Maternal education and child vaccination in Ethiopia: A natural experiment

Abstract Background Maternal education is often linked to improved child vaccination, but the causal relationship is less clear, particularly in low-income settings. Objective To estimate the causal impact of maternal education and child vaccination in Ethiopia using a natural experiment. Methods We analyzed data from the 2011 and 2016 Ethiopian Demographic and Health Surveys leveraging the 1994 Universal Education Reform (UPE) as an exogenous shock to maternal schooling. A fuzzy regression discontinuity design (f-RDD) was employed to assess the effect of of maternal education on full vaccination status of children aged 12–23 months . Results The findings reveal UPE reform increased primary school attendance by 35% among exposed mother compared to 15% for unexposed mothers The f-RDD analysis found significant effect of maternal education attainement on child vaccination. Maternal education is associated with an increase likelihood of a child being fully vaccinated 0.24 (95% CI: 0.14, 0.35). This analysis also shows for each additional year of maternal schooling the likelihood of a child being fully vaccinated increase by 0.23 (95% CI: 0.17, 0.29). Conclusion Ethiopia’s 1994 reform proves education can be a public health tool. By keeping girls in school longer, it equipped them to protect their children from preventable diseases, contributing to a healthier society. However to ripple its lasting impact improving education quality and addressing other social determinants are also critical.