New Incentives
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New Incentives

New Incentives’ mission is to save lives in a way that does the most good per dollar. Guided by evidence, they provide cash incentives to increase childhood vaccination rates. Operating in northern Nigeria, an area with one of the highest child mortality rates and one of the lowest childhood vaccination rates in the world, New Incentives offers cash incentives, equivalent to ~$8 across six visits, to caregivers at government clinics after their children receive their routine vaccinations. A GiveWell top charity, the program is recognized as one of the most cost-effective ways to save a life.

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Founded
2011
2.2 million +
Infants enrolled in the program
7.5 million+
Cash transfers disbursed
29 million+
Vaccinations encouraged

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The problem: Low immunization rates

Childhood vaccines prevent an estimated 4-5 million deaths every year [1].  They are recognized as one of the most cost-effective child health interventions in low-income countries. Yet, in 2022, an estimated 14.3 million infants around the world didn’t receive a single dose of diphtheria-, tetanus-, or pertussis-containing (DTP) vaccines[2]. The problem of low immunization rates is especially clear and pressing in Nigeria. Nigeria is home to just 2.7% of the world’s population [3], yet it accounts for 18% of the world’s mortality of children under five [4]. Nigeria has some of the highest under-five mortality rates [5] and lowest vaccination coverage in the world. Around one-quarter of infants in northern Nigeria get fully immunized, leaving a large population of infants vulnerable to disease outbreaks[6].

The problem of low vaccination coverage in Nigeria is further exacerbated by extreme poverty. This is especially true in northern Nigeria, where many mothers live on less than US$2 a day and cannot visit the clinic for various reasons. They face challenges such as affording the transportation cost to the clinic, associated loss in earnings from small-scale trading or farming, receiving permission from their partners, fear of vaccination side effects, cultural barriers to vaccination, or often a combination of these factors [7].

The solution: Cash incentives for routine childhood vaccination

New Incentives increases vaccination rates by raising awareness about the benefits of childhood vaccinations, providing cash incentives at government clinics after children receive vaccinations, and helping improve the vaccine supply chain to ensure enough vaccines are available at the clinics.

Cash incentives of N1,000 (~US$1.30) are disbursed at six different routine immunization visits, totaling N6,000 (~US$8) over the first 15 months of an infant’s life. 

A randomized controlled trial found that their program led to: 

  • 108% Increase in full vaccination coverage
    (relative to 25% full vaccination coverage rate in the control group)
  • 62% Increase in timely vaccination of measles 12 
    (relative to 53% of timely Measles 1 vaccination in the control group)
  • 180% Less likely for clinics to report stockouts
    (relative to 10% of clinics reporting no stockouts in the control group) [8]

What makes New Incentives so effective


Cost-effectiveness

New Incentives posts quarterly updates on their cost per infant here. Future costs are estimated to be $20/infant as the program continues to expand.

New Incentives’ Accountability

New Incentives focuses on an intervention with very strong evidence of effectiveness and cost–effectiveness. The organization is transparent and has rigorous processes in place to monitor and ensure that its conditional cash transfers reach the intended recipients.

Frequently Asked Questions

The cash transfers are in the amount of 1,000 Naira for each of the first six vaccine visits (at birth, 6 weeks, 10 weeks, 14 weeks, 9 months, and 15 months). In sum, caregivers can receive up to 6,000 Naira (~ US$8).

New Incentives was founded with the mission of doing the most good per dollar and has used evidence to guide its program design and decisions since its inception. Some examples of how they do this: they designed their program to harness the effectiveness of conditional cash transfers (CCTs), an approach that has been proven to be effective in changing health behaviors; they focus on immunizations and operate in northern Nigeria, where only around 25% of infants are fully immunized, thus leading to devastating disease outbreaks; and they base internal operational decisions on data to increase program effectiveness.

New Incentives operates where it can have the biggest impact: rural Nigeria. Nigeria is home to just 2.7% of the world’s population but accounts for 17% of the world’s mortality of children under five. As of 2022, Nigeria has one of the highest mortality rates in the world among children under five years.

Fraud mitigation is one of New Incentives’ core responsibilities. They have comprehensive procedures and systems to prevent and detect fraud. They carry out post-transfer reviews of each disbursement, regularly perform unannounced program audits, and have robust data analytics that they continuously iterate based on lessons learned. They follow rigorous standards for recruiting, training, and managing their personnel.

We recommend New Incentives because it has been named a Top Charity by GiveWell, one of our charity evaluators, for three years in a row.

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