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When sterilizations lower immunizations: The Emergency experience in India (1975–77)

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  • Pelras, Charlotte
  • Renk, Andréa

Abstract

In the 1970s in India, an aggressive family planning program resulted in more than eight million sterilizations in only a few months. Under the assumption that this extremely unpopular sterilization campaign may have shaped demand for health services, we study the effect of this event on children’s immunization and hospital births. To account for possible non-randomness in coercion intensity, we use a difference-in-difference empirical strategy, which relies on the unexpected timing of the program and mother and village fixed effects. We show that an increase in district-wise sterilizations, compared to the previous period, led to a substantial decrease in the use of these services, especially vaccination. Further evidence supports a decline in trust rather than a change in health supply or valuation of children.

Suggested Citation

  • Pelras, Charlotte & Renk, Andréa, 2023. "When sterilizations lower immunizations: The Emergency experience in India (1975–77)," World Development, Elsevier, vol. 170(C).
    • Handle: RePEc:eee:wdevel:v:170:y:2023:i:c:s0305750x23001390
    DOI: 10.1016/j.worlddev.2023.106321
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    References listed on IDEAS

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    1. Pramod Kumar Sur, 2021. "Understanding Vaccine Hesitancy: Empirical Evidence from India," Papers 2103.02909, arXiv.org, revised Feb 2023.
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    6. Grant Miller and Kimberly Singer Babiarz, 2016. "Family Planning Program Effects: A Review of Evidence from Microdata - Working Paper 422," Working Papers 422, Center for Global Development.
    7. Lenisa V. Chang, 2018. "Information, education, and health behaviors: Evidence from the MMR vaccine autism controversy," Health Economics, John Wiley & Sons, Ltd., vol. 27(7), pages 1043-1062, July.
    8. Pramod Kumar Sur, 2021. "Understanding the Paradox of Primary Health Care Use: Empirical Evidence from India," Papers 2103.13737, arXiv.org, revised Jul 2022.
    9. Monica Martinez-Bravo & Andreas Stegmann, 2022. "In Vaccines We Trust? The Effects of the CIA’s Vaccine Ruse on Immunization in Pakistan," Journal of the European Economic Association, European Economic Association, vol. 20(1), pages 150-186.
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    11. Matthew Connelly, 2006. "Population Control in India: Prologue to the Emergency Period," Population and Development Review, The Population Council, Inc., vol. 32(4), pages 629-667, December.
    12. Marianna Battaglia & Nina Pallarés, 2020. "Family Planning and Child Health Care: Effect of the Peruvian Programa de Salud Reproductiva y Planificación Familiar, 1996–2000," Population and Development Review, The Population Council, Inc., vol. 46(1), pages 33-64, March.
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    Cited by:

    1. Aditi Singh & Sarah Vincent, 2024. "Male Sterilization and Persistence of Violence: Evidence from Emergency in India," AMSE Working Papers 2403, Aix-Marseille School of Economics, France.

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    More about this item

    Keywords

    India; Family planning; Sterilization; Immunization; Vaccination; Emergency; Health care use; Trust;
    All these keywords.

    JEL classification:

    • I12 - Health, Education, and Welfare - - Health - - - Health Behavior
    • I15 - Health, Education, and Welfare - - Health - - - Health and Economic Development
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health
    • J13 - Labor and Demographic Economics - - Demographic Economics - - - Fertility; Family Planning; Child Care; Children; Youth
    • N35 - Economic History - - Labor and Consumers, Demography, Education, Health, Welfare, Income, Wealth, Religion, and Philanthropy - - - Asia including Middle East

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