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-Guerin

  (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. (C) 2015 Elsevier

  Ltd. All rights reserved.'
affiliation: 'Hajizadeh, M (Corresponding Author), Dalhousie Univ, Sch Hlth Adm, 5161
  George St,Suite 700, Halifax, NS B3J 1M7, Canada.

  Hajizadeh, Mohammad, Dalhousie Univ, Sch Hlth Adm, Halifax, NS B3J 1M7, Canada.

  Heymann, Jody, Univ Calif Los Angeles, Fielding Sch Publ Hlth, Los Angeles, CA 90024
  USA.

  Strumpf, Erin, McGill Univ, Dept Econ, Montreal, PQ H3A 2T5, Canada.

  Strumpf, Erin; Harper, Sam; Nandi, Arijit, McGill Univ, Dept Epidemiol Biostat \&
  Occupat Hlth, Montreal, PQ H3A 2T5, Canada.

  Nandi, Arijit, McGill Univ, Inst Hlth \& Social Policy, Montreal, PQ H3A 2T5, Canada.'
author: Hajizadeh, Mohammad and Heymann, Jody and Strumpf, Erin and Harper, Sam and
  Nandi, Arijit
author-email: m.hajizadeh@dal.ca
author_list:
- family: Hajizadeh
  given: Mohammad
- family: Heymann
  given: Jody
- family: Strumpf
  given: Erin
- family: Harper
  given: Sam
- family: Nandi
  given: Arijit
da: '2023-09-28'
doi: 10.1016/j.socscimed.2015.07.008
files: []
issn: 0277-9536
journal: SOCIAL SCIENCE \& MEDICINE
keywords: Maternity leave; Childhood vaccination; Low-and-middle-income countries
keywords-plus: 'HEALTH-CARE USE; IMMUNIZATION COVERAGE; PARENTAL PERCEPTIONS; CHILDREN;

  WORK; DETERMINANTS; POPULATION; EMPLOYMENT; BARRIERS; PROGRAM'
language: English
month: SEP
number-of-cited-references: '52'
orcid-numbers: 'Harper, Sam/0000-0002-2767-1053

  Hajizadeh, Mohammad/0000-0002-4591-8531

  Heymann, Jody/0000-0003-0008-4198'
pages: 104-117
papis_id: 351a274c56fd2da1902916d36ee33ab8
ref: Hajizadeh2015paidmaternity
researcherid-numbers: 'Harper, Sam/A-3406-2008

  '
times-cited: '44'
title: 'Paid maternity leave and childhood vaccination uptake: Longitudinal evidence
  from 20 low-and-middle-income countries'
type: Article
unique-id: WOS:000360253600012
usage-count-last-180-days: '0'
usage-count-since-2013: '17'
volume: '140'
web-of-science-categories: 'Public, Environmental \& Occupational Health; Social Sciences,

  Biomedical'
year: '2015'