Document Type

Article

Publication Date

2-29-2016

Publication Title

International Journal of Public Health

Abstract

Objectives To examine what factors, if any, could account for caste/ethnic disparities in vaccine utilization between upper caste and indigenous, and upper caste and low caste (Dalit) groups in Nepal.

Methods Using the Institute of Medicine (IOM) approach to calculate disparity, we estimate the disparity between upper caste and indigenous, and between upper caste and Dalit 0- to 5-year-old children in Nepal. Then we use Fairlie’s non-linear regression-based decomposition technique to account for those disparities in immunization.

Results Using nationally representative data (the Nepal Living Standard Survey II and III), we construct a pooled cross-sectional series and calculate the disparity between upper caste and indigenous (8.047 %), and between upper caste and Dalit (7.215 %). Both of these comparisons are significant at less than 1 % significance level. Decomposition results show that a major portion of the disparity can be attributed to the difference in access to immunization services, followed by differences in household income and parental education.

Conclusions Nepal’s national vaccine programs should increase focus on reaching geographically distant populations, and continue to develop vaccination-related education efforts.

Volume

61

First Page

693

Last Page

699

DOI

http://dx.doi.org/10.1007/s00038-016-0789-9

ISSN

1661-8564

Comments

This article is distributed under a Creative Commons Attribution 4.0 International (CC BY 4.0) license

Rights

(c) Swiss School of Public Health (SSPH+) 2016

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