Persistence and heterogeneity of the effects of educating mothers to improve child immunisation uptake: Experimental evidence from Uttar Pradesh in India

• Published in: Journal of health economics 2024-06, Vol.96, p.102899, Article 102899
• Main Authors: O'Neill, Stephen, Grieve, Richard, Singh, Kultar, Dutt, Varun, Powell-Jackson, Timothy
• Format: Article
• Language: English
• Subjects: Adult; Causal forest; Child, Preschool; Diphtheria-Tetanus-Pertussis Vaccine - administration & dosage; Female; Health Education; Heterogeneity machine learning; Humans; Immunization Programs; India; Infant; Male; Measles Vaccine - administration & dosage; Mothers - education; Randomised controlled trial; Vaccination; Vaccination - statistics & numerical data
• ISSN: 0167-6296; 1879-1646; 1879-1646
• DOI: 10.1016/j.jhealeco.2024.102899

Childhood vaccinations are among the most cost-effective health interventions. Yet, in India, where immunisation services are widely available free of charge, a substantial proportion of children remain unvaccinated. We revisit households 30 months after a randomised experiment of a health information intervention designed to educate mothers on the benefits of child vaccination in Uttar Pradesh, India. We find that the large short-term effects on the uptake of diphtheria–pertussis–tetanus and measles vaccination were sustained at 30 months, suggesting the intervention did not simply bring forward vaccinations. We apply causal forests and find that the intervention increased vaccination uptake, but that there was substantial variation in the magnitude of the estimated effects. We conclude that characterising those who benefited most and conversely those who benefited least provides policy-makers with insights on how the intervention worked, and how the targeting of households could be improved.