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Published on: December 15, 2023
Timeliness in the uptake of hepatitis B birth dose among Indian children under age five: A population-based study
Sumit Kumar Das1, Junaid Khan2
1All India Institute of Medical Sciences, New Delhi, India.
Insights
Hepatitis B birth dose uptake in India improved from 34% to 51.9% within 24 hours between 2015-2021. Delays are linked to maternal education, family economic status, and region, highlighting the need for targeted vaccination interventions.
Area of Science:
- Public Health
- Vaccinology
- Epidemiology
Background:
- Hepatitis B remains a significant global health concern, particularly in low- and middle-income countries.
- The birth dose of the hepatitis B vaccine is crucial for preventing perinatal transmission and long-term complications.
- Timely administration of the hepatitis B birth dose is essential for its maximum effectiveness.
Purpose of the Study:
- To evaluate the timeliness of hepatitis B birth dose administration in Indian children.
- To identify risk factors associated with delays in receiving the hepatitis B birth dose.
- To assess trends in hepatitis B birth dose uptake over time.
Main Methods:
- Utilized data from the National Family Health Survey (NFHS) rounds 4 and 5 (2015-2021).
- Analyzed vaccination card data to determine hepatitis B birth dose uptake and timing.
- Employed multinomial logistic regression and negative binomial regression to identify risk factors and predict timely vaccination.
Main Results:
- Hepatitis B birth dose uptake within 24 hours increased from 34% in 2015-16 to 51.91% in 2019-21.
- Ladakh (85.03%), Jammu & Kashmir (78%), and Arunachal Pradesh (68%) showed the highest timely uptake in 2019-21.
- Maternal education, family economic status, and region were significant predictors of delayed hepatitis B birth dose administration.
Conclusions:
- Significant improvements in timely hepatitis B birth dose uptake were observed, but coverage remains suboptimal.
- Targeted interventions are necessary to address disparities and further enhance timely vaccination.
- Strategies should focus on strengthening healthcare systems, parental awareness, and addressing logistical challenges.
Objective:
To assess the timeliness and risk factors for the delay in the uptake of the hepatitis B birth dose among Indian children aged 0-59 months. Information regarding whether the children received the birth dose and the time of receiving it was recorded based on the vaccination card available at the time of the National Family Health Survey (NFHS).
Methods:
Using data from the fourth and fifth round of India's National Family Health Survey (NFHS), the percentage of uptake and timely receipt of the hepatitis B birth dose were obtained by background characteristics and at the sub-national level (state). Multinomial logistic regression analysis was used to examine the risk factors. This study further performed a negative binomial regression estimation to predict the probability of receiving the birth dose at each day within a multivariable framework.
Results:
It was found that approximately 34 % of the children who received the birth dose and the timing of receiving the birth dose was made available through the vaccination card were administered the dose within 24-hours during 2015-16. However, the percentage increased to 51.91 % during 2019-21. During 2019-21, Ladakh had the highest proportion (85.03 %) of children receiving the dose within 24-hours, followed by Jammu & Kashmir with 78 %, and Arunachal Pradesh with 68 %. Mother's education, economic status of the child's family and region (children belong from) were found to be significant predictors in delay of receiving the birth dose within 24 hours.
Conclusion:
Results indicated a need for targeted interventions to improve the coverage and timeliness in the uptake of this critical vaccine dose in the country. These interventions could include strategies such as strengthening the healthcare system, improving awareness among parents and healthcare providers, addressing logistical challenges in vaccine delivery, and promoting community engagement and education on importance of timely vaccination.
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