Does Birth Underregistration Reduce Childhood Immunization? Evidence from the Dominican Republic

Birth registration is not only a fundamental human right- but also a requirement for obtaining additional documents- proving legal identity- and accessing a number of government benefits. Yet- little is known about the effects of birth under-registration on access to health care. Using data from the Dominican Republic- this paper is the first to shed light on the causal impact of the lack of birth registration on childhood immunization- one of the key components of public services in many developing countries. Controlling for potential endogeneity and standard socioeconomic determinants of immunization- this paper finds that children between 0 and 59 months of age that do not have birth certificates are behind by nearly one vaccine (out of a total of nine) compared to those that have birth certificates. The results are robust to several robustness tests and threats to the exclusion restriction of the instrumental variables. Birth under- registration specifically reduces the probability of vaccination against polio- diphtheria- pertussis- and tetanus