Impact of Conditional Cash Transfers on Routine Childhood Immunizations: Evidence from North West Nigeria

PROGRAM OVERVIEW

New Incentives – All Babies Are Equal Initiative (NI-ABAE) uses conditional cash transfers (CCTs) to increase vaccination rates in North West Nigeria. NI-ABAE educates caregivers about the importance of vaccinating children and disburses cash incentives that are conditional on infants receiving each of four lifesaving vaccines. These vaccinations are part of the routine schedule of infant immunization in Nigeria and are provided for free at government clinics. Caregivers can receive up to 4,000 Naira ($11) if the infant receives all doses in the routine immunization (RI) schedule.

The program was evaluated by a randomized control trial (RCT) from July 2017 until late February 2020. The goal of this evaluation was to measure the impact of NI-ABAE’s CCTs for RI Program on coverage for routine childhood vaccines in North West Nigeria.

KEY RESULTS

• Increased Coverage: Children in NI-ABAE catchment areas were 27 percentage points more likely to be fully immunized than children in control areas.
• Improved Timeliness: Infants who received Measles vaccines were 33 percentage points more likely to receive it within one month of the recommended age.
• Positive Externalities: Children in areas served by the program had higher coverage for all major injectable vaccines – including those not directly incentivized by the program – and were more likely to have visited a health clinic.
• Improved Knowledge and Attitudes: Caregivers in the catchment areas served by the program had better knowledge and more favorable attitudes towards immunization.
• Reduced Stockouts: Government clinics with the NIABAE program were 18 percentage points less likely to report vaccine stockouts during the last 12 months.
• Supplemented Existing Efforts: The program generated impact on top of underlying increases in vaccination rates