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BMC International Health and Human Rights
Published in: BMC International Health and Human Rights 1/2013

Open Access 01-12-2013 | Research article

Effect of the conditional cash transfer program Oportunidades on vaccination coverage in older Mexican people

Authors: Aarón Salinas-Rodríguez, Betty Soledad Manrique-Espinoza

Published in: BMC International Health and Human Rights | Issue 1/2013

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Abstract

Background

Immunization is one of the most effective ways of preventing illness, disability and death from infectious diseases for older people. However, worldwide immunization rates are still low, particularly for the most vulnerable groups within the elderly population. The objective of this study was to estimate the effect of the Oportunidades -an incentive-based poverty alleviation program- on vaccination coverage for poor and rural older people in Mexico.

Methods

Cross-sectional study, based on 2007 Oportunidades Evaluation Survey, conducted in low-income households from 741 rural communities (localities with <2,500 inhabitants) of 13 Mexican states. Vaccination coverage was defined according to three individual vaccines: tetanus, influenza and pneumococcal, and for complete vaccination schedule. Propensity score matching and linear probability model were used in order to estimate the Oportunidades effect.

Results

12,146 older people were interviewed, and 7% presented cognitive impairment. Among remaining, 4,628 were matched. Low coverage rates were observed for the vaccines analyzed. For Oportunidades and non-Oportunidades populations were 46% and 41% for influenza, 52% and 45% for pneumococcal disease, and 79% and 71% for tetanus, respectively. Oportunidades effect was significant in increasing the proportion of older people vaccinated: for complete schedule 5.5% (CI95% 2.8-8.3), for influenza 6.9% (CI95% 3.8-9.6), for pneumococcal 7.2% (CI95% 4.3-10.2), and for tetanus 6.6% (CI95% 4.1-9.2).

Conclusions

The results of this study extend the evidence on the effect that conditional transfer programs exert on health indicators. In particular, Oportunidades increased vaccination rates in the population of older people. There is a need to continue raising vaccination rates, however, particularly for the most vulnerable older people.
Appendix
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Literature
1.
Bentley DW: Immunizations in the elderly. Bul NY Acad Med. 1987, 63: 533-551.
2.
Bader MS: Immunization for the Elderly. Am J Med Sci. 2007, 334: 481-486. 10.1097/MAJ.0b013e318156b4bc.CrossRefPubMed
3.
4.
Zimmerman RK, Santibanez TA, Fine MJ, Janosky JE, Nowalk MP, Bardella IJ, Raymund M, Wilson SA: Barriers and facilitators of pneumococcal vaccination among the elderly. Vaccine. 2003, 21: 1510-1517. 10.1016/S0264-410X(02)00698-9.CrossRefPubMed
5.
Endrich MM, Blank PR, Szucs TD: Influenza vaccination uptake and socioeconomic determinants in 11 European countries. Vaccine. 2009, 27: 4018-4024. 10.1016/j.vaccine.2009.04.029.CrossRefPubMed
6.
Blank PR, Matthias SM, Szucs TD: Influenza vaccination coverage rates in five European countries during season 2006/07 and trends over six consecutive seasons. BMC Publ Health. 2008, 8: 272-10.1186/1471-2458-8-272.CrossRef
7.
Gaughran F, Walwyn R, Lambkin-Williams R, Whelan P, Chatterton K, Oxford J, Macdonald A: Flu: effect of vaccine in elderly care home residents: a randomized trial. J Am Geriatr Soc. 2007, 55: 1912-1920. 10.1111/j.1532-5415.2007.01471.x.CrossRefPubMed
8.
Lemaitre M, Meret T, Rothan-Tondeur M, Belmin J, Lejonc JL, Luquel L, Piette F, Salom M, Verny M, Vetel JM, Veyssier P, Carrat F: Effect of influenza vaccination of nursing home staff on mortality of residents: a cluster-randomized trial. J Am Geriatr Soc. 2009, 57: 1580-1586. 10.1111/j.1532-5415.2009.02402.x.CrossRefPubMed
9.
Shapiro ED, Clemens JD: A controlled evaluation of the protective efficacy of pneumococcal vaccine for patients at high risk of serious pneumococcal infections. Ann Intern Med. 1984, 101: 325-330. 10.7326/0003-4819-101-3-325.CrossRefPubMed
10.
Butler JC, Breiman RF, Campbell JF, Lipman HB, Broome CV, Facklam RR: Pneumococcal polysaccharide vaccine efficacy: an evaluation of current recommendations. JAMA. 1993, 270: 1826-1831. 10.1001/jama.1993.03510150060030.CrossRefPubMed
11.
Farr BM, Johnston BL, Cobb DK, Fisch MJ, Germanson TP, Adal KA, Anglim AM: Preventing pneumococcal bacteremia in patients at risk: results of a matched case–control study. Arch Intern Med. 1995, 155: 2336-2340. 10.1001/archinte.1995.00430210086013.CrossRefPubMed
12.
Shapiro ED, Berg AT, Austrian R, Schroeder D, Parcells V, Margolis A, Adair RK, Clemens JD: The protective efficacy of polyvalent pneumococcal polysaccharide vaccine. N Engl J Med. 1991, 325: 1453-1460. 10.1056/NEJM199111213252101.CrossRefPubMed
13.
McElhaney JE: Influenza vaccine responses in older adults. Ageing Res Rev. 2011, 10: 379-388. 10.1016/j.arr.2010.10.008.CrossRefPubMed
14.
Lang PO, Govind S, Mitchell WA, Siegrist CA, Aspinall R: Vaccine effectiveness in older individuals: what has been learned from the influenza-vaccine experience. Ageing Res Rev. 2011, 10: 389-395. 10.1016/j.arr.2010.09.005.CrossRefPubMed
15.
Monto AS, Ansaldi F, Aspinall R, McElhaney JE, Montaño LF, Nichol KL, Puig-Barberá J, Stephenson I: Influenza control in the 21st century: Optimizing protection of older adults. Vaccine. 2009, 27: 5043-5053. 10.1016/j.vaccine.2009.06.032.CrossRefPubMed
16.
Deans GD, Stiver HG, McElhaney JE: Influenza vaccines provide diminished protection but are cost-saving in older adults. J Intern Med. 2010, 267: 220-227. 10.1111/j.1365-2796.2009.02201.x.CrossRefPubMed
17.
World Health Organization: Influenza vaccines. WHO position paper. Wkly Epidemiol Rec. 2002, 77: 230-234.
18.
Holm MV, Blank PR, Szucs TD: Trends in influenza vaccination coverage rates in Germany over five seasons from 2001 to 2006. BMC Infect Dis. 2007, 7: 144-10.1186/1471-2334-7-144.CrossRefPubMedPubMedCentral
19.
Müller D, Szucs TD: Influenza vaccination coverage rates in 5 European countries: a population-based cross-sectional analysis of the seasons 02/03, 03/04 and 04/05. Infection. 2007, 35: 308-319. 10.1007/s15010-007-6218-5.CrossRefPubMed
20.
de Janvry A, Sadoulet E: Making conditional cash transfer programs more efficient: designing for maximum effect of the conditionality. World Bank Econ Rev. 2006, 20: 1-29. 10.1093/wber/lhj002.CrossRef
21.
Rawlings LB, Rubio GM: Evaluating the impact of conditional cash transfer programs: lessons from Latin America. World Bank Res Obs. 2005, 20: 29-55. 10.1093/wbro/lki001.CrossRef
22.
Heinrich CJ: Demand and supply-side determinants of conditional cash transfer program effectiveness. World Dev. 2007, 35: 121-143. 10.1016/j.worlddev.2006.09.009.CrossRef
23.
24.
25.
26.
Folstein MF, Folstein SE, McHugh PR: "Mini-mental state". A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res. 1975, 2: 189-198.CrossRef
27.
Kohlhammer Y, Schnoor M, Schwartz M, Raspe H, Schäfer T: Determinants of influenza and pneumococcal vaccination in elderly people: a systematic review. Public Health. 2007, 121: 742-751. 10.1016/j.puhe.2007.02.011.CrossRefPubMed
28.
Opstelten W, Hak E, Verheij TJ, van Essen GA: Introducing a Pneumococcal Vaccine to an Existing Influenza Immunization Program: Vaccination Rates and Predictors of Noncompliance. Am J Med. 2001, 111: 474-479. 10.1016/S0002-9343(01)00880-4.CrossRefPubMed
29.
30.
Davis JW, Fujimoto RY, Chan H, Juarez DT: Factors affecting the influenza vaccination of high risk adults in Hawai'i. Hawaii Med J. 2009, 68: 50-54.PubMed
31.
High KP: Overcoming barriers to adult immunization. J Am Osteopath Assoc. 2009, 109: S25-S28.PubMed
32.
Nowalk MP, Zimmerman RK, Tabbarah M, Raymund M, Jewell IK: Determinants of adult vaccination at inner-city health centers: a descriptive study. BMC Fam Pract. 2006, 7: 2-10.1186/1471-2296-7-2.CrossRefPubMedPubMedCentral
33.
34.
Abadie A, Imbens G: Large sample properties of matching estimators for average treatment effects. Econometrica. 2006, 74: 235-267. 10.1111/j.1468-0262.2006.00655.x.CrossRef
35.
Becker S, Ichino A: The estimation of average treatment effects based on propensity scores. Stata J. 2002, 2: 358-377.
36.
37.
Rosenbaum P, Rubin D: The central role of the propensity score in observational studies for causal effects. Biometrika. 1983, 70: 41-55. 10.1093/biomet/70.1.41.CrossRef
38.
Dehejia RH, Wahba S: Causal effects in nonexperimental studies: re-evaluating the evaluation of training programs. J Am Stat Assoc. 1999, 94: 1053-1062. 10.1080/01621459.1999.10473858.CrossRef
39.
Dehejia RH, Wahba S: Propensity score-matching methods for nonexperimental causal studies. Rev Econ Stat. 2002, 84: 151-161. 10.1162/003465302317331982.CrossRef
40.
Diaz JJ, Handa S: An assessment of propensity score matching as a nonexperimental impact estimator: evidence from Mexico’s PROGRESA program. J Hum Resour. 2006, 61: 319-345.CrossRef
41.
42.
White HA: Heteroskedasticity-Consistent Covariance Matrix Estimator and a Direct Test for Heteroskedasticity. Econometrica. 1980, 48: 817-838. 10.2307/1912934.CrossRef
43.
44.
StataCorp: Stata Statistical Software: Release 12. 2011, College Station, TX: StataCorp LP
45.
Gaarder M, Glassman A, Todd J: Conditional cash transfers and health: unpacking the causal chain. Journal of Development Effectiveness. 2010, 2: 6-50. 10.1080/19439341003646188.CrossRef
46.
Lagarde M, Haines A, Palmer N: The impact of conditional cash transfers on health outcomes and use of health services in low and middle income countries. Cochrane Database Syst Rev. 2009, 4: CD008137
47.
48.
Morris SS, Flores R, Olinto P, Medina JM: Monetary incentives in primary health care and effects on use and coverage of preventive health care interventions in rural Honduras: cluster randomised trial. Lancet. 2004, 364: 2030-2037. 10.1016/S0140-6736(04)17515-6.CrossRefPubMed
49.
Barham T, Maluccio J: Eradicating Disease: The Effect of Conditional Cash Transfers on Vaccination Coverage in Nicaragua. J Health Econ. 2009, 38: 611-621.CrossRef
50.
Barham T, Brenzel L, Maluccio JÁ: Beyond 80 %: Are There New Ways of Increasing Vaccination Coverage – Evaluation of CCT Programs in Mexico and Nicaragua. Health, Nutrition and Population Discussion Paper. 2007, Washington D.C: World Bank
51.
52.
Sosa-Rubí SG, Walker D, Serván E, Bautista-Arredondo S: Learning effect of a conditional cash transfer programme on poor rural women’s selection of delivery care in Mexico. Health Policy Plan. 2011, 26: 496-507. 10.1093/heapol/czq085.CrossRefPubMed
53.
Lagarde M, Haines A, Palmer N: Conditional cash transfers for improving uptake of health interventions in low- and middle-income countries: a systematic review. JAMA. 2007, 298: 1900-1910. 10.1001/jama.298.16.1900.CrossRefPubMed
54.
Fernald LCH, Gertler PG, Neufeld LM: Role of cash in conditional cash transfer programmes for child health, growth, and development: an analysis of Mexico's Oportunidades. Lancet. 2008, 371: 828-837. 10.1016/S0140-6736(08)60382-7.CrossRefPubMedPubMedCentral
55.
Kenji S: Conditional cash transfer: a magic bullet for health?. Lancet. 2008, 371: 789-791. 10.1016/S0140-6736(08)60356-6.CrossRef
56.
57.
Mac Donald R, Baken L, Nelson A, Nichol KL: Validation of Self-Report of Influenza and Pneumococcal Vaccination Status in Elderly Outpatients. Am J Prev Med. 1996, 16: 173-177.CrossRef
58.
Skull SA, Andrews RM, Byrnes GB, Kelly HA, Nolan TM, Brown GV, Campbell DA: Validity of self-reported influenza and pneumococcal vaccination status among a cohort of hospitalized elderly inpatients. Vaccine. 2007, 25: 4774-4783.
59.
Bayas JM, Izquierdo C, Ruiz L, Sintes X, Sousa D, Celorrio JM, Varona W, Carratalá J, Nebot M, Batalla J, Sugrañes S, Manzur A, Terren A, García C, Clemente E, Rivera S, Justo I, Arévalo A, Salleras L, Domínguez A: Validity of self-reported pneumococcal vaccination status in the elderly in Spain. Vaccine. 2009, 27: 4560-4564. 10.1016/j.vaccine.2009.05.057.CrossRefPubMed
60.
61.
Jefferson T, Rivetti D, Rivveti A, Rudin M, Di pietrantonj C, Demicheli V: Efficacy and effectiveness of influenza vaccines in elderly people: a systematic review. Lancet. 2005, 366: 1165-1174. 10.1016/S0140-6736(05)67339-4.CrossRefPubMed
Metadata
Title
Effect of the conditional cash transfer program Oportunidades on vaccination coverage in older Mexican people
Authors
Aarón Salinas-Rodríguez
Betty Soledad Manrique-Espinoza
Publication date
01-12-2013
Publisher
BioMed Central
Published in
BMC International Health and Human Rights / Issue 1/2013
Electronic ISSN: 1472-698X
DOI
https://doi.org/10.1186/1472-698X-13-30

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