New Evidence on the Impact of Large-scale Conditional Cash Transfers on Child Vaccination Rates: The Case of a Clustered-Randomized Trial in Indonesia. (October 2017)

• Record Type: Journal Article
• Authors: Kusuma, Dian; Thabrany, Hasbullah; Hidayat, Budi; McConnell, Margaret; Berman, Peter; Cohen, Jessica
• Is Part Of: World development. Volume 98(2017)
• Page Start: 497
• Page End: 505
• Publication Date: 2017-10
• Subjects: Indonesia -- Conditional Cash Transfers (CCT) -- household -- child vaccination -- clustered-randomized trials; Economic history -- 1990- -- Periodicals; Economic assistance -- Developing countries -- Periodicals; 330.9
• DOI: 10.1016/j.worlddev.2017.05.007
• Languages: English
• ISSNs: 0305-750X

Abstract

Highlights: PKH increases child vaccination rates particularly among children <12 months. PKH is equity enhancing toward children <12 months with less educated mothers. Implementation issues may reduce impact towards improved child vaccination. Summary: Despite recent progress, millions of children still die every year from vaccine-preventable diseases. One strategy is Conditional Cash Transfers (CCTs), which provide cash payments to poor households in exchange for compliance with health-related conditionalities including child vaccination. Using a randomized trial, we provide new evidence on the impact of large-scale CCTs on child vaccination rates in Indonesia by investigating the Program Keluarga Harapan (PKH) with a sample of over four thousand children under two years old. After two years of implementation from 2007 to 2009, difference-in-differences (DID) estimates show that PKH significantly increases child vaccination rates for all basic vaccine types by up to 30% compared to the control group means among children aged less than 12 months old but PKH shows modest effects among children aged 12–23 months old. There is also evidence that PKH is equity enhancing by increasing child vaccination rates for most vaccine types by up to 52% among children aged less than 12 months old living with less educated mothers (below six years). All this underscores the ability of cash transfers to reach poor children for whom health systems supply-side-oriented strategies have been less successful.