Community-Based Health Programs and Child Vaccinations: Evidence from Madagascar

Catalina Herrera-Almanza and Maria Rosales-Rueda

No 31340, NBER Working Papers from National Bureau of Economic Research, Inc

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.

JEL-codes: I12 I15 J13 O15 (search for similar items in EconPapers)
Date: 2023-06
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Published as Catalina Herrera-Almanza & Maria F. Rosales-Rueda, 2023. "Community-based health programs and child vaccinations: Evidence from Madagascar," World Development, vol 170.

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Journal Article: Community-based health programs and child vaccinations: Evidence from Madagascar (2023)
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