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The impact of immunization on the association between poverty and child survival: Evidence from Kassena-Nankana District of nor

Author: Ayaga A. Bawah, James F. Phillips, Martin Adjuik, Maya Vaughan-Smith, Bruce MacLeod, and Fred N. Binka 
InfoShare Partner: Population Council
Publication Date: November 2006
Type of Document: Article/Report/Paper
Topics: Child health/survival, Immunization
Region: Sub-Saharan Africa
Language: English
Number of Pages: 21
File Size: 649 KB
File Format: Adobe Acrobat (PDF)

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Population Council Policy Research Division Working Paper no. 218. Research conducted in Africa has demonstrated consistently that parental poverty and low educational attainment adversely affect child survival. Research conducted elsewhere has demonstrated that low-cost vaccines against preventable diseases reduce childhood mortality. Therefore, the extension of vaccination to impoverished populations is widely assumed to diminish equity effects. Recent evidence that childhood mortality is increasing in many countries where vaccination programs are active challenges this assumption. This paper marshals data from accurate and complete immunization records and survival histories for 18,368 children younger than five in a rural northern Ghanaian population that is generally impoverished, but where family wealth and parental educational differentials exist nonetheless. Time-conditional Weibull hazard models are estimated to test the hypothesis that childhood immunization offsets the detrimental effects of poverty and low educational attainment. Findings show that the adverse effects of poverty disappear and that the effects of educational attainment are reduced in survival models that control for immunization status. This finding lends empirical support to policies that promote immunization as a strategic component of poverty-reduction programs.