Complete Childhood Immunization and Child Health Outcomes: Evidence from Indonesia

Abstract

This study aims to examine the effect of complete childhood immunization on child health and growth outcomes in Indonesia, measured by morbidity history and Body Mass Index (BMI). This research is important because complete immunization coverage in Indonesia remains uneven, while child health is a strategic component in improving human capital quality and achieving the Sustainable Development Goals (SDGs). This study uses secondary data from the Indonesian Family Life Survey (IFLS) and applies a quantitative approach. The analysis employs a Probit model to estimate the relationship between complete immunization and child health outcomes. To address the potential endogeneity of immunization decisions, an Instrumental Variable Probit (IV Probit) model is also applied. The instrumental variables used are the distance to the nearest health facility and the cost of accessing vaccination services. The estimation results show that children who receive complete immunization have a 50.8% lower probability of experiencing morbidity requiring rest compared to children who do not receive complete immunization. In addition, complete immunization reduces the probability of children having abnormal BMI status (underweight or overweight) by 50.9%. These findings indicate that complete immunization significantly improves child health and nutritional status in Indonesia. The novelty of this study lies in the use of a causal inference approach through the IV Probit model to address endogeneity bias in immunization decisions, as well as in measuring the impact of immunization not only on morbidity but also on child growth indicators through BMI.