Health Services Insights   

Amal K Halder^1,2 and M Kabir¹

¹Jahangirnagar University, Dhaka-1342, Bangladesh. ²ICDDR,B, GPO Box 128, Dhaka-1000, Bangladesh.

Abstract

Background: Although, health status of Bangladeshis has improved, levels of child mortality in Bangladesh remain unacceptably high. This paper reviews household wealth inequalities in immunization coverage in Bangladesh. The objective of the study is to examine how household wealth status and socio-demographic characteristics relate to immunization status of children.

Methods: Using data from the 2004 Bangladesh Demographic and Health Survey (BDHS), this paper investigated the inequalities and implications of infant immunization coverage in Bangladesh. To prepare the proxy variable of household wealth status we applied principal component analysis (PCA) technique based on variables such as assets, utilities and services available at household level. And then scores of the proxy variable was transferred into quintiles.

Results: The difference in immunization status between the richest and the poorest quintiles was significant (crude OR 5.2, p<0.001). The addition of education to the multivariate model lowered the impact of wealth index by almost half. Increasing education levels were positively associated with achieving full vaccination status. Sex of children and age of mothers were not associated with the child’s immunization status.

Conclusions: Despite free immunizations, use is not uniform throughout the population. Access to wealth and education may contribute to disparities in achieving full immunization. Minimizing indirect costs of immunizations may reduce disparities. Health education needs to be intensified for parents with minimal education.