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Differential achievements in childhood immunization across geographical regions of Pakistan: analysis of wealth-related inequality

Overview of attention for article published in International Journal for Equity in Health, August 2018
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Title
Differential achievements in childhood immunization across geographical regions of Pakistan: analysis of wealth-related inequality
Published in
International Journal for Equity in Health, August 2018
DOI 10.1186/s12939-018-0837-6
Pubmed ID
Authors

Owais Raza, Fahad Saqib Lodhi, Esmaeil Khedmati Morasae, Reza Majdzadeh

Abstract

Childhood immunization is one of the most cost-effective interventions for child health. Still, many children are not able to receive completed immunization status. Wealth - related inequality in immunization is considered a major reason for equitable coverage of immunization in Pakistan. Therefore, we examine wealth-related inequality in completed childhood immunization and to assess achievement indices across geographical regions in Pakistan. The analysis was based on a nationally representative demographic and health survey (DHS) of Pakistan, conducted in 2012-13. We examined completed childhood (12-23 months) immunization in the various regions of the country and we used concentration, extended concentration and achievement indices to demonstrate inequality across geographical regions in Pakistan. Inequality in completed childhood immunization was seen in Pakistan with concentration index (CI) of 0.181 (95% CI: 0.164-0.209). Regions with high average of complete immunization showed lower inequality except for Sindh. Despite having better average immunization coverage in Kyber Pakhtunkhwa, the relative change of 128% in concentration index (CI) from C2 (standard CI) to C5 (when poorer quantile received highest weights) shows this to be also the most inequitable regions. Four parameters of inequality aversion (v = 2, 3, 4 & 5) demonstrated that 'dis - achievement' in completed immunization is densely concentrated among the poorer regions. Balochistan, Sindh and Gilgit Baltistan exhibited broader inequality gaps (93.75%, 83.35%, and 54.93%, respectively) at higher aversion parameter. As hypothesized, achievement index uncovers 'penalized' immunization coverage amongst the poorest population. Thus any policy that stringently focuses on improving average immunization rate without any strategy to deal with inequality will only improve immunization rate within wealthier groups. Based on these results, it is advisable to public health policy makers to use both aspect of information: average and degree of inequality in immunization coverage.

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Mendeley readers

Mendeley readers

The data shown below were compiled from readership statistics for 52 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 52 100%

Demographic breakdown

Readers by professional status Count As %
Student > Master 9 17%
Student > Ph. D. Student 8 15%
Researcher 5 10%
Student > Doctoral Student 2 4%
Unspecified 2 4%
Other 4 8%
Unknown 22 42%
Readers by discipline Count As %
Nursing and Health Professions 7 13%
Social Sciences 4 8%
Economics, Econometrics and Finance 4 8%
Medicine and Dentistry 3 6%
Unspecified 2 4%
Other 5 10%
Unknown 27 52%
Attention Score in Context

Attention Score in Context

This research output has an Altmetric Attention Score of 2. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 30 April 2019.
All research outputs
#14,423,597
of 23,100,534 outputs
Outputs from International Journal for Equity in Health
#1,458
of 1,934 outputs
Outputs of similar age
#187,376
of 333,251 outputs
Outputs of similar age from International Journal for Equity in Health
#46
of 57 outputs
Altmetric has tracked 23,100,534 research outputs across all sources so far. This one is in the 35th percentile – i.e., 35% of other outputs scored the same or lower than it.
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