NextBillion - An Initiative of the William Davidson Institute at the University of Michigan

Friday, August 14, 2015

In 70 local health clinics run by the Indian state of Haryana, the parents of a child who starts the standard series of vaccinations can walk away with a free kilogram of sugar. And if the parents make sure that the child finishes the injections, they also get to take home a free litre of cooking oil.

These simple gifts are part of massive trial testing whether rewards can boost the stubbornly low immunization rates for poor children in the region. Following the model of the randomized controlled trials (RCTs) that are commonly used to test the effectiveness of drugs, scientists randomly assigned clinics in the seven districts with the lowest immunization rates to either give the gifts or not. Initial results are expected next year. But smaller-scale experiments suggest that the incentives have a good chance of working. In a pilot study conducted in India and published in 2010, the establishment of monthly medical camps saw vaccination rates triple, and adding on incentives that offered families a kilogram of lentils and a set of plates increased completion rates by more than sixfold.