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Evaluation of Conditional Cash Transfers (CCTs) for Immunisations — Impact Brief

Introduction

It is estimated that basic immunization services do not reach over 19 million infants worldwide, and over 1.5 million children die from vaccine-preventable diseases.[1] The majority of these children reside in low-and middle-income countries. Existing research suggests that small incentives for parents can increase full immunization rates; however, there are still unknowns about the most effective way to structure incentives in terms of size, schedule, and design. In 2016, GIF provided an $856,215 grant to IRD Global to conduct a three-year randomized controlled trial in Karachi, Pakistan, to understand how small conditional cash transfers (CCTs) can incentivize parents to have their children take up and complete vaccination schedules. Through this study, IRD seeks to understand the optimal design and delivery model for delivering these small cash incentives in a cost-effective and logistically simple way. This evidence is expected to be relevant to driving policy decisions that ultimately contribute to lowering child morbidity and mortality in low-income contexts.

Use of GIF Funds

GIF’s funding of $856,215 is allocated to costs associated with delivering the randomized controlled trial, including research and implementation personnel, participant costs (e.g., incentive payouts), equipment, and other project costs.

In 2020 in response to the Covid-19 pandemic, GIF provided IRD with $307,658 in grant funding to support community-based Covid-response work in Pakistan. Funds are used to cover costs ofCOVID-19 screening, case management, adapting a mHealth application for data management, remote contact tracing, mental health counselling, oxygen therapy at 208 GP clinics in Karachi, and a referral system grounded at the community level.

Objectives

Conduct an experimental study in Karachi, Pakistan, to measure the relative effectiveness of different types of incentive structures (including the optimal amount, progressivity, and certainty of payment) on immunization coverage rates and timeliness. Identify the optimal model of delivering small incentives that has a minimal cost, are logistically simple, and not subject to leakage.

Impact to Date

To date, the program has vaccinated over 11,000 children in Karachi, Pakistan. Interim results suggest that small mobile-based incentives coupled with SMS reminders can significantly improve immunization coverage in children.[2] The final results of the study are yet to be published.

Over 26,000 people were reached through Covid-19 response work delivered by IRD and its partners in the Sindh province of Pakistan.


 

[1] https://www.gavi.org/programmes-impact/our-impact/facts-and-figures

[2] https://academic.oup.com/eurpub/article-abstract/30/Supplement_5/ckaa165.993/5916067