Why immunization coverage fails to catch up in India? A community-based analysis.

摘要

BACKGROUND: An effort has been made in this paper to examine the impact of community and household vis-a-vis individual-level variables on immunization coverage among Indian children. METHODS: National Family Health Survey-2 data set has been used for the analysis. Multilevel regression analyses have been used to explore the relative effects of community-, household- and individual-level factors on immunization coverage. Three community-level variables, i.e. availability of health facilities, availability of all-weather roads and information, education and communication (IEC) activities conducted during last year, are included in this analysis. RESULTS: Availability of health facility and information, education and communication activities plays a significant role in determining the level of immunization coverage among children. Even with community-level variables in the model, individual-level variables, i.e. parent's education, birth order of child and number of antenatal care visits, retain their predictive role for the potential immunization coverage. CONCLUSIONS: Universal immunization can be achieved by providing services at community level and information about the available services and their benefits to the community. There is a considerable, unexplained variation in the immunization coverage between different communities, even in the most complex model used in this study, which could explain the entire heterogeneity of immunization coverage among Indian states.