State of inequality in diphtheria-tetanus-pertussis immunisation coverage in low-income and middle-income countries: a multicountry study of household.

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State of inequality in diphtheria-tetanus-pertussis immunisation coverage in low-income and middle-income countries: a multicountry study of household health surveys Dr Ahmad Reza Hosseinpoor, MD, Nicole Bergen, MHSc, Anne Schlotheuber, MSc, Marta Gacic-Dobo, MSc, Peter M Hansen, PhD, Kamel Senouci, MD, Ties Boerma, MD, Prof Aluisio J D Barros, PhD The Lancet Global Health Volume 4, Issue 9, Pages e617-e626 (September 2016) DOI: 10.1016/S2214-109X(16)30141-3 Copyright © 2016 World Health Organization Terms and Conditions

Figure 1 Latest situation of DTP3 coverage among children aged 12–23 months in 51 low-income and middle-income countries, by economic status Data taken from DHS and MICS 2010–13. Box and whisker plots show the distribution of DTP3 coverage within wealth quintiles of 51 low-income and middle-income countries. Whiskers represent maximum and minimum values; the centre line denotes the median value; and the shaded box indicates the IQR (middle 50% of country estimates). DHS=Demographic and Health Survey. DTP3=three doses of the combined diphtheria, tetanus toxoid, and pertussis vaccine. MICS=Multiple Indicator Cluster Survey. The Lancet Global Health 2016 4, e617-e626DOI: (10.1016/S2214-109X(16)30141-3) Copyright © 2016 World Health Organization Terms and Conditions

Figure 2 Change over time in national average of DTP3 coverage among children aged 12–23 months, and in quintile 1 compared with quintile 5, in 21 low-income and middle-income countries Data taken from DHS and MICS 2000–03 and 2010–13. Every country is represented by a shape, which corresponds to its WHO region. For every study country, the annual absolute change in national average was calculated by subtracting the national coverage in survey year 1 (2000–03) from coverage in survey year 2 (2010–13) and dividing by the number of intervening years. The annual absolute excess change was calculated by subtracting the annual absolute change in quintile 5 from the annual absolute change in quintile 1. Red and blue boxes portray undesirable and desirable scenarios, respectively. DHS=Demographic and Health Survey. DTP3=three doses of the combined diphtheria, tetanus toxoid, and pertussis vaccine. MICS=Multiple Indicator Cluster Survey. The Lancet Global Health 2016 4, e617-e626DOI: (10.1016/S2214-109X(16)30141-3) Copyright © 2016 World Health Organization Terms and Conditions

Figure 3 Change over time in DTP3 coverage among children aged 12–23 months in six high-priority countries, by economic status Data taken from DHS 2000–13. For each country, disaggregated data are presented for wealth quintiles by coloured dots; the horizontal lines indicate the difference between the most extreme quintile values. DHS=Demographic and Health Survey. DTP3=three doses of the combined diphtheria, tetanus toxoid, and pertussis vaccine. The Lancet Global Health 2016 4, e617-e626DOI: (10.1016/S2214-109X(16)30141-3) Copyright © 2016 World Health Organization Terms and Conditions

Figure 4 Latest situation of DTP3 coverage among children aged 12–23 months in three high-priority countries, by economic status Data taken from DHS 2011–13. DHS=Demographic and Health Survey. DTP3=three doses of the combined diphtheria, tetanus toxoid, and pertussis vaccine. The Lancet Global Health 2016 4, e617-e626DOI: (10.1016/S2214-109X(16)30141-3) Copyright © 2016 World Health Organization Terms and Conditions