ObjectiveTo investigate the effect of different aspects of inequality on childhood immunisation rates in Nepal. The study hypothesised that social inequality factors (eg, gender of a child, age of mother, caste/ethnic affiliation, mother’s socioeconomic status, place of residence and other structural barrier factors such as living in extreme poverty and distance to health facility) affect the likelihood of children being immunised.DesignUsing gender of a child, age of mother, caste/ethnic affiliation, mother’s socioeconomic status, place of residence and other structural barrier factors such as living in extreme poverty and distance to health facility as independent variables, we performed bivariate and multivariate logistic regression analyses.SettingThis study used data from the most recent nationally representative cross-sectional Nepal Demographic and Health Survey in 2016.ParticipantsThe analysis reviewed data from 1025 children aged 12–23 months old.Outcome measuresThe main outcome variable was childhood immunisation.ResultsOnly 79.2% of children were fully immunised. The complete vaccination rate of ethnic/caste subpopulations ranged from 66.4% to 85.2%. Similarly, multivariate analysis revealed that children from the previously untouchable caste (OR 0.58; CI 0.33 to 0.99) and the Terai caste (OR 0.54; CI 0.29 to 0.99) were less likely to be fully immunised than children from the high Hindu caste.ConclusionGiven Nepal’s limited resources, we suggest that programmes that target the families of children who are least likely to be fully immunised, specifically those who are not only poor but also in financial crises and ‘underprivileged’ caste families, might be an effective strategy to improve Nepal’s childhood immunisation rates.

Non‐governmental organizations (NGOs) and the government of Nepal have made some effort to reduce poverty in Nepal by creating women's affiliation groups, some of which are micro‐credit organizations. Using capabilities as defined by Amartya Sen (Development as freedom, Oxford University Press, New Delhi, 2000), which includes employment opportunities, women's ownership in productive resources such as land and/or homes, educational opportunities, and women's participation in decision‐making in the family, this study evaluated the extent to which women's ethnic group or caste affiliation affected a woman's likelihood of being empowered by participation in these groups. We analyzed a sample of 8,973 women which was taken from the 2011 Nepal Demographic and Health Survey. Previous research has demonstrated that participation in gender‐based groups is correlated with higher economic status. This study adds to the literature on women's affiliation groups by investigating the impact of structural factors, such as caste and ethnicity, on women's self‐help group participation (women's groups and credit groups).

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