Inequality And Inequity Analysis On Timely Children Hepatitis B Vaccination In Rural China

Research OverviewHepatitis B virus result in severe burden of disease and death, and hundreds of millions of people are suffering from acute or chronic hepatitis. What’s worse, it will further lead to cirrhosis and hepatic carcinoma.The express terms on immunization program in China’s "EPI Technical Management Rules (CDC [1998] No.50)", "vaccination work norms (CDC (2005) No.373)" said the first dose of hepatitis B vaccine and three doses of hepatitis B vaccine should be vaccinated at the time of birth,1 month and 6 months (5-8 months old) and basic immunization should complete within 12 months. To improve hepatitis B timely birth dose rate is a long-term goal of the World Health Organization, it is desirable to protect the fairness of the immunization, but the data show that only 27%of newborns can enjoy the treatment of hepatitis B vaccine in the world.Hepatitis B is a world-wide problems, currently more than 2 billion people infected with hepatitis B, there are 240 million patients with chronic hepatitis B disease and the number of deaths each year caused by hepatitis B disease has reached about 780,000, in China alone 9 millions of people infected with hepatitis B.Hepatitis B virus can be carried and spread by the in perinatal infected mother to the newborn, or through infected family members transmitted to the baby in early childhood. The hepatitis B vaccine is most effective initiatives in preventing the transmission of Hepatitis B and timely vaccination is important.Research purposesSince the timely hepatitis B vaccine has great significance and scientific basis, for this study we hope that through analyzing timely hepatitis B vaccination status of children between typical rural areas of the provinces with different economic levels, (including HB vaccine timely vaccination at birth within 24 hours and timely completion status of three doses of hepatitis B vaccine within a year after birth) the factors and equity analysis could help understanding whether rural children in their neonatal period enjoy fair treatment, if there existence of unfair treatment, what are origins of this unfairness. Thus providing some suggestions to our immunization policy, and expecting neonatal hepatitis B vaccination status in rural China can be improved.Research methodsIn this study, data was screened from the National Bureau of a Norwegian-funded projects Rural residents’knowledge and demand of vaccination, lasting for two years, and completed in April 2012. Project taken in accordance with certain rules, five provinces (Heilongjiang, Shandong, Hebei, Hainan and Jiangsu Province), one municipality (Beijing) and one autonomous region (Ningxia), a total of 30 rural villages were extracted, sample households were selected according to the PPS and cluster sampling method. To learn hepatitis B vaccine inoculation status in aged below and in 15 years old children in selected households, their parents or guardians knowledge on hepatitis B, the implementation of local EPI policies and so on. In this study, by using the data we analyzed hepatitis B vaccination status of children in rural areas. Stata/MP14.0 software was used. Using univariate logistic regression method to filter out the relevant factors, and then using multivariate logistic regression method to integrate influence factors, and then take advantage of the concentration index method to explore its unfairness existence and extent of the last decomposition method according to the concentration index exploring various factors that influence the degree of fairness, namely the contribution rate. Conclusion and Significance In this study, logistic regression analysis and analysis of concentration index drew results and conclusions.1.Birth and inoculated in places with good health conditions result in better timely vaccination status, the same situation also occurs in newborns with the higher maternal education level of and reliable sources of neonatal vaccination information;2.Economic level in sample households no longer have a significant impact on timely three doses of hepatitis B vaccination, the parents will be more care about children health, rather than simply worry about the financial burden;3.The impact of national policies and the policy environment for vaccination are important and policy support and free vaccination can greatly improve timely vaccination rate, it is necessary to conduct investigation on the implementation of hepatitis B vaccination policy throughout China, to ensure full free policy;4.The unfairness of hepatitis B vaccination for newborns is real existing in rural China, relevant government agencies need attention.This study has some importance, the lack of literature on hepatitis B vaccination equity for children in rural China lead to lack of attention to policy implementation, this study is to a certain extent, providing policy implementation basis for policy makers and implementers.