THE IMMUNIZATION DIVIDE

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THE IMMUNIZATION DIVIDE   Who Do Get Vaccinated
in Bangladesh?
Bangladesh Health Equity Watch
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Immunizations in Bangladesh

• The Near Miracle
• 2 in 1986
• 70 in 1991

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National trends in coverage () of children (lt12
months) by year of survey, Bangladesh (1992-2001)
Source Government of Bangladesh, (2001)
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Percent of children (12-23 months) vaccinated by
gender and year
 Sources BDHS (1994 1997 2001)
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Percent of children (12-23 months) by dose of
antigens received and gender (1999-00)
 
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Children (12-23 months) fully immunized by source
of household income in Bhairab, Bangladesh (1997)
 
Salaried employment in any government or
non-government or private institution (mostly
white collared) Source Bhairab Survey (1997)
 
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Children (12-23 months) immunized by self-rated
annual household food security status in Bhairab
(1997)
 Source Bhairab Survey (1997)
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Children (12-23 months) immunized by wealth
quintile (1996/7)
Source BDHS 1997. Compiled from Gwatkin et al
(2000)
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Size of Village and Isolation Matter!
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Immunization coverage of children (12 months)
living in selected geographical pockets
 Sources 1. Aziz et al (1999) 2. Karim and
Begum (2001) 3. Bhuiya et al. (1999)
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Children (12 months) fully immunized by ethnicity
(1998)  in CHT
 Source Karim and Begum (2001)
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Does economic power matter?
Health Workers (HW) behave differently with
different people...... a HW gave a syringe and a
Measles vaccine vial to the porter, just before
closing the centre. The porter and the HW then
went to a house on the other side of the road to
vaccinate a child. The house owner was a rich man
and the parents did not want to come to the
centre.
 Source Chowdhury et al. (1999 73)
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THE CHALLENGE   How do we take immunizations
to a greater number of children?  
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An Example from the Education Sector in
Bangladesh
Good gains in primary school enrollment in the
past decade.
Gains concentrated in these groups

• Girls
• Socio-economically poor
• Rural areas

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Affirmative Actions by the Government and NGOs

• Food for Education
• Secondary education scholarships for girls
• Non-formal schools by NGOs

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Thank You!