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J Health Econ. 2009 May;28(3):611-21. doi: 10.1016/j.jhealeco.2008.12.010. Epub 2009 Jan 15.

Eradicating diseases: The effect of conditional cash transfers on vaccination coverage in rural Nicaragua.

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University of Colorado at Boulder, Department of Economics and Institute of Behavioral Science, 483 UCB, Boulder, CO 80304-0483, USA.


Despite significant global efforts to improve vaccination coverage against major childhood diseases, vaccination rates are below 90%. To eradicate diseases such as measles, however, vaccination rates close to 95% are needed. We use a randomized experiment to investigate the effect of a demand incentive, a conditional cash transfer program, in improving vaccination coverage in rural Nicaragua. Double-difference estimates show the program led to large increases in vaccination coverage, and these resulted in vaccination levels greater than 95% for some vaccines. Effects were especially large for children who are typically harder to reach with traditional supply-side interventions.

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