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Eradicating diseases: The effect of conditional cash transfers on vaccination coverage in rural Nicaragua


  • Barham, Tania
  • Maluccio, John A.


Despite significant global efforts to improve vaccination coverage against major childhood diseases, vaccination rates are below 90%. To eradicate diseases such as measles, however, vaccination rates close to 95% are needed. We use a randomized experiment to investigate the effect of a demand incentive, a conditional cash transfer program, in improving vaccination coverage in rural Nicaragua. Double-difference estimates show the program led to large increases in vaccination coverage, and these resulted in vaccination levels greater than 95% for some vaccines. Effects were especially large for children who are typically harder to reach with traditional supply-side interventions.

Suggested Citation

  • Barham, Tania & Maluccio, John A., 2009. "Eradicating diseases: The effect of conditional cash transfers on vaccination coverage in rural Nicaragua," Journal of Health Economics, Elsevier, vol. 28(3), pages 611-621, May.
  • Handle: RePEc:eee:jhecon:v:28:y:2009:i:3:p:611-621

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    References listed on IDEAS

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    Cited by:

    1. Ryoko Sato & Yoshito Takasaki, 2015. "Psychic vs. Economic Barriers to Vaccine Take-up: Evidence from a Field Experiment in Nigeria," CIRJE F-Series CIRJE-F-983, CIRJE, Faculty of Economics, University of Tokyo.
    2. Gentilini,Ugo, 2016. "The revival of the"cash versus food"debate : new evidence for an old quandary ?," Policy Research Working Paper Series 7584, The World Bank.
    3. Omar Galárraga & Sandra Sosa-Rubí & César Infante & Paul Gertler & Stefano Bertozzi, 2014. "Willingness-to-accept reductions in HIV risks: conditional economic incentives in Mexico," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 15(1), pages 41-55, January.
    4. Barrientos, Armando & Nino-Zarazua, Miguel, 2010. "Social Assistance in Developing Countries Database Version 5.0," MPRA Paper 20001, University Library of Munich, Germany.
    5. Barham, Tania, 2011. "A healthier start: The effect of conditional cash transfers on neonatal and infant mortality in rural Mexico," Journal of Development Economics, Elsevier, vol. 94(1), pages 74-85, January.
    6. Joshi, Shareen & Sivaram, Anusuya, 2014. "Does it Pay to Deliver? An Evaluation of India’s Safe Motherhood Program," World Development, Elsevier, vol. 64(C), pages 434-447.
    7. Sudhanshu Handa & John A. Maluccio, 2010. "Matching the Gold Standard: Comparing Experimental and Nonexperimental Evaluation Techniques for a Geographically Targeted Program," Economic Development and Cultural Change, University of Chicago Press, vol. 58(3), pages 415-447, April.
    8. Gentilini, Ugo, 2014. "Our daily bread : what is the evidence on comparing cash versus food transfers?," Social Protection and Labor Policy and Technical Notes 89502, The World Bank.
    9. 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.
    10. Ebenezer Owusu-Addo & Ruth Cross, 2014. "The impact of conditional cash transfers on child health in low- and middle-income countries: a systematic review," International Journal of Public Health, Springer;Swiss School of Public Health (SSPH+), vol. 59(4), pages 609-618, August.
    11. Enami, Ali, 2016. "Determinants of Child Mortality in Africa: A Methodological Discussion," MPRA Paper 68671, University Library of Munich, Germany.
    12. Martin Persson, U. & Alpízar, Francisco, 2013. "Conditional Cash Transfers and Payments for Environmental Services—A Conceptual Framework for Explaining and Judging Differences in Outcomes," World Development, Elsevier, vol. 43(C), pages 124-137.
    13. Tania Barham & Karen Macours & John A. Maluccio, 2013. "Boys' Cognitive Skill Formation and Physical Growth: Long-Term Experimental Evidence on Critical Ages for Early Childhood Interventions," American Economic Review, American Economic Association, vol. 103(3), pages 467-471, May.
    14. Driessen, Julia & Olson, Zachary D. & Jamison, Dean T. & Verguet, Stéphane, 2015. "Comparing the health and social protection effects of measles vaccination strategies in Ethiopia: An extended cost-effectiveness analysis," Social Science & Medicine, Elsevier, vol. 139(C), pages 115-122.
    15. repec:eee:wdevel:v:98:y:2017:i:c:p:497-505 is not listed on IDEAS


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