Estimation of child vaccination coverage at state and national levels in India

OBJECTIVE To review the data, for 1999-2013, on state-level child vaccination coverage in India and provide estimates of coverage at state and national levels. METHODS We collated data from administrative reports, population-based surveys and other sources and used them to produce annual estimates of vaccination coverage. We investigated bacille Calmette-Guérin vaccine, the first and third doses of vaccine against diphtheria, tetanus and pertussis, the third dose of oral polio vaccine and the first dose of vaccine against measles. We obtained relevant data covering the period 1999-2013 for each of 16 states and territories and the period 2001-2013 for the state of Jharkhand - which was only created in 2000. We aggregated the resultant state-level estimates, using a population-weighted approach, to give national values. FINDINGS For each of the vaccinations we investigated, about half of the 253 estimates of annual coverage at state level that we produced were based on survey results. The rest were based on interpolation between - or extrapolation from - so-called anchor points or, more rarely, on administrative data. Our national estimates indicated that, for each of the vaccines we investigated, coverage gradually increased between 1999 and 2010 but then levelled off. CONCLUSION The delivery of routine vaccination services to Indian children appears to have improved between 1999 and 2013. There remains considerable scope to improve the recording and reporting of childhood vaccination coverage in India and regular systematic reviews of the coverage data are recommended.