Inequalities in child immunization coverage: potential lessons from the Guinea-Bissau case
Autor(a) principal: | |
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Data de Publicação: | 2023 |
Outros Autores: | , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Cadernos de Saúde Pública |
Texto Completo: | https://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/8289 |
Resumo: | Immunization is one of the main interventions responsible for the decline in under-5 mortality. This study aimed to assess full immunization coverage trends and related inequalities, according to wealth, area of residence, subnational regions, and maternal schooling level in Guinea-Bissau. Data from the 2006, 2014, and 2018 Guinea-Bissau Multiple Indicator Cluster Surveys (MICS) were analyzed. The slope index of inequality (SII) was estimated by logistic regression for wealth quintiles and maternal schooling level as a measure of absolute inequality. A linear regression model with variance-weighted least squares was used to estimate the annual change of immunization indicators at the national level and for the extremes of wealth, maternal schooling level, and urban-rural areas. Full immunization coverage increased by 1.8p.p./year (95%CI: 1.3; 2.3) over the studied period. Poorer children and children born to uneducated mothers were the most disadvantaged groups. Over the years, wealth inequality decreased and urban-rural inequalities were practically extinguished. In contrast, inequality of maternal schooling level remained unchanged, thus, the highest immunization coverage was among children born to the most educated women. This study shows persistent low immunization coverage and related inequalities in Guinea-Bissau, especially according to maternal schooling level. These findings reinforce the need to adopt equity as a main principle in the development of public health policies to appropriately reduce gaps in immunization and truly leave no one behind in Guinea-Bissau and beyond. |
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Inequalities in child immunization coverage: potential lessons from the Guinea-Bissau caseDesigualdades en la cobertura de vacunación infantil: potenciales lecciones del caso de Guinea-BissauDesigualdades na cobertura vacinal infantil: potenciais lições do caso da Guiné-BissauSaúde da CriançaDisparidades em Assistência à SaúdeImunizaçãoVacinasSalud InfantilDisparidades en Atención de SaludInmunizaciónVacunasChild HealthHealthcare DisparitiesImmunizationVaccinesImmunization is one of the main interventions responsible for the decline in under-5 mortality. This study aimed to assess full immunization coverage trends and related inequalities, according to wealth, area of residence, subnational regions, and maternal schooling level in Guinea-Bissau. Data from the 2006, 2014, and 2018 Guinea-Bissau Multiple Indicator Cluster Surveys (MICS) were analyzed. The slope index of inequality (SII) was estimated by logistic regression for wealth quintiles and maternal schooling level as a measure of absolute inequality. A linear regression model with variance-weighted least squares was used to estimate the annual change of immunization indicators at the national level and for the extremes of wealth, maternal schooling level, and urban-rural areas. Full immunization coverage increased by 1.8p.p./year (95%CI: 1.3; 2.3) over the studied period. Poorer children and children born to uneducated mothers were the most disadvantaged groups. Over the years, wealth inequality decreased and urban-rural inequalities were practically extinguished. In contrast, inequality of maternal schooling level remained unchanged, thus, the highest immunization coverage was among children born to the most educated women. This study shows persistent low immunization coverage and related inequalities in Guinea-Bissau, especially according to maternal schooling level. These findings reinforce the need to adopt equity as a main principle in the development of public health policies to appropriately reduce gaps in immunization and truly leave no one behind in Guinea-Bissau and beyond.La inmunización es una de las principales intervenciones responsables de la disminución de la mortalidad de niños menores de cinco años. Este estudio tuvo como objetivo explorar las tendencias en la cobertura total de inmunización y las desigualdades relacionadas con la riqueza, el área de domicilio, las regiones subnacionales y la educación materna en Guinea-Bissau. Se analizaron datos de la Encuesta de Indicadores Múltiples (MICS) de Guinea-Bissau de 2006, 2014 y 2018. El índice absoluto de desigualdad (SII) se calculó mediante regresión logística para quintiles de riqueza y educación materna como medida de desigualdad absoluta. Se ajustó un modelo de regresión lineal con mínimos cuadrados ponderados por varianza para estimar la variación anual de los indicadores de inmunización a nivel nacional y para los extremos de riqueza, educación materna y áreas urbano-rurales. Hubo un aumento de 1,8p.p./año (IC95%: 1,3; 2,3) en la cobertura total de inmunización durante el período de estudio. Los niños más pobres y los nacidos de madres sin educación formal componían los grupos más desfavorecidos. A lo largo de los años, hubo una reducción de la desigualdad de riqueza, y las discrepancias urbano-rurales casi desaparecieron. Por otro lado, no hubo cambio en el nivel de desigualdad según la educación materna, y prevaleció una mayor cobertura entre los hijos de mujeres con mayor nivel de educación. Este estudio muestra la persistente baja cobertura de vacunación y las desigualdades asociadas en Guinea-Bissau, principalmente con relación a la educación materna. Los resultados apuntan la necesidad de adoptar la equidad como un principio fundamental en el desarrollo de políticas de salud pública para reducir las brechas de inmunización y no dejar a nadie atrás ni adelante en Guinea-Bissau.A imunização é uma das principais intervenções responsáveis pelo declínio da mortalidade de crianças menores de cinco anos. Este estudo teve como objetivo explorar as tendências da cobertura vacinal total e as desigualdades relacionadas a riqueza, área de residência, regiões subnacionais e educação materna na Guiné-Bissau. Foram analisados dados do Inquérito de Indicadores Múltiplos (MICS) da Guiné-Bissau de 2006, 2014 e 2018. O índice absoluto de desigualdade (SII) foi calculado por meio de regressão logística para quintis de riqueza e escolaridade materna como medida de desigualdade absoluta. Um modelo de regressão linear foi ajustado com mínimos quadrados ponderados pela variância para estimar a variação anual dos indicadores de imunização em nível nacional e para os extremos de riqueza, educação materna e áreas urbano-rurais. Houve um aumento de 1,8p.p./ano (IC95%: 1,3; 2,3) na cobertura vacinal total ao longo do período estudado. Crianças mais pobres e nascidas de mães sem educação formal foram os grupos mais desfavorecidos. Ao longo dos anos, a desigualdade de riqueza diminuiu e as discrepâncias urbano-rurais foram praticamente extintas. Em contrapartida, não houve mudança no padrão de desigualdade de acordo com a escolaridade materna, prevalecendo a maior cobertura entre crianças nascidas de mulheres mais escolarizadas. Este estudo mostra a persistente baixa cobertura vacinal e as desigualdades relacionadas na Guiné-Bissau, principalmente considerando a educação materna. Estes resultados reforçam a necessidade de adotar a equidade como princípio fundamental no desenvolvimento de políticas de saúde pública para reduzir adequadamente as lacunas na imunização e não deixar ninguém para trás na Guiné-Bissau e além.Reports in Public HealthCadernos de Saúde Pública2023-07-02info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersiontext/xmlapplication/pdfhttps://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/8289Reports in Public Health; Vol. 39 No. 1 (2023): JanuaryCadernos de Saúde Pública; v. 39 n. 1 (2023): Janeiro1678-44640102-311Xreponame:Cadernos de Saúde Públicainstname:Fundação Oswaldo Cruz (FIOCRUZ)instacron:FIOCRUZenghttps://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/8289/18515https://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/8289/18516Copyright (c) 2023 Cadernos de Saúde Públicainfo:eu-repo/semantics/openAccessRaffi Lerm, BeatrizSilva, YanickO. Cata-Preta, BiancaGiugliani, Camila2023-07-02T19:44:08Zoai:ojs.teste-cadernos.ensp.fiocruz.br:article/8289Revistahttps://cadernos.ensp.fiocruz.br/ojs/index.php/csphttps://cadernos.ensp.fiocruz.br/ojs/index.php/csp/oaicadernos@ensp.fiocruz.br||cadernos@ensp.fiocruz.br1678-44640102-311Xopendoar:2024-03-06T13:09:27.835976Cadernos de Saúde Pública - Fundação Oswaldo Cruz (FIOCRUZ)true |
dc.title.none.fl_str_mv |
Inequalities in child immunization coverage: potential lessons from the Guinea-Bissau case Desigualdades en la cobertura de vacunación infantil: potenciales lecciones del caso de Guinea-Bissau Desigualdades na cobertura vacinal infantil: potenciais lições do caso da Guiné-Bissau |
title |
Inequalities in child immunization coverage: potential lessons from the Guinea-Bissau case |
spellingShingle |
Inequalities in child immunization coverage: potential lessons from the Guinea-Bissau case Raffi Lerm, Beatriz Saúde da Criança Disparidades em Assistência à Saúde Imunização Vacinas Salud Infantil Disparidades en Atención de Salud Inmunización Vacunas Child Health Healthcare Disparities Immunization Vaccines |
title_short |
Inequalities in child immunization coverage: potential lessons from the Guinea-Bissau case |
title_full |
Inequalities in child immunization coverage: potential lessons from the Guinea-Bissau case |
title_fullStr |
Inequalities in child immunization coverage: potential lessons from the Guinea-Bissau case |
title_full_unstemmed |
Inequalities in child immunization coverage: potential lessons from the Guinea-Bissau case |
title_sort |
Inequalities in child immunization coverage: potential lessons from the Guinea-Bissau case |
author |
Raffi Lerm, Beatriz |
author_facet |
Raffi Lerm, Beatriz Silva, Yanick O. Cata-Preta, Bianca Giugliani, Camila |
author_role |
author |
author2 |
Silva, Yanick O. Cata-Preta, Bianca Giugliani, Camila |
author2_role |
author author author |
dc.contributor.author.fl_str_mv |
Raffi Lerm, Beatriz Silva, Yanick O. Cata-Preta, Bianca Giugliani, Camila |
dc.subject.por.fl_str_mv |
Saúde da Criança Disparidades em Assistência à Saúde Imunização Vacinas Salud Infantil Disparidades en Atención de Salud Inmunización Vacunas Child Health Healthcare Disparities Immunization Vaccines |
topic |
Saúde da Criança Disparidades em Assistência à Saúde Imunização Vacinas Salud Infantil Disparidades en Atención de Salud Inmunización Vacunas Child Health Healthcare Disparities Immunization Vaccines |
description |
Immunization is one of the main interventions responsible for the decline in under-5 mortality. This study aimed to assess full immunization coverage trends and related inequalities, according to wealth, area of residence, subnational regions, and maternal schooling level in Guinea-Bissau. Data from the 2006, 2014, and 2018 Guinea-Bissau Multiple Indicator Cluster Surveys (MICS) were analyzed. The slope index of inequality (SII) was estimated by logistic regression for wealth quintiles and maternal schooling level as a measure of absolute inequality. A linear regression model with variance-weighted least squares was used to estimate the annual change of immunization indicators at the national level and for the extremes of wealth, maternal schooling level, and urban-rural areas. Full immunization coverage increased by 1.8p.p./year (95%CI: 1.3; 2.3) over the studied period. Poorer children and children born to uneducated mothers were the most disadvantaged groups. Over the years, wealth inequality decreased and urban-rural inequalities were practically extinguished. In contrast, inequality of maternal schooling level remained unchanged, thus, the highest immunization coverage was among children born to the most educated women. This study shows persistent low immunization coverage and related inequalities in Guinea-Bissau, especially according to maternal schooling level. These findings reinforce the need to adopt equity as a main principle in the development of public health policies to appropriately reduce gaps in immunization and truly leave no one behind in Guinea-Bissau and beyond. |
publishDate |
2023 |
dc.date.none.fl_str_mv |
2023-07-02 |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
https://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/8289 |
url |
https://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/8289 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
https://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/8289/18515 https://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/8289/18516 |
dc.rights.driver.fl_str_mv |
Copyright (c) 2023 Cadernos de Saúde Pública info:eu-repo/semantics/openAccess |
rights_invalid_str_mv |
Copyright (c) 2023 Cadernos de Saúde Pública |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
text/xml application/pdf |
dc.publisher.none.fl_str_mv |
Reports in Public Health Cadernos de Saúde Pública |
publisher.none.fl_str_mv |
Reports in Public Health Cadernos de Saúde Pública |
dc.source.none.fl_str_mv |
Reports in Public Health; Vol. 39 No. 1 (2023): January Cadernos de Saúde Pública; v. 39 n. 1 (2023): Janeiro 1678-4464 0102-311X reponame:Cadernos de Saúde Pública instname:Fundação Oswaldo Cruz (FIOCRUZ) instacron:FIOCRUZ |
instname_str |
Fundação Oswaldo Cruz (FIOCRUZ) |
instacron_str |
FIOCRUZ |
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FIOCRUZ |
reponame_str |
Cadernos de Saúde Pública |
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Cadernos de Saúde Pública |
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Cadernos de Saúde Pública - Fundação Oswaldo Cruz (FIOCRUZ) |
repository.mail.fl_str_mv |
cadernos@ensp.fiocruz.br||cadernos@ensp.fiocruz.br |
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1798943398872219648 |