Modeling the Effects of Immunizations Timing on Child Health Outcomes in India (Health Economics, in Press)

Abstract

Timely vaccinations of children in developing countries are important for reducing morbidity and mortality that are Millennium Development Goals. However, a majority of children do not possess vaccination cards compiling information on timing. We investigated the benefits of vaccination cards for the uptake of immunizations against diphtheria, pertussis and tetanus (DPT), polio, tuberculosis (BCG), and measles using data on over 200,000 Indian children from District Level Health and Facility Survey-3. Methodological issues such as whether parents of children with higher morbidity levels may have them vaccinated were investigated. The results from the models for DPT, polio, measles and BCG vaccinations showed significant beneficial effects of maternal education, household possessions, and access to healthcare facilities. Second, models for children’s ages at the time of vaccination showed significant interactions between maternal education and access to and availability of healthcare facilities. Finally, models for child morbidity due to diarrhea, cough, and fever showed that timely vaccinations against DPT, access to piped water, and cooking with electricity or natural gas were associated with lower morbidity. Overall, issuing paper or electronic vaccination cards to children is likely to enhance timely uptake of various immunizations thereby reducing child morbidity.

Keywords: childhood vaccinations, economic development, healthcare services, morbidity, simultaneity

JEL Classification: C31, I12, J10