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Effect of a conditional cash transfer programme on infant up-to-date and timely vaccination
  1. Evelyn Lima de Souza1,2,
  2. Vinicius Leati de Rossi Ferreira1,
  3. Eliseu Alves Waldman1,
  4. Ana Paula Sayuri Sato1
  1. 1School of Public Health, University of São Paulo, São Paulo, Brazil
  2. 2Center for Studies, Research and Practice in PHC and Health Care Network (CEPPAR), Hospital Israelita Albert Einstein, São Paulo, Brazil
  1. Correspondence to Evelyn Lima de Souza, School of Public Health, University of São Paulo, Av. Dr. Arnaldo, 715 - Cerqueira César, 01246-904, São Paulo, Brazil; evelyn.souza{at}usp.br

Abstract

Background Conditional cash transfer (CCT) programmes are one of the strategies to increase vaccination coverage among underprivileged families by conditioning cash transfer to the up-to-date immunisation of children. However, there are gaps in knowledge of its impact on vaccination at the recommended age (timely).

Methods We performed two cross-sectional analyses of secondary data from a retrospective cohort, at the landmark ages of 12 and 24 months, to assess the effect of the Brazilian CCT on the up-to-date and timely vaccination in children born between 2014 and 2016 and resident in the city of Araraquara, São Paulo (Southeast Brazil). The Propensity Score Matching (PSM) was used to balance two pre-defined groups (beneficiaries and non-beneficiaries) according to the profile of socioeconomic and demographic characteristics.

Results From a total of 7386 children within the cohort, 22.2% (1636) were from beneficiary families of the CCT. After the pairing by PSM, the final sample size included in the analyses was 1440 for each group. We found higher up-to-date vaccination coverage, at 12 (92.1%, 95% CI=90.6% to 93.5%) and 24 months (83.8%, 95% CI=81.8% to 85.7%), among the CCT beneficiaries compared with the non-beneficiaries (85.1%, 95% CI=83.2% to 86.9% at 12 months and 73.6%, 95% CI=71.2% to 75.8% at 24 months). The coverage of timely vaccination did not statistically differ between beneficiaries (41.5%, 95% CI=38.9% to 44.1% and 17.4%, 95% CI=15.4% to 19.4%) and non-beneficiaries (40.7%, 95% CI=38.1% to 43.3% and 17.1%, 95% CI=15.2% to 19.1%) at 12 and 24 months, respectively.

Conclusion The study highlights a positive effect of the CCT on vaccination coverage of the up-to-date infant vaccination schedule. However, there was no difference in timely vaccination.

  • vaccination
  • health inequalities
  • immunization
  • child health
  • primary health care

Data availability statement

No data are available.

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Footnotes

  • Contributors ELdS was responsible for conceptualisation, data curation, analysis, interpretation and writing, being responsible for the overall content as guarantor. VLdRF was responsible for interpretation of data, writing and revising it critically for important intellectual content. EAW was responsible for substantial contributions to the conception of the work and revising it critically for important intellectual content. APSS was responsible for conceptualisation, data acquisition, analysis, interpretation and writing, funding acquisition and project administration. All authors were responsible for final approval of the version to be published and agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.

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