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Comparative Study
. 2005 Feb;95(2):241-4.
doi: 10.2105/AJPH.2003.036848.

Inequities in coverage of preventive child health interventions: the rural drinking water supply program and the universal immunization program in Rajasthan, India

Pavitra Mohan  1
Affiliations
Comparative Study

Inequities in coverage of preventive child health interventions: the rural drinking water supply program and the universal immunization program in Rajasthan, India

Pavitra Mohan. Am J Public Health. 2005 Feb.

Abstract

Objectives: I assessed whether the Rural Drinking Water Supply Program (RDWSP) and the Universal Immunization Program (UIP) have achieved equitable coverage in Rajasthan, India, and explored program characteristics that affect equitable coverage of preventive health interventions.

Methods: A total of 2460 children presenting at 12 primary health facilities in one district of Rajasthan were enrolled and classified into economic quartiles based on possession of assets. Immunization coverage and prime source of drinking water were compared across quartiles.

Results: A higher access to piped water by wealthier families (P< .001) was compensated by higher access to hand pumps by poorer families (P<.001), resulting in equal access to a safe source (P=.9). Immunization coverage was inequitable, favoring the wealthier children (P<.001).

Conclusions: The RDWSP has achieved equitable coverage, while UIP coverage remains highly inequitable. Programs can make coverage more equitable by formulating explicit objectives to ensure physical access to all, promoting the intervention's demand by the poor, and enhancing the support and monitoring of frontline workers who deliver these interventions.

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Comment in

  • Reaching the underserved.
    Victora CG. Victora CG. Am J Public Health. 2005 Feb;95(2):195. doi: 10.2105/ajph.95.2.195. Am J Public Health. 2005. PMID: 15762014 Free PMC article. No abstract available.

References

    1. The World Health Report 2000. Health Systems: Improving Performance. Geneva, Switzerland: World Health Organization; 2000:55–56.
    1. Victora CG, Wagstaff A, Schellenberg JA, Gwatkin D, Claeson M, Habicht JP. Applying an equity lens to child health and mortality: more of the same is not enough. Lancet. 2003;362:233–241. - PubMed
    1. Rajasthan Human Development Report, 2002. Government of Rajasthan, Jaipur, India; 2002.
    1. National Family Health Survey (NFHS-2), 1998–1999: Rajasthan. Mumbai, India: International Institute of Population Sciences & ORC Macro, 2000.
    1. Rural Drinking Water Supply Programme. New Delhi, India: Dept of Drinking Water Supply, Ministry of Rural Development, Government of India; 2000.

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