Determinant of Rural-urban differentials of measles vaccination in India: A cross sectional study

Measles is considered as one of the leading vaccine preventable causes of child mortality and morbidity worldwide. Global measles incidence, morbidity and mortality trends improved over the past six decades until a reversal in the downward incidence trend was observed between early 2018 and late 2019. No studies in India have established on rural-urban differentials of measles vaccination on malnutrition, anemia, and diarrhea. The present study tries to examine the coverage of measles, its rural-urban differentials across the various population subgroups, and its associated covariates. National Family Health Survey (NFHS-4), a nationally representative cross-sectional household survey in India conducted in 2015–16 has been used. Descriptive statistics and logistic regression analysis were applied to ascertain the influence of specified socio-demographic variables affecting measles vaccination coverage in India. Investigation of rural-urban differences in vaccination coverage by states shows that measles vaccination coverage is significantly higher in urban areas for 18 of the 36 Indian states. Mother's educations significantly improve vaccination outcomes for children. A socio-economic gradient exists in India's Measles vaccination coverage, mediated by place delivery, education of mothers, and highlighted socio-demographic factors. Eliminating morbidity and mortality from measles in India is feasible, although it will require efficient expanded program on immunization management, enhanced health literacy among mothers, continuing commitment from central state and district political authorities.