Childhood immunization, mortality and human capital accumulation: Micro-evidence from India

In the mid-1980s, the Indian government embarked on one of the largest childhood immunization programs-called “Universal Immunization Program” (UIP)-in order to reduce the high mortality and morbidity among children. I examine the effect of this immunization program on child mortality and educational attainment by exploiting district-by-cohort variation in exposure to the program. Results indicate that exposure to the program reduced infant mortality by 0.4 percentage points and underfive child mortality by 0.5 percentage points. These effects on mortality are sizable–they account for approximately one-fifth of the decline in infant and under-five child mortality rates between 19851990. The effects are more pronounced in rural areas, for poor people, and for members of historically disadvantaged groups. While the program clearly reduced mortality, it had mixed effects on children’s educational outcomes. I find it had a negative impact on primary school completion, but a positive impact on secondary school completion. The negative effect at low levels of schooling may be due to lower average health among marginal surviving children or a quantity-quality trade-off where the unanticipated survival of children induces families to under-invest in each child. The greater propensity to complete secondary school on the other hand may be due to improved health among those farther away from the margin of survival. JEL classification: I1, I2, J13, J18, O15.