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Caste-ethnic disparity in vaccine use among 0- to 5-year-old children in Nepal: a decomposition analysis

Satis Devkota1, Christopher Butler2

  • 1Discipline of Economics and Management, Division of Social Science, University of Minnesota, Morris, USA.

International Journal of Public Health
|March 1, 2016
PubMed

Insights

Caste and ethnic disparities in Nepal result in significant gaps in childhood vaccination. Unequal access to immunization services, income, and education contribute to these inequities.

Area of Science:

  • Public Health
  • Health Equity
  • Epidemiology

Background:

  • Significant disparities exist in vaccine utilization across caste and ethnic groups in Nepal.
  • Understanding the drivers of these inequities is crucial for improving child immunization coverage.

Purpose of the Study:

  • To quantify caste/ethnic disparities in vaccine utilization among children aged 0-5 years in Nepal.
  • To identify factors contributing to disparities between upper caste, indigenous, and Dalit groups.

Main Methods:

  • Utilized the Institute of Medicine (IOM) approach to calculate disparities.
  • Employed Fairlie's non-linear regression-based decomposition technique for factor analysis.
  • Analyzed nationally representative data from the Nepal Living Standard Survey II and III.

Main Results:

  • Significant disparities in immunization were found: 8.05% between upper caste and indigenous groups, and 7.22% between upper caste and Dalit groups.
  • Disparities were primarily attributed to differences in access to immunization services.
  • Household income and parental education levels also significantly contributed to the observed inequities.

Conclusions:

  • Nepal's national vaccine programs require enhanced strategies to reach geographically remote populations.
  • Continued development of vaccination education initiatives is essential to address disparities.
Abstract

Keywords:
Access to health facilityCaste ethnicityDisparitiesImmunizationNepalVaccines

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