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Equity and determinants of routine child immunisation programme among tribal and non-tribal populations in rural Tangail subdistrict, Bangladesh: a cohort study
  1. Aminur Rahman1,
  2. Ashek Ahmed Shahid Reza2,
  3. Badrul Alam Bhuiyan3,
  4. Nurul Alam1,
  5. Shushil K Dasgupta1,
  6. Shabnam Mostari4,
  7. Iqbal Anwar1
  1. 1 Health System and Population Studies Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
  2. 2 Expended Program on Immunization Department, Director General of Health Services (DGHS), Government of Bangladesh (GoB), Dhaka, Bangladesh
  3. 3 Global Consortium for Public Health Research, Liverpool John Moores University, Liverpool, UK
  4. 4 Community Skilled Birth Attendant Program, Obstetrical and Gynaecological Society of Bangladesh (OGSB), Mohammadpur, Bangladesh
  1. Correspondence to Dr Aminur Rahman; draminur{at}


Objectives The study estimated valid vaccination coverage of under 5 children in a rural area under Tangail subdistrict and examined their sociodemographic correlates including ethnicity.

Setting The study sites are three primary areas where tribal and non-tribal population resides together in a rural subdistrict of Bangladesh.

Participants Routine vaccination information of a cohort of 2802 children, born between 1 January 2011 and 31 December 2012, were retrieved from the Expanded Program on Immunization (EPI) registers maintained by the health assistants. Collected data were entered in an Oracle-based computer program. Univariate, bivariate and multivariate analyses were performed in SPSS V.20 to explore coverage and differentials for full valid vaccination coverage in the study area.

Results Valid vaccination coverage was 90.6% among tribal population and 87.3% among non-tribal population(p=0.25). Compared with females, males had higher valid vaccination coverage (89.2% vs 85.9%) and lower invalid (5.4% vs 6.9%) and no-coverage (5.3% vs 7.3%) (p=0.03). Households with mobile phones had higher valid coverage (90.9% vs 86.5%) and lower invalid (4.5% vs 6.7%) and no coverage (4.5% vs 6.9%) compared with those without mobile phones (p=0.01). Coverage of valid vaccination was higher among children of Oronkhola union than in children of the other two unions.

Conclusion The study documented that valid vaccination coverage was high in this rural area, and there was no significant ethnic variation which was one of the strengths of the national EPI. However, there is significant variation by gender of the child, household ownership of mobile phones and geographical location of households.

  • ethnicity
  • child health
  • immunization
  • bangladesh

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  • Contributors AR conceptualised the study. AR, AASR and BAB wrote the first draft of this protocol with substantial inputs from all authors. SDG organised and cleaned the data and participated in the analysis with AR, NA, BAB, SM and IA. AR, NA, AASR, IA, SD, BAB and SM contributed to the interpretation. All the authors were involved in developing the manuscript and approved the final version for submission. All authors read and approved the final manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent Not required.

  • Ethics approval This study has used the routine Expanded Program on Immunization (EPI) data but permission to use this data was approved by the EPI Directorate office. Any information about the study participant cannot be traced back and all the reports were presented anonymously.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement Data can be available through icddr,b data access policy. Data can be accessed through contacting Research Administration Department of icddr,b by mailing to

  • Author note Findings of this study will be cared to publish at international peer-reviewed journal for dissemination.

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