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Objective: To report on vaccination status by 12 months of age among tribal children from nine districts of India. Methods: Cross‐sectional study of 2631 tribal women having a child aged 12 months or below from nine Indian districts with a considerable proportion of the tribal population. Socio‐demographic details, reception of various vaccines by 12 months of age, mother's antenatal care utilisation and health system‐related details were collected through a pre‐tested, interviewer‐administered questionnaire from mothers. Multiple logistic regression analysis was used to identify the factors associated with complete vaccination by 12 months of age. Results: Only 52% of children were fully vaccinated by the age of 12 months among the tribal populations; 11% did not receive any vaccine, and 37% of the tribal children received some vaccines. The age‐appropriate vaccination was unsatisfactory as only 75% of the infants received all birth dose vaccines, and only 60.5% received all doses by 14 weeks. Only 73% were vaccinated against measles. Illness of the child, home births and communication gaps concerning vaccination were the main reasons for an infant not being vaccinated appropriately. Frequency of health worker's visits to the village, hospital birth, reception of advice on vaccination and educational status of the head of the households were significantly associated with full vaccination status. Conclusion: A relatively low proportion of children were fully vaccinated among the tribal populations. Health systems factors, mainly the outreach services and advice by the health workers, were positively and significantly associated with a child being fully vaccinated by 12 months of age. Improving outreach services is crucial to improve vaccination coverage in tribal areas, and there is a need to address the social determinants in the long run. [ABSTRACT FROM AUTHOR]

A lack of a universal adult immunization scheme in India poses a challenge to achieve universal health coverage. Healthcare disparity is one of the biggest challenges in low- and middle-income countries such as India. We aimed to estimate the disparities in coverage of various adult vaccines among older adults in India using nationally representative data. An observational analysis among 31,464 participants aged ≥60 years from the Longitudinal Ageing Study in India, 2017–2018, was conducted. Vaccination coverage across wealth quintiles and selected non-communicable diseases were reported as frequencies and weighted proportions along with their 95% confidence intervals as a measure of uncertainty. The highest coverage was of the diphtheria and tetanus vaccine (2.75%) followed by typhoid (1.84%), hepatitis B (1.82%), influenza (1.59%), and pneumococcal (0.74%). The most affluent groups had a higher coverage of all vaccines. Participants having high cholesterol, psychiatric conditions, and cancer had the highest coverage of all vaccines. Overall, a very low coverage of all vaccines was observed. The coverage was influenced by social determinants of health, depicting a disparity in accessing immunization. Hence, at-risk groups such as the deprived and multimorbid patients need to be covered under the ambit of free immunization to achieve universal health coverage. [ABSTRACT FROM AUTHOR]

Background: The free-of-cost supply could not meet the demand for Coronavirus disease-2019 (COVID-19) vaccines in India, so the government approved an injection option with a price. We aimed to determine how much money an individual would be willing to pay for a COVID-19 vaccine for themselves and their children and assess the factors determining it. Methods: We conducted a study among all adults visiting the outpatient department of a government tertiary care hospital in West Bengal, India, in August 2021. Trained nursing officers combined bidding game and open-ended question methods during personal interviews to estimate the willingness-to-pay (WTP) values. Results: The mean (standard deviation) age of 1565 participants was 40.8 (12.2) years with 46.5% (n = 727) males, 70.4% (n = 1102) parents, 50.0% (n = 783) educated up to class 12 and 30.9% (n = 483) belonging to upper-middle socio-economic scale (SES). The median (inter-quartile range [IQR]) WTP amount for the first dose and the subsequent/booster dose among the unvaccinated (50.2%, n = 785) and vaccinated (49.8%, n = 780) participants were ₹0 (0-100) and ₹0 (0-200), respectively. The median (IQR) WTP for inoculating children with any COVID-19 vaccine was ₹50 (0-300) in both groups. Significant differences were found in the WTP prices for adult vaccines in both groups concerning age category (P = 0.02), education (P < 0.01) and SES (P < 0.01). Conclusion: Although more than half of the respondents were unwilling to pay for themselves, WTP for COVID-19 vaccination was higher for their children. Policy-makers should consider income, education and age to cap the private sector vaccination price. [ABSTRACT FROM AUTHOR]

Background: Construction workers are one of the important neglected occupation groups. The study aimed to assess the prevalence and health risk score of tobacco and alcohol use and its association with sociodemographic factors and self-reported morbidities among construction workers. Materials and Methods: A cross-sectional study was conducted among 400 male construction workers in a tertiary care medical institution in Puducherry, India. A semi-structured questionnaire based on the World Health Organization Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) guidelines for assessment and health risk score of alcohol and tobacco use was used. The association of current tobacco and alcohol use with associated factors was analyzed by univariate analysis. Results: About 371 male construction workers participated. The mean (standard deviation) age of construction workers was 28.28 (9.04) years. The prevalence of current tobacco and alcohol use was 60.1% (223/371) and 47.7% (177/371), respectively. Out of 133 smokers, 60.9% (81) were used only bidi, 27.1% (36) only cigarette, and 12% (16) both bidi and cigarette. Most of the workers (126/151 [83.4%]) used khaini among smokeless tobacco users. The majority (204/241 [84.6%]) of ever smokers and nearly half of alcohol users (103 [49.8%]) had moderate risk based on ASSIST score. Higher current tobacco consumption is associated with higher age group, married, lower education status, unskilled occupation, contractual workers, migrants from other states, more duration of work in construction field, and the presence of self-reported health problems (P < 0.05). Current alcohol consumption is associated with more duration of work in construction field and the presence of self-reported health problems (P < 0.05). Conclusions: Tobacco and alcohol use is high, and health risk due to substance use is also more in construction workers. [ABSTRACT FROM AUTHOR]

• Government health care services are the primary source of maternal care for the tribes (indigenous communities). • Particularly vulnerable tribal groups are at risk of foregoing antenatal care and are more likely to give childbirth at home. • Health workers' home visits and advice significantly and positively influence maternal healthcare-seeking behaviour. • Maternal education and having all-weather roads are crucial determinants for institutional childbirths. • Certain socio-cultural practices (early marriages leading to teenage pregnancies) need to be addressed. To report the utilisation of maternal healthcare services and factors associated with adequate antenatal care and institutional childbirths among mothers in the tribal communities from nine districts in India. Cross-sectional data were collected from 2636 tribal women who had a childbirth experience in the past 12 months. Socio-demographic, maternal healthcare services and health system-related details were collected. Multiple logistic regression analyses were done to identify factors associated with adequate antenatal care (receiving at least four antenatal care visits, the first visit being in the first trimester and receiving a minimum of 100 iron-folic acid tablets) and institutional childbirth (mother giving birth in a health facility). Only 23% of the mothers received adequate antenatal care. 82% were institutional childbirths. The logistic regression revealed that particularly vulnerable tribal groups (PVTGs), those lacking all-weather roads, and women of advanced age were at risk of inadequate antenatal care. Mother's education, health worker's home visits during pregnancy and reception of advice on antenatal care were significantly associated with the reception of adequate antenatal care. Having all-weather roads, and education of the mother and head of the household were positively associated with institutional childbirths, whereas PVTGs, children of birth order three or above, and working mothers were more likely to give childbirth at home. PVTGs are at risk of foregoing adequate antenatal care and are more likely to give childbirth at home. Having all-weather roads is a strong correlate of adequate maternal care. Outreach activities by the health workers are to be strengthened as they are positively and significantly associated with the reception of adequate antenatal care. Investing in education and other social determinants and addressing certain socio-cultural practices is important to improve maternal health. [ABSTRACT FROM AUTHOR]