Immunizations, Poverty and Child Survival in the Kasena-Nankana District of Northern Ghana

Bawah A Ayaga, Population Council
James F. Phillips, Population Council
Peter Wontuo, Navrongo Health Research Centre
George Wak, Navrongo Health Research Centre

Many African children continue to die each year from vaccine-preventable diseases despite well promoted evidence-based programs that aim to expand the coverage of childhood vaccination programs. Recent international attention to Millennium Development Goals often promote the view that low cost and effective immunization modalities may differentially impact on survival among the poor. This paper tests this assumption in a rural traditional district of northern Ghana where poverty is both pervasive and variable. Generalized Cox survival models are estimated that assess the main and interaction effects of poverty and immunization on childhood survival in a cohort of under-five children observed for five years. Results are consistent with findings in many other settings showing that immunization status has a major impact irrespective of poverty status. Interaction effects in this analysis demonstrate, however that this survival benefit is greater among the very poor than the less poor.