TY - JOUR
T1 - Community-based health programs and child vaccinations
T2 - Evidence from Madagascar
AU - Herrera-Almanza, Catalina
AU - Rosales-Rueda, Maria F.
N1 - We would like to thank Rocio Valdebenito, Leonel Borja, Allie Smith, and Shuang Wang for their excellent research assistance and INSTAT-Madagascar, particularly Harivelo Rajemison, for providing access to and assistance with the databases. The authors thank the Associate Editor and three anonymous referees as well as Mary-Arends Kuenning and the seminar participants at the Agricultural and Applied Economics Meetings for helpful comments and discussions. The authors are grateful for funding support from the Population Reference Bureau and the Hewlett Foundation.
We would like to thank Rocio Valdebenito, Leonel Borja, Allie Smith, and Shuang Wang for their excellent research assistance and INSTAT-Madagascar, particularly Harivelo Rajemison, for providing access to and assistance with the databases. The authors thank the editor and three anonymous referees as well as Mary-Arends Kuenning and the seminar participants at the Agricultural and Applied Economics Meetings for helpful comments and discussions. The authors are grateful for funding support from the Population Reference Bureau and the Hewlett Foundation.
We would like to thank Rocio Valdebenito, Leonel Borja, Allie Smith, and Shuang Wang for their excellent research assistance and INSTAT-Madagascar, particularly Harivelo Rajemison, for providing access to and assistance with the databases. The authors thank the Associate Editor and three anonymous referees as well as Mary-Arends Kuenning and the seminar participants at the Agricultural and Applied Economics Meetings for helpful comments and discussions. The authors are grateful for funding support from the Population Reference Bureau and the Hewlett Foundation. ☆ We would like to thank Rocio Valdebenito, Leonel Borja, Allie Smith, and Shuang Wang for their excellent research assistance and INSTAT-Madagascar, particularly Harivelo Rajemison, for providing access to and assistance with the databases. The authors thank the editor and three anonymous referees as well as Mary-Arends Kuenning and the seminar participants at the Agricultural and Applied Economics Meetings for helpful comments and discussions. The authors are grateful for funding support from the Population Reference Bureau and the Hewlett Foundation.
PY - 2023/10
Y1 - 2023/10
N2 - 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.
AB - 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.
KW - Africa
KW - Child health
KW - Community health workers
KW - Vaccinations
UR - http://www.scopus.com/inward/record.url?scp=85161296348&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85161296348&partnerID=8YFLogxK
U2 - 10.1016/j.worlddev.2023.106322
DO - 10.1016/j.worlddev.2023.106322
M3 - Article
AN - SCOPUS:85161296348
SN - 0305-750X
VL - 170
JO - World Development
JF - World Development
M1 - 106322
ER -