Duke 2008 | ASHE | Equity and Efficiency in Health and Healthcare

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.