Multivariate Assessment of Vaccine Equity in Cambodia: A Longitudinal VERSE Tool Case Study Using Demographic and Health Survey 2004, 2010, and 2014

Author:

Zhao Yijin1,Mak Joshua12,de Broucker Gatien12ORCID,Patenaude Bryan12ORCID

Affiliation:

1. International Vaccine Access Center, Johns Hopkins University, Baltimore, MD 21231, USA

2. Department of International Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD 21205, USA

Abstract

Cambodia has exhibited great progress in achieving high coverage in nationally recommended immunizations. As vaccination program managers plan interventions to reach last-mile children, it is important to consider issues of equity immunization priority setting. In this analysis, we apply the VERSE Equity Tool to Cambodia’s Demographic and Health Survey for the years 2004, 2010, and 2014 to evaluate multivariate equity in vaccine coverage for 11 vaccination statuses, emphasizing the results of the 2014 survey for MCV1, DTP3, fully immunized for age (FULL), and zero dose (ZERO). The largest drivers of vaccination inequity are socioeconomic status and the educational attainment of the child’s mother. MCV1, DTP3, and FULL exhibit increasing levels of both coverage and equity with increasing survey years. The national composite Wagstaff concentration index values from the 2014 survey for DTP3, MCV1, ZERO, and FULL are 0.089, 0.068, 0.573, and 0.087, respectively. The difference in vaccination status coverage between the most and least advantaged quintiles of Cambodia’s population, using multivariate ranking criteria, is 23.5% for DTP3, 19.5% for MCV1, 9.1% for ZERO, and 30.3% for FULL. By utilizing these VERSE Equity Tool outputs, immunization program leaders in Cambodia can identify subnational regions in need of targeted interventions.

Funder

Bill & Melinda Gates Foundation Seattle, Washington, USA

Publisher

MDPI AG

Subject

Pharmacology (medical),Infectious Diseases,Drug Discovery,Pharmacology,Immunology

Reference44 articles.

1. World Health Organization (2022, July 14). Vaccines and Immunization. Available online: https://www.who.int/health-topics/vaccines-and-immunization#tab=tab_1.

2. (2023, March 27). Over 13 Million Cchildren Did Not Receive Any Vaccines at All Even before COVID-19 Disrupted Global Immunization–UNICEF. Available online: https://www.unicef.org/eap/press-releases/over-13-million-children-did-not-receive-any-vaccines-all-even-covid-19-disrupted.

3. Impact of COVID-19 pandemic on routine vaccination coverage of children and adolescents: A systematic review;SeyedAlinaghi;Health Sci. Rep.,2022

4. WHO TEAM Immunization, Vaccines and Biologicals (2023, March 27). Immunization Agenda 2030: A Global Strategy to Leave No One Behind. Available online: https://www.who.int/publications/m/item/immunization-agenda-2030-a-global-strategy-to-leave-no-one-behind.

5. Ministry of Health, National Maternal and Child Health Center, National Immunization Program (2008). CAMBODIA National Immunization Program Strategic Plan 2008–2015, Ministry of Health.

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