by a vaccine. Despite immunization interventions taken up by government and non-government organizations, NFHS-4 assessed measles vaccination coverage in northeastern states, India holds 68.3% coverage which is much lower than the 95% coverage level required for elimination. The region is physically isolated from the rest of the country due to mountain terrains, poor infrastructure and also inhabited by numerous tribal and ethnic groups with diverse socio-cultural practices, lack of awareness and education. This paper attempts to identify the socio-economic factors and to quantify their contributions in generating inequalities in measles vaccination coverage and explore the spatial pattern of measles vaccination coverage across different geographical areas of northeastern states. Data and Methods: The data used in this study has been taken from the National Family Health Survey-4 (2015-2016). Binary logistic regression, log-binomial regression and concentration index decomposition techniques were used to quantify and explain the degrees of inequality. Exploratory Spatial Data Analysis (ESDA) techniques, Moran’s-I and LISA, was applied to analyse the spatial patterns in vaccination coverage across the districts and identify those areas with statistically significant clustering of high and low values, as well as spatial outliers. Results: The results of concentration index decomposition revealed that the inequality in measles vaccination coverage is highest among poorest classes of the society (50.8%). Religion (21.6%), mother’s education (17.6%) and birth order (8.5%) were found to be important contributors to this inequality. Through spatial analysis, striking variation in measles vaccination coverage was observed among the northeastern states. The lowest percentage was observed in the East Kameng district of Arunachal Pradesh and the highest in South and North districts of Sikkim. The Moran’s-I value (0.35) shows a non-significant positive spatial autocorrelation at the district level. Conclusion: To improve the immunization coverage and to reduce the socio-economic inequalities in the northeastern states, focus must be channelled to the vulnerable sections of the society and regions where the actual reach of health programs are poor. The poor households need to be uplifted through income-generating programs and policies. Programs and policymakers should shift their concern from achieving ‘average’ lower vaccination coverage to ‘distribution’ of the schemes to needy sections of the society.
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How to cite this article:
KH Jitenkumar Singh, Vinod Joseph KJ, Subhash Gautam, Sunita Sharma, Jeetendra Yadav. Measles Vaccination Coverage in Northeastern States, India: Inequality and Spatial Distribution Perspective. International Journal of Medical and Health Research, Volume 5, Issue 8, 2019, Pages 137-146
International Journal of Medical and Health Research