Increased immunization coverage addresses the equity gap in Nepal.

Area of Science:

• Public Health
• Epidemiology
• Global Health

Background:

• Monitoring immunization coverage and equity is crucial for public health.
• Nepal has implemented various immunization programs over the years.

Purpose of the Study:

• To compare immunization coverage and equity in Nepal between 2001 and 2014.
• To analyze trends in vaccine uptake across different socioeconomic groups.

Main Methods:

• Utilized data from Nepal Demographic and Health Surveys (2001, 2006, 2011) and the 2014 Multiple Indicator Cluster Survey.
• Calculated coverage proportions for bacille Calmette-Guérin (BCG), polio, diphtheria-pertussis-tetanus (DPT), and measles vaccines.
• Measured socioeconomic inequities using the Slope Index of Inequality (SII) and Relative Index of Inequality (RII) across wealth quintiles.

Main Results:

• Overall immunization coverage for children aged 12 months increased from 68.8% to 82.4% between 2001 and 2014.
• Coverage for BCG, DPT, and measles vaccines increased, while third-dose polio vaccine coverage decreased from 93.3% to 88.1%.
• The poorest wealth quintile experienced the most significant improvement in coverage (58% to 77.9%), narrowing the gap with the wealthiest quintile.

Conclusions:

• Immunization coverage in Nepal substantially improved between 2001 and 2014.
• Interventions targeting disadvantaged populations were key drivers of this improvement.
• Progress indicates a positive trend towards greater equity in childhood immunization.