Postneonatal mortality impacts following grants from the Gavi Vaccine Alliance: an econometric analysis from 2000 to 2014

We completed a retrospective multivariate panel study to evaluate the effect of Gavi Vaccine Alliance grants on vaccine-preventable disease (VPD) postneonatal mortality. We separately tested a composite VPD mortality rate and five vaccine-preventable mortality rates: pertussis, meningitis, measles, diarrhea, and pneumonia (lower-respiratory infection) as dependent variables. All 77 countries eligible for Gavi assistance from 2000 to 2014 were included in the study. To isolate the effect of Gavi funding in our primary model, we controlled for known and likely predictors of child mortality. We found evidence that, among other factors, Gavi investment, antenatal care access, and girls' primary education are important elements to reduce vaccine-preventable mortality rates. For every $1 per capita invested by the Gavi Vaccine Alliance, there are statistically significant effects decreasing the VPD postneonatal mortality rate by 1.848 per 1000 live births. We also found Gavi investments to be significantly associated with reductions in three VPD-specific rates: pertussis, meningitis, and pneumonia. We conclude that Gavi investments in developing country immunization programs have measurably contributed to reductions in postneonatal VPD mortality rates.