The 17 Sustainable Development Goals (SDGs) comprise an ambitious agenda with multisectoral goals covering health, nutrition, water and sanitation, education, and several other topics, with the ultimate aim of achieving “a better and more sustainable future for all”. The concept of multiple deprivation recognizes that the same individuals, households, and communities are often exposed to several forms of scarcity. Integrated approaches to service delivery can be efficient ways to reduce inequalities in health service coverage because children and households that are missing out on immunization are often also being missed by other health interventions.  

Our goal is to investigate whether zero-dose children and their families are missing out on other health services and interventions in relevant sectors such as nutrition, environmental health, and education. To that end, we studied 80 low- and middle-income countries with surveys carried out from 2010 onwards. We performed individual and ecological analyses to assess the overlap between immunization and a set of indicators for social, environmental, or nutritional disadvantage.

Zero-dose children were significantly more likely to be exposed to the other markers for deprivation than vaccinated children. The strongest, most consistent associations were found with maternal education, water, and sanitation, while the weakest associations were found for wasting and bed nets.

Our results provide empirical evidence and quantify the degree to which zero-dose children and their families face multiple deprivations, which are apparent at individual, subnational, and national levels. More generally, our results underscore the potential impact of multisectoral interventions to improve equity in health and development outcomes on the pathway to achieving the Sustainable Development Goals.

You can access the full paper at: Vaccines (MDPI)