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Inequalities in child immunization coverage: potential lessons from the Guinea-Bissau case
Beatriz Raffi Lerm1, Yanick Silva1, Bianca O Cata-Preta2
1Universidade Federal do Rio Grande do Sul, Porto Alegre, Brasil.
Cadernos De Saude Publica
|January 18, 2023
Summary
Full immunization coverage in Guinea-Bissau increased annually, but significant disparities persist, particularly for children of less educated mothers. Addressing these inequalities is crucial for child survival.
Area of Science:
- Global Health
- Public Health Policy
- Pediatric Medicine
Background:
- Immunization is a cornerstone of reducing under-5 mortality globally.
- Persistent disparities in child health interventions, including immunization, highlight the need for equity-focused strategies.
Purpose of the Study:
- To analyze trends in full immunization coverage in Guinea-Bissau from 2006 to 2018.
- To assess socioeconomic and demographic inequalities in immunization coverage, focusing on wealth, residence, region, and maternal education.
Main Methods:
- Analysis of data from the 2006, 2014, and 2018 Guinea-Bissau Multiple Indicator Cluster Surveys (MICS).
- Estimation of absolute inequality using the Slope Index of Inequality (SII) via logistic regression.
- Application of a linear regression model with variance-weighted least squares to determine annual changes in coverage.
Main Results:
- Full immunization coverage demonstrated an annual increase of 1.8 percentage points.
- Children from poorer households and those with uneducated mothers faced the greatest disadvantages.
- While wealth and urban-rural inequalities diminished, maternal education-based disparities remained stagnant, with higher coverage among children of more educated mothers.
Conclusions:
- Guinea-Bissau exhibits persistently low immunization coverage with significant, particularly maternal education-related, inequalities.
- Public health policies must prioritize equity to effectively reduce immunization gaps and ensure all children are reached.
- Targeted interventions are needed to address disparities linked to maternal schooling to achieve universal immunization goals.
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