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教育母亲以提高儿童疫苗接种率之效应的持续性与异质性:来自印度北方邦的实验证据

Persistence and heterogeneity of the effects of educating mothers to improve child immunisation uptake: Experimental evidence from Uttar Pradesh in India
Journal of Health Economics · 2024 · O'Neill, Stephen、Grieve, Richard、Singh, Kultar、Dutt, Varun、Powell-Jackson, Timothy

中文摘要

儿童疫苗接种是最具成本效益的卫生干预措施之一。然而,在免疫服务广泛免费提供的印度,仍有相当比例的儿童未能接种疫苗。印度北方邦曾开展一项随机实验,实施一项旨在教育母亲了解儿童疫苗接种益处的健康信息干预;我们在该实验30个月后重访了相关家庭。我们发现,该干预对百白破(白喉—百日咳—破伤风)疫苗和麻疹疫苗接种的大幅短期效应在30个月时得以持续,表明该干预并非仅仅使疫苗接种时点提前。我们运用因果森林方法,发现该干预提高了疫苗接种率,但估计效应的量级存在较大差异。我们的结论是,刻画受益最多的群体以及相反受益最少的群体,能够为政策制定者提供关于干预如何发挥作用以及如何改进对家庭瞄准的洞见。

Abstract

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.
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