TY - JOUR
T1 - Multivariate Assessment of Vaccine Equity in Cambodia
T2 - A Longitudinal VERSE Tool Case Study Using Demographic and Health Survey 2004, 2010, and 2014
AU - Zhao, Yijin
AU - Mak, Joshua
AU - de Broucker, Gatien
AU - Patenaude, Bryan
N1 - Funding Information:
The VERSE Project is funded by the Bill & Melinda Gates Foundation Seattle, Washington, USA, grant number INV-003813.
Publisher Copyright:
© 2023 by the authors.
PY - 2023/4
Y1 - 2023/4
N2 - 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.
AB - 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.
KW - Cambodia
KW - absolute equity gap
KW - concentration index
KW - equity
KW - monitoring and evaluation
KW - national immunization program
KW - vaccines
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U2 - 10.3390/vaccines11040795
DO - 10.3390/vaccines11040795
M3 - Article
C2 - 37112707
AN - SCOPUS:85153721062
SN - 2076-393X
VL - 11
JO - Vaccines
JF - Vaccines
IS - 4
M1 - 795
ER -