Beyond 80%: Are There New Ways of Increasing Vaccination Coverage?: Evaluation of CCT Programs in Mexico and Nicaragua

Tania Barham, University of Colorado at Boulder
John A. Maluccio, Middlebury College
Logan Brenzel, World Bank Group

In recent years there has been a significant global effort to scale-up immunization programs to achieve higher levels of vaccine coverage against major childhood diseases. However, coverage disparities still exist, and traditional supply-side program strategies may not be sufficient to achieve coverage goals. This study evaluates the impact of a demand side program, Condition Cash Transfers, on vaccination coverage in two countries, Mexico and Nicaragua. The intent-to-treat effect on vaccination coverage is assessed using a randomized treatment and control design. Six months after the program introduction, implementation of Oportunidades in Mexico was associated with a statistically significant 5 and 3 percentage point increase in BCG and MCV coverage for on-time vaccination respectively. Five months after the introduction of the health component in Nicaragua, the program impact led to a statistically significant 37 percent increase in fully vaccinated children. Program effects are even greater for hard to reach populations in both countries.