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Health Policy and Planning; 17(4): 412-419
© Oxford University Press 2002

The role of public health programmes in reducing socioeconomic inequities in childhood immunization coverage

David Bishai1, Emi Suzuki1, Michael McQuestion1, Jyostnamoy Chakraborty2 and Michael Koenig1

1 Department of Population and Family Health Sciences, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA and
2 International Centre for Diarrhoeal Disease Research, Bangladesh (ICDDR,B), Dhaka, Bangladesh

Objectives: This paper asks whether intensive outreach services can eliminate socioeconomic differentials in vaccine coverage.

Methods: In 1990, the Matlab Maternal and Child Health/Family Planning Project (MCH-FP) surveyed 4238 respondents in an intervention area that received outreach and 3708 respondents in a comparison area in rural Bangladesh. Interacted multiple regression methods assessed the degree to which various socioeconomic indicators predicted the probability of vaccine receipt in each area.

Results: Low parental schooling, small dwelling size and female gender were significantly associated with incomplete vaccination in the comparison area, where only the limited government services existed. Residence in the MCH-FP outreach area greatly reduced, and in some cases eliminated, the effects of these socioeconomic barriers to vaccine receipt.

Conclusions: Public health programmes utilizing outreach can reduce prevailing gender and socioeconomic differentials in vaccine receipt.


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