Effect of a conditional cash transfer programme on infant up-to-date and timely vaccination

Evelyn Lima de Souza · Vinícius Leati de Rossi Ferreira · Eliseu Alves Waldman · Ana Paula Sayuri Sato

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Vaccine Coverage and Hesitancy Global Maternal and Child Health Poverty, Education, and Child Welfare

Abstract

BACKGROUND: Conditional cash transfer (CCT) programmes are one of the strategies to increase vaccination coverage among underprivileged families by conditioning cash transfer to the up-to-date immunisation of children. However, there are gaps in knowledge of its impact on vaccination at the recommended age (timely). METHODS: We performed two cross-sectional analyses of secondary data from a retrospective cohort, at the landmark ages of 12 and 24 months, to assess the effect of the Brazilian CCT on the up-to-date and timely vaccination in children born between 2014 and 2016 and resident in the city of Araraquara, São Paulo (Southeast Brazil). The Propensity Score Matching (PSM) was used to balance two pre-defined groups (beneficiaries and non-beneficiaries) according to the profile of socioeconomic and demographic characteristics. RESULTS: From a total of 7386 children within the cohort, 22.2% (1636) were from beneficiary families of the CCT. After the pairing by PSM, the final sample size included in the analyses was 1440 for each group. We found higher up-to-date vaccination coverage, at 12 (92.1%, 95% CI=90.6% to 93.5%) and 24 months (83.8%, 95% CI=81.8% to 85.7%), among the CCT beneficiaries compared with the non-beneficiaries (85.1%, 95% CI=83.2% to 86.9% at 12 months and 73.6%, 95% CI=71.2% to 75.8% at 24 months). The coverage of timely vaccination did not statistically differ between beneficiaries (41.5%, 95% CI=38.9% to 44.1% and 17.4%, 95% CI=15.4% to 19.4%) and non-beneficiaries (40.7%, 95% CI=38.1% to 43.3% and 17.1%, 95% CI=15.2% to 19.1%) at 12 and 24 months, respectively. CONCLUSION: The study highlights a positive effect of the CCT on vaccination coverage of the up-to-date infant vaccination schedule. However, there was no difference in timely vaccination.

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References

2005Evaluating the Impact of Conditional Cash Transfer Programs 2013Effect of a conditional cash transfer programme on childhood mortality: a nationwide analysis of Brazilian municipalities 2010Evaluating the Impact of Brazil's Bolsa Família: Cash Transfer Programs in Comparative Perspective 2011Promoting healthy behaviours and improving health outcomes in low and middle income countries: A review of the impact of conditional cash transfer programmes 2013Effects of unconditional and conditional cash transfers on child health and development in Zimbabwe: a cluster-randomised trial 2013Financial incentives and coverage of child health interventions: a systematic review and meta-analysis 2012Socioeconomic inequalities and vaccination coverage: results of an immunisation coverage survey in 27 Brazilian capitals, 2007–2008 2002Timeliness of Childhood Immunizations

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