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Health Interventions and Health Equity: The Example of Measles Vaccination in Bangladesh


  • Michael A. Koenig
  • David Bishai
  • Mehrab Ali Khan


Although the existence of socioeconomic differentials in infant and childhood mortality in developing countries is well established. little consensus exists as to the most effective approaches to reducing such differentials. This article utilizes longitudinal data from the Matlab study area in rural Bangladesh to investigate the impact of an efficacious child survival intervention-measles vaccination-on reductions in gender and socioeconomic differentials in childhood mortality. The article analyzes data from 16,270 vaccinated children and randomly matched controls, and evaluates their subsequent mortality risks. Proportional hazards analysis demonstrates that unvaccinated children from very poor families face more than a threefold higher risk of subsequent early child mortality, compared to vaccinated children from families of high economic status. While measles vaccination has little impact on mortality risks among children of higher economic status, the improvement in survival among children from poorer households is pronounced. The provision of measles vaccination markedly reduces mortality risks for poorer children-from over three times higher to just over 1.5 times higher relative to vaccinated children from wealthier families. The findings of this study are evaluated in terms of the potential of child survival interventions such as measles vaccination to promote greater health equity. Copyright 2001 by The Population Council, Inc..

Suggested Citation

  • Michael A. Koenig & David Bishai & Mehrab Ali Khan, 2001. "Health Interventions and Health Equity: The Example of Measles Vaccination in Bangladesh," Population and Development Review, The Population Council, Inc., vol. 27(2), pages 283-302.
  • Handle: RePEc:bla:popdev:v:27:y:2001:i:2:p:283-302

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    References listed on IDEAS

    1. Mitchell,Donald O. & Ingco,Merlinda D. & Duncan,Ronald C., 1997. "The World Food Outlook," Cambridge Books, Cambridge University Press, number 9780521589840, March.
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    Cited by:

    1. David E. Bloom & David Canning & Erica S. Shenoy, 2012. "The effect of vaccination on children's physical and cognitive development in the Philippines," Applied Economics, Taylor & Francis Journals, vol. 44(21), pages 2777-2783, July.
    2. Eva Deuchert & Conny Wunsch, 2010. "Evaluating Nationwide Health Interventions When Standard Before-After Doesn't Work: Malawi's ITN Distribution Program," University of St. Gallen Department of Economics working paper series 2010 2010-12, Department of Economics, University of St. Gallen.
    3. Trudy Harpham & Sharon Huttly & Ian Wilson & Thea De Wet, 2003. "Linking public issues with private troubles: panel studies in developing countries," Journal of International Development, John Wiley & Sons, Ltd., vol. 15(3), pages 353-363.
    4. J. Driessen & A. Razzaque & D. Walker & D. Canning, 2015. "The effect of childhood measles vaccination on school enrolment in Matlab, Bangladesh," Applied Economics, Taylor & Francis Journals, vol. 47(55), pages 6019-6040, November.
    5. Yusuf, Shahid & Nabeshima, Kaoru & Wei Ha, 2007. "What makes cities healthy ?," Policy Research Working Paper Series 4107, The World Bank.
    6. Canning, David & Razzaque, Abdur & Driessen, Julia & Walker, Damian G. & Streatfield, Peter Kim & Yunus, Mohammad, 2011. "The effect of maternal tetanus immunization on children's schooling attainment in Matlab, Bangladesh: Follow-up of a randomized trial," Social Science & Medicine, Elsevier, vol. 72(9), pages 1429-1436, May.
    7. Steve Brito & Ana Corbacho & Rene Osorio, 2017. "Does birth under-registration reduce childhood immunization? Evidence from the Dominican Republic," Health Economics Review, Springer, vol. 7(1), pages 1-18, December.
    8. Wagstaff, Adam & Nga Nguyet Nguyen, 2002. "Poverty and survival prospects of Vietnamese children under Doi Moi," Policy Research Working Paper Series 2832, The World Bank.
    9. Adam Wagstaff & Naoko Watanabe, 2003. "What difference does the choice of SES make in health inequality measurement?," Health Economics, John Wiley & Sons, Ltd., vol. 12(10), pages 885-890.
    10. McGovern, Mark E. & Canning, David, 2015. "Vaccination and All Cause Child Mortality 1985-2011: Global Evidence from the Demographic and Health Surveys," Working Paper 227741, Harvard University OpenScholar.
    11. Naushin Mahmood & Saima Bashir, 2012. "Applying an Equity Lens to Maternal Health Care Practices in Pakistan," PIDE-Working Papers 2012:83, Pakistan Institute of Development Economics.

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