Socioeconomic determinants of rural urban differences in childhood immunisation in India

Abstract Background In developing countries such as India, vaccine-preventable diseases among infants and women are often associated with malnutrition and poor hygiene conditions. Immunisation plays a crucial role in protecting children from these diseases. This study examines the socio-economic determinants of immunisation among children under five years of age. It also analyses the relationship between immunisation status and factors such as the gender and education of the household head, rural–urban residence, source of immunisation, and the state-level MPI. Methods This study uses unit-level data from the 75th round of the Indian National Sample Survey (NSS). The level of immunisation is considered as the outcome variable and is categorised into three groups i.e., fully-immunised, under-immunised, and non-immunised. Since the dependent variable represents multiple discrete outcomes, a multinomial logistic regression model is employed to analyse the factors influencing households choices regarding full, partial, or non-immunisation of children. Results The estimated proportion of fully-, under-, and non-immunised children in rural regions accounted for 45.92%, 51.58%, and 2.43%. On the contrary, the percentage of fully-immunised children were reduced to 45.76%, under-immunised to 52.42%, and non-immunised to 1.76% in urban regions. The household head’s general education status and the sources of immunisation strongly influence and are significantly associated with the immunisation status of children. Conclusion The findings suggest that disparities in resource allocation contribute to differences in immunisation outcomes between rural and urban areas. Strengthening grassroots health centres can improve immunisation coverage. Additionally, ensuring that all newborns, whether at home or in a health facility, should have health cards to avoid incorrect immunisation coverage.