{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T23:05:31Z","timestamp":1788390331108,"version":"build-2803163510"},"reference-count":29,"publisher":"BMJ","issue":"9","license":[{"start":{"date-parts":[[2020,9,25]],"date-time":"2020-09-25T00:00:00Z","timestamp":1600992000000},"content-version":"unspecified","delay-in-days":24,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2020,8,18]]},"published-print":{"date-parts":[[2020,9]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To investigate the effect of different aspects of inequality on childhood immunisation rates in Nepal. The study hypothesised that social inequality factors (eg, gender of a child, age of mother, caste\/ethnic affiliation, mother\u2019s socioeconomic status, place of residence and other structural barrier factors such as living in extreme poverty and distance to health facility) affect the likelihood of children being immunised.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Using gender of a child, age of mother, caste\/ethnic affiliation, mother\u2019s socioeconomic status, place of residence and other structural barrier factors such as living in extreme poverty and distance to health facility as independent variables, we performed bivariate and multivariate logistic regression analyses.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>This study used data from the most recent nationally representative cross-sectional Nepal Demographic and Health Survey in 2016.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>The analysis reviewed data from 1025 children aged 12\u201323 months old.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Outcome measures<\/jats:title>\n                    <jats:p>The main outcome variable was childhood immunisation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Only 79.2% of children were fully immunised. The complete vaccination rate of ethnic\/caste subpopulations ranged from 66.4% to 85.2%. Similarly, multivariate analysis revealed that children from the previously untouchable caste (OR 0.58; CI 0.33 to 0.99) and the Terai caste (OR 0.54; CI 0.29 to 0.99) were less likely to be fully immunised than children from the high Hindu caste.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Given Nepal\u2019s limited resources, we suggest that programmes that target the families of children who are least likely to be fully immunised, specifically those who are not only poor but also in financial crises and \u2018underprivileged\u2019 caste families, might be an effective strategy to improve Nepal\u2019s childhood immunisation rates.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2020-037646","type":"journal-article","created":{"date-parts":[[2020,9,25]],"date-time":"2020-09-25T17:35:56Z","timestamp":1601055356000},"page":"e037646","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":16,"title":["Inequalities in complete childhood immunisation in Nepal: results from a population-based cross-sectional study"],"prefix":"10.1136","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0617-3917","authenticated-orcid":false,"given":"In Han","family":"Song","sequence":"first","affiliation":[{"name":"Graduate School of Social Welfare, Yonsei University, Seoul, The Republic of Korea"},{"name":"Department of Health Policy & Management, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth","family":"Palley","sequence":"additional","affiliation":[{"name":"School of Social Work, Adelphi University, Garden City, New York, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Madhu Sudhan","family":"Atteraya","sequence":"additional","affiliation":[{"name":"Department of Social Welfare, Keimyung University, Daegu, The Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2020,9,25]]},"reference":[{"key":"2026062608030110000_10.9.e037646.1","unstructured":"UNICEF, WHO . Progress and challenges with achieving universal immunization coverage, 2019. 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