Incentivizing Health

14.73 - Group 4
Proposal
● 5 year plan to change the mindset of people’s views
toward immunization through making indifference
into action
● Presentation Today:
○ Explore Supply-Side interventions to improve the supply chain
○ Explore Demand-Side interventions to improve people’s receptiveness to
immunization
○ Explore effectiveness of Demand-Side interventions through incentives
Improving Supply Chain:
● Simplify distribution network by taking advantage of current technology
(i.e. allowing health centers to contact one main distribution center)
● At national level: invest more in improved chain equipment, space
allocation, and manpower that can manage cold chain
● New Vaccines with larger packaging need a lot more cold storage
space.
● Temp of vaccines do not need to be 2-8 degrees Celsius for short term
(month) storage
● Vaccines need to leave the cold chain and get into the remote areas.
Change in Understanding at the local clinic level
● Problems with it:
○ Cost-ineffective and time-ineffective because of HUGE overhaul of
a long-standing system
Demand side
● Suspicion due to lack of clarity in the
information about vaccines
● Lack of trust in public and private institutions
(conflict of interests, private players, etc.)
● Lack of immediate incentives leading to
procrastination
● International disagreements discourage the
policy makers
 Demand side
● Low efficiency of educational programs, just
with them, 80% of the children do not get
immunization

● Even in wealthy and well-educated countries,

like USA, immunization is not a choice
Demand side
● Need for immediate incentives, easy
oversight.

● Material incentives such as food, but also

social incentives such as employment
opportunities...
Demand-side: Increasing Incentives
● JPAL study conducted in rural
Udaipur, India to see the
effectiveness of different
immunization camps
● Number of children getting at least
one immunization increased to nearly
80% with camps
● With only well-publicized
immunization camps (and no
incentives), percentage getting full
vaccination package increased from
only 6% to 18%
● Camps with incentives gave lentils +
plates for the last visit
Incentivization: Cost-Effective + It works
● Overall, incentives saw higher long-term
effectiveness with immunizations
○ 39% of children were fully immunized in
camps w/ incentives vs. 18% of camps
without
● Much more cost effective than not having
incentives
○ Almost ½ price to run camps with
incentives and effectively immunize
Implications of education & incentives
● Incentives (e.g. plates and lentils for last visit of camps)
countered parental procrastination, nudged them to go
to camps
○ Information and supply alone not enough
● Through increased RTCs, countering lack of data on
disease burden in India
● Small incentives substantially change behavior with low
cost
○ “inconvenient task” → “worthwhile activity”