Foreign Aid and Vaccination Coverage: Subnational Evidence from Nigeria

Abstract

This paper examines whether foreign aid is associated with improvements in vaccination coverage at the local level. While a large literature studies the effects of aid on aggregate health outcomes, less is known about whether aid translates into improvements where it is actually delivered. To address this question, I combine geocoded data on aid projects from AidData with individual-level data from the 2008 and 2013 Nigeria Demographic and Health Surveys. The analysis exploits variation in aid exposure across birth cohorts within Local Government Areas (LGAs), comparing children born in the same LGA in years with and without active aid projects. Across all specifications, the results indicate that exposure to health aid at birth is associated with a higher probability of receiving the BCG vaccine. In addition, exposure to both all aid and health aid is associated with increases in the probability of receiving the measles vaccine. Overall, the findings suggest that aid can help improve access to vaccination services at the local level. At the same time, the weaker and less consistent results for DPT3 and full vaccination indicate that aid may be more effective in improving uptake of relatively simple vaccines requiring limited contact with the health system.