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

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


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.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Child, Preschool
  • Communicable Disease Control*
  • Health Care Surveys
  • Humans
  • Immunization Programs / economics*
  • Immunization Programs / statistics & numerical data*
  • Infant
  • Infant, Newborn
  • Models, Statistical
  • Motivation*
  • Nicaragua
  • Poverty
  • Program Evaluation
  • Rural Health*