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Community-based health programs and child vaccinations: Evidence from Madagascar

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  • Herrera-Almanza, Catalina
  • Rosales-Rueda, Maria F.

Abstract

Vaccinations are a cost-effective tool to prevent child mortality and morbidity; however, their access and take-up remain low in developing countries. We analyze the effects on child vaccinations of a large-scale community-based health worker program that aimed to reach remote areas distant from public health facilities in Madagascar. We identify these effects using a triple-difference design that leverages the time and geographic variation in the program rollout and the geocoded household distance to the closest health facility. Our findings indicate that, on average, the program did not improve the vaccination uptake in treated areas; however, the community health workers component had an additional effect on children’s vaccinations in the most remote areas from the closest health facility. Despite this improvement, we find that mothers’ religious affiliation might constitute a barrier for the vaccination uptake of the most remote and vulnerable children.

Suggested Citation

  • Herrera-Almanza, Catalina & Rosales-Rueda, Maria F., 2023. "Community-based health programs and child vaccinations: Evidence from Madagascar," World Development, Elsevier, vol. 170(C).
  • Handle: RePEc:eee:wdevel:v:170:y:2023:i:c:s0305750x23001407
    DOI: 10.1016/j.worlddev.2023.106322
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    More about this item

    Keywords

    Vaccinations; Child health; Community health workers; Africa;
    All these keywords.

    JEL classification:

    • I12 - Health, Education, and Welfare - - Health - - - Health Behavior
    • I15 - Health, Education, and Welfare - - Health - - - Health and Economic Development
    • J13 - Labor and Demographic Economics - - Demographic Economics - - - Fertility; Family Planning; Child Care; Children; Youth
    • O15 - Economic Development, Innovation, Technological Change, and Growth - - Economic Development - - - Economic Development: Human Resources; Human Development; Income Distribution; Migration

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