This article presents the findings of secondary analyses of data sourced from the National Family Health Survey (NFHS). NFHS is a large-scale, multi-round survey conducted in a representative sample of households throughout India [9 ]. It is used as a reference to assess the progress the country has achieved across a multitude of programs. These include family planning, maternal and delivery care, child vaccinations, treatment of childhood diseases, feeding practices and nutrition status of children, nutrition status of adults, anemia among children and adults, blood sugar and hypertension level among adults, tobacco and alcohol consumption, screening for cancer among adults, knowledge on HIV/AIDs among adults, women empowerment, and gender-based violence. The data are publicly available in the form of factsheets, state reports, and raw data for national, state, and district levels.
Data for immunization are available for the point of service (public and private) and the coverage estimates for individual antigens (BCG), hepatitis B birth dose, pentavalent (DPT, hepatitis B, and Haemophilus influenzae type b), oral polio vaccine, measles-containing vaccine (MCV), and rotavirus vaccine (RVV). In addition, data are available for key equity parameters including gender, place of residence, religion, birth order, caste, and mother’s schooling. While the NFHS factsheets provide data on key coverage indicators, the equity indicators are included as part of the state reports. The state reports also provide data on other program indicators, the impact of which can be assessed on the immunization program. Coverage of key immunization indicators for districts is available in the state reports.
Using equity differentiated data from NFHS state reports, this article aims to analyze the progress achieved across states of the country in reaching out to ZD children between the last two NFHS rounds (NFHS 5, 2019-2021 and NFHS 4, 2015-2016). ZD proportions were measured using pentavalent 1 coverage as the indicator. The key determinants studied include the change in ZD prevalence at the national, state, and district levels; the proportion of change in equity determinants; the states with maximum improvements; the maximum disparity across these indicators; and the overall reduction in disparities. The data were interpreted in the form of tables and maps. The maps were created using choropleth maps on Datawrapper [10 ] and the map feature on Microsoft Excel.
A correlation analysis was conducted to understand the nature of the association between ZD prevalence and critical maternal and child health (MCH) indicators which include four or more antenatal care (ANC) visits, the timing of pregnancy registration, institutional delivery (birth at a health facility), children under five years old who are stunted (height-for-age), and children under five years old who are wasted (weight-for-height). For each of these indicators, data were collated for both the NFHS rounds (NFHS 5 and NFHS 4), and the Pearson correlation coefficient was obtained using the following formula:
r=∑[(xi-x ¯)(yi-ȳ)] ⁄ √[∑(xi-x ¯)^2 ∑(yi-ȳ)^2]
with the coefficient value r signifying the strength and direction of correlation between the two variables. The strength of association as per the correlation coefficient values was interpreted as follows: no association: 0, weak association: (±) 0.1 to less than 0.3, moderate association: (±) 0.3 to less than 0.5, strong association: (±) 0.5 to less than 1, and perfect association: (±) 1.
Data for immunization are available for the point of service (public and private) and the coverage estimates for individual antigens (BCG), hepatitis B birth dose, pentavalent (DPT, hepatitis B, and Haemophilus influenzae type b), oral polio vaccine, measles-containing vaccine (MCV), and rotavirus vaccine (RVV). In addition, data are available for key equity parameters including gender, place of residence, religion, birth order, caste, and mother’s schooling. While the NFHS factsheets provide data on key coverage indicators, the equity indicators are included as part of the state reports. The state reports also provide data on other program indicators, the impact of which can be assessed on the immunization program. Coverage of key immunization indicators for districts is available in the state reports.
Using equity differentiated data from NFHS state reports, this article aims to analyze the progress achieved across states of the country in reaching out to ZD children between the last two NFHS rounds (NFHS 5, 2019-2021 and NFHS 4, 2015-2016). ZD proportions were measured using pentavalent 1 coverage as the indicator. The key determinants studied include the change in ZD prevalence at the national, state, and district levels; the proportion of change in equity determinants; the states with maximum improvements; the maximum disparity across these indicators; and the overall reduction in disparities. The data were interpreted in the form of tables and maps. The maps were created using choropleth maps on Datawrapper [10 ] and the map feature on Microsoft Excel.
A correlation analysis was conducted to understand the nature of the association between ZD prevalence and critical maternal and child health (MCH) indicators which include four or more antenatal care (ANC) visits, the timing of pregnancy registration, institutional delivery (birth at a health facility), children under five years old who are stunted (height-for-age), and children under five years old who are wasted (weight-for-height). For each of these indicators, data were collated for both the NFHS rounds (NFHS 5 and NFHS 4), and the Pearson correlation coefficient was obtained using the following formula:
r=∑[(xi-x ¯)(yi-ȳ)] ⁄ √[∑(xi-x ¯)^2 ∑(yi-ȳ)^2]
with the coefficient value r signifying the strength and direction of correlation between the two variables. The strength of association as per the correlation coefficient values was interpreted as follows: no association: 0, weak association: (±) 0.1 to less than 0.3, moderate association: (±) 0.3 to less than 0.5, strong association: (±) 0.5 to less than 1, and perfect association: (±) 1.
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