{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T01:35:05Z","timestamp":1787016905127,"version":"build-2736575974"},"reference-count":41,"publisher":"BMJ","issue":"8","funder":[{"DOI":"10.13039\/100004440","name":"Wellcome Trust","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100004440","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2016,6,22]]},"published-print":{"date-parts":[[2016,8]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Aggregate data on childhood immunisation from urban settings may not reflect the coverage among the urban poor. This study provides information on complete childhood immunisation coverage among the urban poor, and explores its household and neighbourhood-level determinants.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Urban poor community in the Southeast district of Delhi, India.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>We randomly sampled 1849 children aged 1\u20133.5\u2005years from 13\u2005451 households in 39 clusters (cluster defined as area covered by a community health worker) in 2 large urban poor settlements. Of these, 1343 completed the survey. We collected information regarding childhood immunisation (BCG, oral polio vaccine, diphtheria\u2013pertussis\u2013tetanus vaccine, hepatitis B and measles) from vaccination cards or mothers\u2019 recall. We used random intercept logistic regression to explore the sociodemographic determinants of complete immunisation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Complete immunisation coverage was 46.7% and 7.5% were not immunised. The odds of complete vaccination (OR, 95% CI) were lower in female children (0.70 (0.55 to 0.89)) and Muslim households (0.65 (0.45 to 0.94)). The odds of complete vaccination were higher if the mother was literate (1.6 (1.15 to 2.16)), if the child was born within the city (2.7 (1.97 to 3.65)), in a health facility ( 1.5 (1.19 to 2.02)), belonged to the highest wealth quintile (compared with the poorest; 2.46 (1.5 to 4.02)) or possessed a birth certificate (1.40 (1.03 to 1.91)). Cluster effect due to unmeasured neighbourhood factors expressed as median OR was 1.32.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Immunisation coverage in this urban poor area was much lower than that of regional surveys reporting overall urban data. Socioeconomic status of the household, female illiteracy, health awareness and gender inequality were important determinants of coverage in this population. Hence, in addition to enhancing the infrastructure for providing mother and child services, efforts are also needed to address these issues in order to improve immunisation coverage in deprived urban communities.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial registration number<\/jats:title>\n                    <jats:p>CTRI\/2011\/091\/000095.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2016-013015","type":"journal-article","created":{"date-parts":[[2016,8,26]],"date-time":"2016-08-26T22:49:16Z","timestamp":1472251756000},"page":"e013015","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":65,"title":["Determinants of childhood immunisation coverage in urban poor settlements of Delhi, India: a cross-sectional study"],"prefix":"10.1136","volume":"6","author":[{"given":"Niveditha","family":"Devasenapathy","sequence":"first","affiliation":[{"name":"Indian Institute of Public Health, Delhi, Public Health Foundation of India, Gurgaon, Haryana, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suparna","family":"Ghosh Jerath","sequence":"additional","affiliation":[{"name":"Indian Institute of Public Health, Delhi, Public Health Foundation of India, Gurgaon, Haryana, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saket","family":"Sharma","sequence":"additional","affiliation":[{"name":"Indian Institute of Public Health, Delhi, Public Health Foundation of India, Gurgaon, Haryana, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth","family":"Allen","sequence":"additional","affiliation":[{"name":"Department of Medical Statistics, London School of Hygiene and Tropical Medicine, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anuraj H","family":"Shankar","sequence":"additional","affiliation":[{"name":"Department of Nutrition, Harvard School of Public Health, Boston, Massachusetts, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sanjay","family":"Zodpey","sequence":"additional","affiliation":[{"name":"Indian Institute of Public Health, Delhi, Public Health Foundation of India, Gurgaon, Haryana, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2016,8,26]]},"reference":[{"key":"2025101813575856000_6.8.e013015.1","unstructured":"The Expanded Programme on Immunization. http:\/\/www.who.int\/immunization\/programmes_systems\/supply_chain\/benefits_of_immunization\/en\/ (accessed 1 Jun 2015)."},{"key":"2025101813575856000_6.8.e013015.2","unstructured":"Immunization coverage, Fact sheet. http:\/\/www.who.int\/mediacentre\/factsheets\/fs378\/en\/ (accessed 1 Jun 2015)."},{"key":"2025101813575856000_6.8.e013015.3","unstructured":"Despite major progress, the full potential of immunization continues to elude many of the world's children. http:\/\/data.unicef.org\/child-health\/immunization#sthash.njAgYeRC.dpuf (accessed 1 Jun 2015)."},{"key":"2025101813575856000_6.8.e013015.4","unstructured":"District Level Household and Facility Survey 2008\u201309, Fact sheets (India). http:\/\/www.rchiips.org\/pdf\/rch3\/report\/DL.pdf (accessed 1 Jun 2015)."},{"key":"2025101813575856000_6.8.e013015.5","unstructured":"Rapid Survey on Children (2013\u201314). India Fact Sheet. http:\/\/wcd.nic.in\/ (accessed 29 Aug 2015)."},{"key":"2025101813575856000_6.8.e013015.6","doi-asserted-by":"crossref","first-page":"163","DOI":"10.1016\/j.socscimed.2015.05.004","article-title":"District-level variations in childhood immunizations in India: the role of socio-economic factors and health infrastructure","volume":"145:","author":"Rammohan","year":"2015","journal-title":"Soc Sci Med"},{"key":"2025101813575856000_6.8.e013015.7","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0073102"},{"key":"2025101813575856000_6.8.e013015.8","unstructured":"District Level Household and Facility Survey 2008\u201309, Fact sheets (Delhi). http:\/\/www.rchiips.org\/pdf\/rch3\/report\/DL.pdf (accessed 1 Jun 2015)."},{"key":"2025101813575856000_6.8.e013015.9","unstructured":"National fact sheet, Coverage Evaluation survey. 2009. http:\/\/files.givewell.org\/files\/DWDA%202009\/GAIN\/UNICEF%20India%20Coverage%20Evaluation%20Survey%20(2009).pdf (accessed 1 Jun 2015)."},{"key":"2025101813575856000_6.8.e013015.10","unstructured":"Rapid Survey on Children (2013\u201314). Delhi Fact Sheet. http:\/\/wcd.nic.in\/ (accessed 30 Aug 2015)."},{"key":"2025101813575856000_6.8.e013015.11","unstructured":"Health and living conditions in eight Indian cities. dhsprogram.com\/pubs\/pdf\/od58\/od58.pdf (accessed 1 Jun 2015)."},{"key":"2025101813575856000_6.8.e013015.12","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-3156.2010.02628.x"},{"key":"2025101813575856000_6.8.e013015.13","doi-asserted-by":"publisher","DOI":"10.1007\/s12098-007-0004-3"},{"key":"2025101813575856000_6.8.e013015.14","unstructured":"Delhi gets two more revenue districts: Southeast, Shahdara. http:\/\/archive.indianexpress.com\/news\/delhi-gets-two-more-revenue-districts-southeast-shahdara\/1001325\/ (accessed 1 Jun 2015)."},{"key":"2025101813575856000_6.8.e013015.15","doi-asserted-by":"crossref","first-page":"212.","DOI":"10.1186\/s12884-015-0635-8","article-title":"Reproductive healthcare utilization in urban poor settlements of Delhi: baseline survey of ANCHUL (Ante Natal and Child Health care in Urban Slums) project","volume":"15","author":"Devasenapathy","year":"2015","journal-title":"BMC Pregnancy Childbirth"},{"key":"2025101813575856000_6.8.e013015.16","doi-asserted-by":"publisher","DOI":"10.1007\/s11524-011-9556-7"},{"key":"2025101813575856000_6.8.e013015.17","doi-asserted-by":"publisher","DOI":"10.1136\/jech.2004.029454"},{"key":"2025101813575856000_6.8.e013015.18","doi-asserted-by":"publisher","DOI":"10.1093\/tropej\/47.4.199"},{"key":"2025101813575856000_6.8.e013015.19","doi-asserted-by":"publisher","DOI":"10.1093\/heapol\/17.1.99"},{"key":"2025101813575856000_6.8.e013015.20","doi-asserted-by":"publisher","DOI":"10.1186\/1472-698X-9-S1-S3"},{"key":"2025101813575856000_6.8.e013015.21","doi-asserted-by":"crossref","first-page":"e104598","DOI":"10.1371\/journal.pone.0104598","article-title":"Socioeconomic dynamics of gender disparity in childhood immunization in India, 1992\u20132006","volume":"9","author":"Prusty","year":"2014","journal-title":"PLoS ONE"},{"key":"2025101813575856000_6.8.e013015.22","first-page":"10","article-title":"Evaluation of primary immunization coverage in an urban area of Bareilly city using Cluster Sampling Technique","volume":"1","author":"Chaudhary","year":"2010","journal-title":"NJIRM"},{"key":"2025101813575856000_6.8.e013015.23","doi-asserted-by":"crossref","first-page":"21","DOI":"10.4103\/2230-8598.109315","article-title":"A study to assess the immunization coverage in an urban slum of Mumbai by lot quality technique","volume":"3","author":"Kulkarni","year":"2013","journal-title":"Int J Med Public Health"},{"key":"2025101813575856000_6.8.e013015.24","doi-asserted-by":"publisher","DOI":"10.4161\/hv.19003"},{"key":"2025101813575856000_6.8.e013015.25","doi-asserted-by":"publisher","DOI":"10.1136\/jech-2014-205436"},{"key":"2025101813575856000_6.8.e013015.26","doi-asserted-by":"publisher","DOI":"10.1016\/j.socscimed.2012.02.043"},{"key":"2025101813575856000_6.8.e013015.27","doi-asserted-by":"crossref","first-page":"36","DOI":"10.4103\/1947-2714.152076","article-title":"Determinants of immunization coverage in Lucknow district","volume":"7","author":"Gupta","year":"2015","journal-title":"N Am J Med Sci"},{"key":"2025101813575856000_6.8.e013015.28","unstructured":"Mother-Child Protection Card CBT. http:\/\/hetv.org\/programmes\/mother-child-protection-card-cbt.htm. (accessed 1 Aug 2015)."},{"key":"2025101813575856000_6.8.e013015.29","first-page":"491","article-title":"A brief history of vaccines & vaccination in India","volume":"139","author":"Lahariya","year":"2014","journal-title":"Indian J Med Res"},{"key":"2025101813575856000_6.8.e013015.30","unstructured":"Mission Indradhanush. http:\/\/www.nhp.gov.in\/health-programmes\/national-health-programmes\/mission-indradhanush (accessed 1 Aug 2015)."},{"key":"2025101813575856000_6.8.e013015.31","doi-asserted-by":"crossref","first-page":"81","DOI":"10.1186\/1478-4491-7-81","article-title":"Are vaccination programmes delivered by lay health workers cost-effective? A systematic review","volume":"7","author":"Corluka","year":"2009","journal-title":"Hum Resour Health"},{"key":"2025101813575856000_6.8.e013015.32","doi-asserted-by":"publisher","DOI":"10.4103\/0019-5359.37046"},{"key":"2025101813575856000_6.8.e013015.33","doi-asserted-by":"crossref","first-page":"71","DOI":"10.4103\/2277-9175.115809","article-title":"Reasons for failure of immunization: a cross-sectional study among 12\u201323-month-old children of Lucknow, India","volume":"2","author":"Vohra","year":"2013","journal-title":"Adv Biomed Res"},{"key":"2025101813575856000_6.8.e013015.34","first-page":"37","article-title":"Coverage evaluation of primary immunization and the associated determinants in an urban slum of Rewa","volume":"26","author":"Trivedi","year":"2014","journal-title":"Indian J Community Health"},{"key":"2025101813575856000_6.8.e013015.35","unstructured":"Yadav S , Mangal S , Padhiyar N , et al . Evaluation of immunization coverage in urban slums of Jamnagar City. 2006;31 :(2006\u201310, 2006\u201312):300\u2013303."},{"key":"2025101813575856000_6.8.e013015.36","first-page":"110","article-title":"An study on utilization of immunization services by slum dwellers of municipal corporation area of Rewa city in Madhya Pradesh","volume":"25","author":"Dubey","year":"2013","journal-title":"Indian J Community Health"},{"key":"2025101813575856000_6.8.e013015.37","first-page":"50","article-title":"Study on immunization coverage in urban slums of Ahmedabad city","volume":"33:","author":"Kadri","year":"2010","journal-title":"Health Popul Perspect Issues"},{"key":"2025101813575856000_6.8.e013015.38","first-page":"2803","article-title":"A study of knowledge, attitude and practices on immunization of children in urban slums of Bijapur city, Karnataka, India","volume":"7","author":"Angadi","year":"2013","journal-title":"J Clin Diagn Res"},{"key":"2025101813575856000_6.8.e013015.39","doi-asserted-by":"publisher","DOI":"10.1093\/heapol\/czp041"},{"key":"2025101813575856000_6.8.e013015.40","first-page":"107","article-title":"Socio-economic factors affecting the trend towards vaccination of mother and infants in Multan city","volume":"15","author":"Yasin","year":"2004","journal-title":"J Res (Science)"},{"key":"2025101813575856000_6.8.e013015.41","first-page":"565","article-title":"Childhood immunization coverage in zone 3 of Dhaka City: the challenge of reaching impoverished households in urban Bangladesh","volume":"76","author":"Perry","year":"1998","journal-title":"Bull World Health Organ"}],"container-title":["BMJ Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjopen-2016-013015","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,18]],"date-time":"2025-10-18T20:58:06Z","timestamp":1760821086000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjopen.bmj.com\/lookup\/doi\/10.1136\/bmjopen-2016-013015"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2016,8]]},"references-count":41,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2016,8,26]]},"published-print":{"date-parts":[[2016,8]]}},"alternative-id":["10.1136\/bmjopen-2016-013015"],"URL":"https:\/\/doi.org\/10.1136\/bmjopen-2016-013015","relation":{},"ISSN":["2044-6055","2044-6055"],"issn-type":[{"value":"2044-6055","type":"print"},{"value":"2044-6055","type":"electronic"}],"subject":[],"published":{"date-parts":[[2016,8]]}}}