O efeito do Cartão Mais Infância Ceará na vacinação infantil

Abstract

This study evaluates the impact of Cartão Mais Infância Ceará (CMIC), a state conditional cash transfer program, on childhood vaccination coverage in the municipalities of Ceará. The study investigated whether financial incentives coupled with intersectoral monitoring are effective in increasing vaccination rates during early childhood. To this end, a panel dataset covering the period from 2015 to 2022 was constructed, utilizing an identification strategy that compares municipalities in Ceará with their border neighbors in the states of Piauí, Rio Grande do Norte, Paraíba, and Pernambuco. The empirical strategy consisted of estimating Two-Way Fixed Effects models, controlling for socioeconomic and health infrastructure variables. The results evidence that the CMIC has a positive and statistically significant impact on vaccines administered at birth and on doses administered after the first year of life. However, the effect proved to be heterogeneous, with no robust evidence of impact found for vaccines administered during the first six months of life. Furthermore, a counterintuitive decline was observed for Meningococcal C and Pneumococcal booster shots, suggesting the existence of non-financial barriers.