New Incentives — Exit Grant and Immunizations Pilot

Published: January 2017

Note: this page summarizes the rationale behind a grant to New Incentives made by Good Ventures at GiveWell's recommendation. New Incentives staff reviewed this page prior to publication.

As part of GiveWell's Incubation Grants to support the development of potential future top charities and improve the quality of our recommendations, in November of 2016 Good Ventures granted $368,587 to New Incentives. Part of this funding ($205,024) is intended as an "exit grant" to support New Incentives in closing down its program giving conditional cash transfers to women who deliver at a health facility.1 The remaining $163,563 is intended to support New Incentives' pilot program to instead make conditional cash transfers to incentivize routine immunizations. GiveWell has previously recommended grants to New Incentives in January 2014, March 2015, and March 2016.

As discussed in our October 2016 blog post about New Incentives, we have decided that New Incentives' existing program, which uses cash transfers to incentivize women in Nigeria to deliver in a health facility, does not meet our criteria to be a top charity. In that blog post, we discussed several options for how we might move forward in working with New Incentives; with this grant, we are taking the options to recommend an exit grant for the old program and a grant to support the pilot of a new program (options #1 and #3 in our blog post).

The pilot program funding will enable New Incentives to run a four-month pilot to incentivize routine immunizations in Nigeria.2 New Incentives explored a similar program in 2014.

We (and New Incentives) are still uncertain about several very important factors relating to how this pilot will go. These include:

• How effective is the program, i.e., how much will cash incentives increase immunization rates?
• Will New Incentives be able to collect data of high enough quality to determine whether its work meaningfully increases immunizations?
• How cost-effective is the program? Our preliminary, tentative estimate puts its cost-effectiveness at roughly 3-4x the cost-effectiveness of unconditional cash transfers (à la GiveDirectly).

By the end of February 2017, New Incentives plans to have enrolled approximately 4,800 children in 12 clinics (in four states)3 testing both larger and smaller transfer sizes.4 New Incentives also expects to reach around 2,400 children through a measles immunization catch-up campaign. This means that by the end of this pilot period, we will have some data on retention (e.g., what proportion of children that receive the first dose of a vaccine sequence return for the second dose) as well as uptake of the measles catch-up campaign.

We remain optimistic about New Incentives as an organization that is aligned with us in its aim to start a very cost-effective, transparent charity with high-quality monitoring and evaluation, and that has shown the ability to live and execute in Nigeria.

Sources

• 1See New Incentives, Exit Grant Budget.
• 2See New Incentives, CCTs for Immunizations Proposal.
• 3”New Incentives seeks $181,563 for the pilot of its CCTs for Immunizations program that runs from November 2016 to February 2017 (four months). The pilot includes 12 clinics in four states and approximately 4,800 beneficiaries.” New Incentives, CCTs for Immunizations Proposal, Pg 4.
• 4”Two implementation models will be tested... While Model 1 tests the lowest amounts deemed effective (N4,000, $13 in total), Model 2 includes higher amounts (N7,000, $23).” New Incentives, CCTs for Immunizations Proposal, Pg 1.