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Caste-ethnic disparity in vaccine use among 0- to 5-year-old children in Nepal: a decomposition analysis

Author

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  • Satis Devkota

    (University of Minnesota)

  • Christopher Butler

    (University of Minnesota)

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.

Suggested Citation

  • Satis Devkota & Christopher Butler, 2016. "Caste-ethnic disparity in vaccine use among 0- to 5-year-old children in Nepal: a decomposition analysis," International Journal of Public Health, Springer;Swiss School of Public Health (SSPH+), vol. 61(6), pages 693-699, July.
    • Handle: RePEc:spr:ijphth:v:61:y:2016:i:6:d:10.1007_s00038-016-0789-9
    DOI: 10.1007/s00038-016-0789-9
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    Cited by:

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    2. Do Thi Thuy, Thuy & Nguyen, Quang Dung & Nguyen Van, Huy & Thomas-Agnan, Christine & Trinh, Thi-Huong, 2018. "Measuring the progress of the timeliness childhood immunization compliance in Vietnam between 2006-2014: A decomposition analysis," TSE Working Papers 18-920, Toulouse School of Economics (TSE).
    3. Sharma, Hari & Smieliauskas, Fabrice, 2022. "Undernutrition inequality between Dalits and non-Dalits in Nepal – A decomposition analysis," World Development, Elsevier, vol. 159(C).
    4. Madhu Sudhan Atteraya & In Han Song & Nasser B. Ebrahim & Shreejana Gnawali & Eungi Kim & Thakur Dhakal, 2023. "Inequalities in Childhood Immunisation in South Asia," IJERPH, MDPI, vol. 20(3), pages 1-11, January.

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