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Paid maternity leave and childhood vaccination uptake: Longitudinal evidence from 20 low-and-middle-income countries

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  • Hajizadeh, Mohammad
  • Heymann, Jody
  • Strumpf, Erin
  • Harper, Sam
  • Nandi, Arijit
Abstract
The availability of maternity leave might remove barriers to improved vaccination coverage by increasing the likelihood that parents are available to bring a child to the clinic for immunizations. Using information from 20 low-and-middle-income countries (LMICs) we estimated the effect of paid maternity leave policies on childhood vaccination uptake. We used birth history data collected via Demographic and Health Surveys (DHS) to assemble a multilevel panel of 258,769 live births in 20 countries from 2001 to 2008; these data were merged with longitudinal information on the number of full-time equivalent (FTE) weeks of paid maternity leave guaranteed by each country. We used Logistic regression models that included country and year fixed effects to estimate the impact of increases in FTE paid maternity leave policies in the prior year on the receipt of the following vaccines: Bacillus Calmette-Guérin (BCG) commonly given at birth, diphtheria, tetanus, and pertussis (DTP, 3 doses) commonly given in clinic visits and Polio (3 doses) given in clinic visits or as part of campaigns. We found that extending the duration of paid maternity leave had a positive effect on immunization rates for all three doses of the DTP vaccine; each additional FTE week of paid maternity leave increased DTP1, 2 and 3 coverage by 1.38 (95% CI = 1.18, 1.57), 1.62 (CI = 1.34, 1.91) and 2.17 (CI = 1.76, 2.58) percentage points, respectively. Estimates were robust to adjustment for birth characteristics, household-level covariates, attendance of skilled health personnel at birth and time-varying country-level covariates. We found no evidence for an effect of maternity leave on the probability of receiving vaccinations for BCG or Polio after adjustment for the above-mentioned covariates. Our findings were consistent with the hypothesis that more generous paid leave policies have the potential to improve DTP immunization coverage. Further work is needed to understand the health effects of paid leave policies in LMICs.

Suggested Citation

  • Hajizadeh, Mohammad & Heymann, Jody & Strumpf, Erin & Harper, Sam & Nandi, Arijit, 2015. "Paid maternity leave and childhood vaccination uptake: Longitudinal evidence from 20 low-and-middle-income countries," Social Science & Medicine, Elsevier, vol. 140(C), pages 104-117.
    • Handle: RePEc:eee:socmed:v:140:y:2015:i:c:p:104-117
    DOI: 10.1016/j.socscimed.2015.07.008
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    1. Centro Internacional de Políticas para el Crecimiento Inclusivo (IPC-IG) & UNICEF — Oficina Regional para América Latina y el Caribe, 2020. "Maternidad y paternidad en el lugar de trabajo en América Latina y el Caribe — políticas para la licencia de maternidad y paternidad y apoyo a la lactancia materna," Research Report Spanish (Country Study) 40, International Policy Centre for Inclusive Growth.
    2. Mohammad Hajizadeh & Son Nghiem, 2020. "Does unwanted pregnancy lead to adverse health and healthcare utilization for mother and child? Evidence from low- and middle-income countries," International Journal of Public Health, Springer;Swiss School of Public Health (SSPH+), vol. 65(4), pages 457-468, May.
    3. Kien Le & My Nguyen, 2022. "The long-run impacts of paid maternity leave on height and educational attainment," Palgrave Communications, Palgrave Macmillan, vol. 9(1), pages 1-8, December.
    4. Barnish, Maxwell S. & Tan, Si Ying & Robinson, Sophie & Taeihagh, Araz & Melendez-Torres, G.J., 2023. "A realist synthesis to develop an explanatory model of how policy instruments impact child and maternal health outcomes," Social Science & Medicine, Elsevier, vol. 339(C).
    5. Choudhury, Agnitra Roy & Polachek, Solomon, 2019. "The Impact of Paid Family Leave on the Timing of Infant Vaccinations," IZA Discussion Papers 12483, Institute of Labor Economics (IZA).

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