Immunization is one of the main interventions responsible for the decline in under-5 mortality. In Guinea-Bissau, a low-income African country, vaccination is supported by international agencies, such as the World Bank, the World Health Organization (WHO), and GAVI, the Vaccine Alliance. Vaccines are provided free of charge in health centers and the program is implemented via routine vaccinations, specific campaigns, and catch-up and mop-up campaigns. The immunization schedule includes one dose of the Bacillus Calmette-Guérin (BCG) vaccine at birth, followed by three doses of the DTP vaccine and oral polio vaccines (OPV) at 6, 10, and 14 weeks of age and one dose of measles vaccine at nine months of age.

This study aimed to analyze inequalities in wealth, area of residence, maternal schooling level, and subnational regions in full immunization coverage over the years in Guinea-Bissau, as an effort that can be replicate for other countries.

To that end, we used three Multiple Indicator Cluster Survey (MICS) carried out in 2006, 2014 and 2018. We estimated the slope index of inequality (SII) for wealth quintiles and maternal schooling level as a measure of absolute inequality.

Overall, full immunization coverage increased over the years, but it remains at suboptimal level. Urban-rural and wealth inequalities were reduced, but maternal education inequality remained unchanged, with a higher coverage among children born to the most educated women.

You can access the full paper at: Cadernos Saude Publica