Socioeconomic Correlates of Child Immunization among Scheduled Tribes in India, 1990-2006

Abstract

Background: Immunization is a way of protecting the human body against infectious diseases through vaccination. Immunization coverage has been accorded high priority on international and national agendas as the vaccine-preventable diseases have been a major cause of child mortality and morbidity. In India, the basic childhood immunization services have been part of essential health services and accorded top priority in its health delivery system. As per NFHS-3 estimates, the under-five mortality rate and the child Mortality rate are much higher for Scheduled Tribes than any other social group/ castes at all childhood ages (95.7 and 35.8 respectively). Only 31.3 percent of Scheduled tribe's children were found to be fully vaccinated as compared to 53.8 percent belonging to Others.

Aim: The main aim of this study is to provide socioeconomic correlates of child immunization among Scheduled Tribes in India, during last one and half decade. Further, this study traces the changes in child immunization patterns that occurred along with the development of the socioeconomic and health sectors from 1990-20006.

Methodology: Data from three round of the Demographic and Health Survey (DHS), known as the National Family Health Survey (NFHS) in India were analyzed. Bivariate and multivariate-pooled logistic regression model were applied to examine the socioeconomic correlates of child immunization among Scheduled Tribes in India, during last one and half decade 1990-2006.

Key finding: The results from analysis indicate that the coverage of child immunization has increased from 24.8 percent to 32.0 percent during the last one and half decade, 1990-2006. Overall, it can be said that, there was an improvement in the level of child immunization over the period of time. There are considerable differentials in child immunization by various individual (education, gender and birth order), household (wealth) and community (place of residence, region of residence) characteristics. Along with the mother's education, father's education, ANC status, delivery status, economic status, mass media exposure and region of residence is a significant predictor in explaining the child immunization irrespective of time over last one and half decade.

Conclusion: The study concludes that much of these inequalities are social constructs that can be reduced by prioritizing the needs of the disadvantaged and adopting appropriate policy change options. The vaccination rates are lower among infants with mothers having no or low literacy, and families with insufficient empowerment of women. Paternal literacy and awareness has an inconsistent positive relationship with child vaccination. The study also recommends that the targeted intervention among the marginalized sections of society and addressing obstacles in the way of utilizing health services and effort should be made through Information, Education and Communication (IEC) activities targeted to educate, especially rural tribes and counseling them about adverse effect of child immunization.