New Incentives — Top Charity Fund Allocation (November 2023) and Program Additions/Expansion (April 2024)

Note: This page provides an update on New Incentives' use of GiveWell funds in 2024-2026. New Incentives staff reviewed this page prior to publication.

Published: July 2024

The organization

New Incentives runs a conditional cash transfer program in northern Nigeria that seeks to increase uptake of routine childhood vaccinations through cash transfers, raising public awareness of the benefits of vaccination, and partnering with the government to reduce the frequency of vaccine stockouts. New Incentives is a GiveWell Top Charity. In part, this means that we've directed significant funding to the organization and have seen it operate effectively,2 and we think further grants to New Incentives have a high likelihood of substantial impact (more about our criteria for Top Charities). For more information on New Incentives, including how it works and our qualitative assessment of the organization, see this page.

Simple cost-effectiveness analysis

We use a cost-effectiveness analysis to quantify our reasoning for supporting New Incentives' program.3 Here is a summary of our latest analysis, using one state, Bauchi, as an example. You can see the full cost-effectiveness analysis here.

Program additions

In November 2023, New Incentives proposed adding two components to its program: a "livelihood grant" for caregivers whose children complete the full routine immunization schedule, and a monthly stipend for government-employed clinic staff who meet certain conditions around attendance, training, and following procedures. At a high level, New Incentives proposed these additions because it believes they will increase enrollments in the program, reduce drop-outs for later vaccines, and increase engagement from clinic staff.4 New Incentives estimated these program additions would cost roughly $19.2 million across 2024-2026.5

After reviewing the case for these program additions, in April 2024 we approved the reallocation of prior GiveWell funds to cover the costs from 2024-2026. New Incentives plans to pilot these program additions in one state (Sokoto) before initiating a phased roll-out across the program.6 We expect the pilot to yield information on feasibility, stakeholder reception, and program quality.

What we think the program additions will do

The two program additions that New Incentives will pilot are: 1) providing an additional 5,000 naira7 incentive for caregivers whose infants complete the entire vaccination schedule (referred to as a "livelihood grant"), and 2) providing a monthly stipend of up to 5,000 naira (in the form of airtime for a mobile phone) for clinic staff who meet certain conditions around attendance, training, and following procedures.8 The vast majority of the reallocated funding would support the former.9

To be eligible for the livelihood grant, children enrolled in the program will need to complete the full routine immunization schedule and be screened by clinic staff for malnutrition during their Measles 2 visit.10 New Incentives is including a malnutrition screening because it believes malnutrition rates are high in northern Nigeria,11 it believes it could leverage its existing footprint and systems to impact nutrition services, feedback from a variety of stakeholders indicated strong enthusiasm for adding a malnutritional component, it believes its program might gain wider acceptance if it is seen as a child health program rather than an immunization-specific program,12 and because New Incentives has heard anecdotally that malnutrition screenings and growth monitoring are not consistently provided at clinics. New Incentives plans to provide information on feeding practices alongside the malnutrition screenings, and will encourage caregivers to speak to clinic staff for referrals to malnutrition services.13 New Incentives also plans to consolidate the data it collects on malnutrition status and share it with government stakeholders and partners to support targeting of malnutrition services.14

For the clinic staff stipend, New Incentives plans to pilot the exact eligibility conditions but envisions making the stipend conditional on attendance at immunization days and outreach sessions, following data collection protocols, and completing growth monitoring training and protocols.15 Part of the stipend will be used to compensate clinic staff for their help with the malnutrition screening component of the livelihood grant.16

Why we approved these program additions

• Inflation has been high in Nigeria, and the livelihood grant would bring the total value of caregiver incentives roughly back in line with its value during the randomized controlled trial of the program. Caregiver incentives totaled 4,000 naira during the randomized controlled trial (RCT) of New Incentives' program, which we use to estimate the program's effect on vaccination rates.17 New Incentives increased incentives to a total of 6,000 naira in 2023, but they are still worth less than the value of the incentives provided during the RCT. We think this is a problem because we estimate the program's cost-effectiveness based on the RCT results, but the program may not be as enticing to caregivers if the incentives are now less valuable. With the livelihood grant, caregivers would be eligible to receive a total of 11,000 naira, which we believe will be roughly as valuable as 4,000 naira was during the RCT.18
• We estimate New Incentives' program is highly cost-effective even with these additional costs. New Incentives estimates its cost per child with these program additions would be $16.26 (and $12.65 without them).19 We assume some children will be enrolled in the program more than once (there are safeguards against this, but they don't prevent 100% of cases)20 , so we expect the cost per unique child to be slightly higher. However, even after adjusting for repeat enrollments, our cost per child estimate is still lower than we estimated at the time of our last grant to New Incentives ($18.21 vs $21.27), due to changes in the foreign exchange rate and some cost efficiencies as New Incentives has grown.21 Consequently these program additions aren't bringing the program below our funding bar.22
• New Incentives expects the livelihood grant will increase both enrollments in the program and retention rates throughout the vaccination schedule. Part of the reasoning for the livelihood grant is that it might increase buy-in from caregivers' husbands. Most of the caregivers who bring their infants into clinics are mothers, and New Incentives has heard anecdotally that their husbands sometimes do not permit them to bring their children to clinics for vaccinations. New Incentives believes the livelihood grant may increase buy-in from husbands since the 5,000 naira lump sum would be large enough to be shared with husbands or used as an investment (rather than just covering the transportation or opportunity costs of a caregiver traveling to the clinic).23 New Incentives' proposal is also based on its experience increasing total incentives from 5,000 naira to 6,000 naira in 2023. It saw a 26 percentage point increase in enrollments and a 1-5 percentage point increase in retention rates (the rate at which children return for follow-up vaccination visits) after that change.24 This increase in incentives would be structured differently (the change in 2023 entailed increasing the amount offered at earlier vaccination visits, whereas the livelihood grant would be offered just at the end), but New Incentives conducted some informal surveys that suggest the livelihood grant would be preferred over a structure that increased the size of incentives at each visit.25

Reservations

• New Incentives does not plan to pilot multiple versions of the increased incentives, and the version that New Incentives plans to use may not be the most cost-effective. Although we generally think caregiver incentives should be increased to keep up with inflation, there are multiple ways New Incentives could structure that change. We discussed the proposed incentive structure with Rachel Glennerster26 , a member of the GiveWell Research Council, who advised that while there was not a huge amount of evidence, offering a higher incentive later in the vaccination schedule aligns with existing literature on immunization incentives. She noted that the limited evidence could not distinguish between the impact of putting this additional incentive all on the Measles 2 visit versus splitting it up across several visits. It's possible that a different structure, like some of the options New Incentives included in its informal surveys, would have a greater impact on program enrollment and retention. However, we don't feel strongly enough about this to push New Incentives on it and ask the organization to put more time into experimentation. Leadership time spent on this experimentation could delay other program improvements/expansions, and a delay in rolling out the livelihood grant means missed opportunities for cost-effective impact.
• Malnutrition screening is a new health area for the program, and there may be downsides to integrating it into immunization visits that we and New Incentives have not thought of. One concern we had was that providing malnutrition screening and education but not referrals might leave caregivers with the impression that there are no malnutrition services available to them. New Incentives plans to encourage caregivers to speak to clinic staff about malnutrition services,27 but we are unsure how often caregivers will be referred to services in practice. We plan to review the data New Incentives will collect during the pilot and may recommend adjustments to the malnutrition component of the livelihood grant if this remains a concern.
• Stipends could decrease clinic staff motivation if removed, and the added time spent on the incentivized activities could take away from other important priorities for clinic staff. We're recording these as potential concerns, though New Incentives has provided some information to assuage them. We're not very concerned about backlash in the event that the stipends are removed as New Incentives tried something similar previously and did not see any lasting negative effects following discontinuation.28 The stipend is also a pretty small amount.29 Regarding taking time away from other activities, New Incentives told us it expects each malnutrition screening to take a few minutes to complete and that the volume of screenings taking place on a given day will be limited (since only infants receiving measles vaccines will get screened). New Incentives does not expect the incentivized activities to affect clinic staff's work hours in most cases, though the introduction of the livelihood grant might increase the time they spend at clinics and reduce idle time between vaccinations if it leads to greater demand for vaccinations.30 New Incentives expects to receive informal and formal feedback from clinic staff throughout the pilot to learn about any issues that might arise.31
• We limited the staff time spent on this investigation due to our familiarity with New Incentives' program, so we may have missed key considerations. We discussed the proposed incentive structure with Rachel Glennerster and New Incentives, but did not solicit feedback from other outside experts. We conducted a few checks on program performance, but these were fairly light-touch checks focused on identifying any concerns that might indicate the program is not performing as well as expected. We did not conduct a deep investigation of other considerations, such as the funding landscape for conditional cash transfers in Nigeria, partly because these program additions are covered by prior GiveWell grants.

Program expansion

In November 2023, New Incentives raised the possibility of expanding to 10 local government areas (LGAs) that were previously deemed unsafe, but where New Incentives now believed it could operate its program. These higher risk LGAs are located in Katsina, Kebbi, Sokoto, and Zamfara, states where New Incentives already operates and where we estimate its program is highly cost-effective. New Incentives estimated operating in these LGAs would cost $4.4 million from 2024-2026, including the cost of the program additions described above.32 After reviewing the case for expansion, we approved the reallocation of prior GiveWell funds to cover the costs from 2024-2026.

Why we approved this expansion

• We expect operating in these 10 LGAs would be highly cost-effective. We conducted a rough sensitivity analysis to estimate cost-effectiveness in these areas, since we do not have data on vaccination coverage in these LGAs to input into our cost-effectiveness model.33 Despite adding in some negative adjustments to account for the more challenging operating conditions, we still expect New Incentives' program in these LGAs would be more than 8 times as cost-effective as unconditional cash transfers (our funding bar at the time of this analysis). We made the following assumptions when conducting this sensitivity analysis:
  • We assume the cost per child reached will be higher in these areas, due to higher costs for security measures and a less efficient allocation of staff. We have assumed a 20% increase in costs, though this is a rough guess.
  • We assume the program may operate less effectively due to more challenging operating conditions (such as clinics being closed more frequently, greater rates of vaccine stockouts, etc.). We have assumed a 20% decrease in the program's impact on vaccination rates, though this is a rough guess. Our sensitivity analysis indicates that the program's effectiveness would need to fall below 50% of current levels in order for any of these LGAs to potentially not meet our cost-effectiveness bar.
  • We assume existing vaccination rates in these LGAs are very low. Due to the higher security risks in these LGAs, New Incentives does not expect to be able to conduct surveys measuring baseline vaccination coverage as it does in other areas. However, we looked at baseline vaccination rates in areas New Incentives identified as most similar to the LGAs in question, and assumed the rates would be similarly low.
• New Incentives has a strong track record of operating its program in a challenging environment. Our understanding is that security dynamics in northern Nigeria are fluid, and the program faces some security risks in all states where it operates. We think New Incentives will be able to expand to these 10 LGAs partly because it already operates in some areas deemed "high risk," the same classification used for the 10 LGAs in question. Those areas were initially expanded to at a time when New Incentives estimated them to be lower risk, but their risk profile has since changed.34 New Incentives has continued to operate in those areas despite the heightened risk profile and has not reported deteriorations in program quality. Additionally, New Incentives has been transparent about the likelihood of some clinics and wards within these LGAs being inaccessible to its program, and we generally trust that it would not recommend expansion to these 10 LGAs if it did not think it could safely operate there.

Reservations

• Operating in these LGAs may be more challenging than we or New Incentives expect, and may put New Incentives staff and caregivers at risk of harm. We have assumed the program will be moderately more costly and less effective in these LGAs compared to the rest of New Incentives' program, but we may be underestimating the challenges of operating in these LGAs. New Incentives expects to be able to conduct audits and supervision visits in these LGAs at the same rate as in other areas35 , but it's possible this will prove infeasible and that the program will run a greater risk of fraud in these areas. Additionally, kidnappings and other security incidents may be more common in these LGAs, putting New Incentives staff or caregivers at increased risk while traveling to and from clinics, or while at clinics. New Incentives believes that caregivers are unlikely to be targeted by bandits and it expects to provide additional staff safety training for staff operating in these areas.36 However we continue to believe there may be a greater risk of harm for both staff and caregivers in these LGAs.
• We will not have direct evidence on the program's effect on vaccination rates in these areas. New Incentives does not expect to conduct either baseline or follow-up surveys measuring vaccination coverage in these areas. This is because New Incentives believes traveling household to household to conduct these surveys may be dangerous for New Incentives staff (but it believes operating at health clinics is generally safer).37 As a result, we will not have any direct evidence showing the program's impact on vaccination rates in these areas. New Incentives still expects to be able to collect other indicators of program performance38 , which will give us a signal of how well the program operates in these areas in practice, but we will not be able to use these indicators to directly estimate changes in vaccination rates—which is one of the key inputs in our cost-effectiveness model.

Plans for follow up

We plan to follow the progress of both the program additions and expansion in our regular check-ins with New Incentives. We have monthly calls with New Incentives and receive monthly written program updates. New Incentives also shares information on program performance across a variety of indicators (such as number of children enrolled, percentage of children returning for later vaccinations, rate of vaccine stockouts, etc.). Specific indicators we plan to check, and follow up questions we expect to ask New Incentives, are laid out in this spreadsheet.

For the expansion component in particular, we plan to re-assess the expansion roughly one year after we approved it (we approved it in January 2024). Our goal will be to update our best guess of the cost and effectiveness adjustments described above. We plan to do so by 1) confirming how many of the 10 LGAs New Incentives has expanded to, 2) discussing with New Incentives any differences in operations in these LGAs, and 3) comparing key indicators of program performance across the 10 LGAs and the rest of the program. We will then decide whether to do a similar review a year after that, or roll the 10 LGAs into our reviews of all of New Incentives' results.

Internal forecasts

We are recording the following forecasts associated with these program additions and expansion:

Program additions

High risk LGAs expansion

Sources

• 1

  As of April 25, 2024, the Nigerian Central Bank reported a naira:USD market exchange rate of approximately 1,165 naira per $1. See here. The average foreign exchange rate New Incentives received in 2022 was approximately 668 naira per $1. See GiveWell's analysis of New Incentives' room for more funding [May 2023]. The ability to receive more naira for every dollar has left New Incentives with a large surplus of funding from prior GiveWell grants, which were sized based on previous foreign exchange rates and did not anticipate the large devaluation in the naira.

• 2

  See a table of all grants we have made or recommended to New Incentives here.

• 3

  Note that we view our cost-effectiveness analyses as simplified models that are highly uncertain, and do not recommend funding solely on the basis of our cost-effectiveness calculations. You can read more about how we use cost-effectiveness analysis in our grantmaking on this page.

• 4

  "Over the course of the program, New Incentives has received repeated suggestions from stakeholders, partners, staff members, and caregivers to incorporate program components that will:

  • Attract greater spousal participation and support
  • Be linked to full immunization/receipt of all vaccines in the RI schedule
  • Broaden the perception of the program beyond RI to attract more widespread support
  • Motivate clinic staff to help reduce clinic staff absenteeism and stockouts
  • Increase cash transfer amounts and encourage full RI completion"

  New Incentives, Proposal for Program Additions to Increase Coverage Rates, p. 1.

• 5

  New Incentives, Summary of Funding Gap Estimates (unpublished).

• 6

  New Incentives, comments during review of a draft of this page (unpublished)

• 7

  At the time of writing, the 5,000 naira incentive equates to roughly $4.30.
  As of April 25, 2024, the Nigerian Central Bank reported a naira:USD market exchange rate of approximately 1,165 naira per $1. See here. 5,000 / 1,165 = 4.2918.

• 8

  "New Incentives proposes to add two components to its current All Babies program in order to increase
  program acceptance and vaccination coverage:
  1. A livelihood grant of ₦5,000 awarded to caregivers upon completion of all vaccines in the RI
  schedule.
  2. Airtime of up to ₦5,000 for two clinic staff, totaling ₦10,000, per clinic per month."
  New Incentives, Proposal for Program Additions to Increase Coverage Rates, p. 1.
  For more information on the program additions, see New Incentives, Proposal for Program Additions to Increase Coverage Rates.

• 9

  New Incentives previously estimated the livelihood grant would increase its cost per child by $4.20, while the clinic staff stipend would increase it by only $0.30. These exact numbers are no longer accurate as New Incentives has updated its assumption of the foreign exchange rate it will receive, but they still provide a roughly accurate comparison of the relative cost of the two additions. New Incentives, email to GiveWell, December 13, 2023 (unpublished).

• 10

  "₦5,000 livelihood grant awarded to caregivers upon RI completion:
  ● Eligibility criteria for caregivers:
  ○ Infant received all vaccines in the Nigeria Routine Immunization Schedule (exceptions
  such as OPV 0 and Hep B 0 will be considered)
  ○ Infant nutritional status measured by clinic staff at Measles 1 and 2 stages in most clinics
  ○ Valid ABAE ID (with no duplicate enrollment of the same infant)"
  New Incentives, Proposal for Program Additions to Increase Coverage Rates, p. 1.
  Note that New Incentives plans to pilot malnutrition screening at both Measles 1 and 2 visits, but expects to make receipt of the livelihood grant conditional only on the screening at the Measles 2 visit. New Incentives, email to GiveWell, April 15, 2024 (unpublished)

• 11

  Note that we did not review data on malnutrition rates in Nigeria as part of this investigation.

• 12

  New Incentives conducted informal surveys to gather feedback from caregivers, spouses, community members, government stakeholders, and others on the proposed program additions. "Respondents were asked to rate whether they believed the program should focus only on immunizations or expand to include measurement of nutritional status. The majority of respondents, 73% (224), indicated strong enthusiasm for adding a nutritional status at the last visit while 21% (64) of respondents indicated that the program should continue to focus on immunizations only." New Incentives, Summary of feedback on revised incentive amounts and structure, p. 7.

• 13

  New Incentives plans to test the feasibility of having New Incentives Field Officers provide the information on feeding practices, but may end up having clinic staff provide this information if there are concerns around male Field Officers providing information related to breastfeeding. New Incentives plans to work with state nutrition teams to develop the information on feeding practices and will align this information with guidelines from UNICEF and WHO (like those on page 254 of this report). New Incentives will encourage caregivers to speak to clinic staff and get referrals to malnutrition services based on availability, and also plans to collect data during the pilot on the type of information (including referrals to services) that clinic staff provide to caregivers. New Incentives, email to GiveWell, April 15, 2024 (unpublished)

• 14

  New Incentives, email to GiveWell, April 15, 2024 (unpublished).

• 15

  "Eligibility criteria for clinic staff:
  ○ A maximum of 1 missed immunization day in the month for the respective clinic
  ○ Attended at least 5 sessions in the month (based on photos taken by NI-ABAE staff at
  each immunization day)
  ○ Registered with NI-ABAE with a valid bank account
  ○ Passed test confirming training related to basic RI protocols and growth monitoring (this
  will be piloted to determine the frequency of training and feasibility of verifying training
  completion)
  ○ Adherence to protocols on immunization days and growth monitoring for infants at 9-month
  and 15-month RI visits"
  New Incentives, Proposal for Program Additions to Increase Coverage Rates, p. 2.
  New Incentives confirmed during review of this page that it plans to test different eligibility conditions during the pilot, and the final conditions will be based on feasibility and lessons learned from the pilot.

• 16

  "Based on feedback, as of March 2024, New Incentives plans to give airtime in the following ways:

  • ₦2,000 airtime will be given to clinic staff (2 per clinic) based on immunization session attendance and vaccine data matching with DHIS2 (threshold to be defined).
  • An additional ₦2,000 will be given to the clinic staff or another member regularly conducting MUAC measurements.
  • An ad-hoc performance-based airtime bonus will be implemented, depending on criteria such as adherence to protocols on immunization days and retention."

  New Incentives, Proposal for Program Additions to Increase Coverage Rates, p. 2.

• 17

  "Caregivers could receive up to 4,000 Naira, which was approximately 11 USD at the time of the RCT." New Incentives, Proposal for Program Additions to Increase Coverage Rates, footnote 4, p. 2.

• 18

  If we assume that the January - August 2023 inflation rate (the latest we've found) continues through 2024, 10,000 naira at the end of 2024 will be about equivalent to 4,000 naira during the RCT. We think 11,000 naira is a reasonable amount as this funding reallocation would cover 2024-2026 and we think it's likely that some inflation will continue over that period. See GiveWell, Nigeria CPI change 2019-2022.

• 19

  New Incentives, Summary of Funding Gap Estimates (unpublished).

• 20

  For example, New Incentives Field Officers check infants for scars from BCG vaccination (as most infants will have a visible scar after receiving this vaccine) as one way of checking whether an infant is being enrolled in the program more than once (as we assume the main reason that an infant would receive more than one BCG vaccination would be to receive an additional cash transfer). You can read more about New Incentives' criteria for enrollment here and how we estimate the rate of repeat enrollments here.

• 21

  For our May 2023 grant to New Incentives, we assumed its cost per child (before adjusting for repeat enrollments) would be $20.00, based on a foreign exchange rate of 650 naira per dollar. See GiveWell's analysis of New Incentives' room for more funding [May 2023]. New Incentives is estimating its cost per child in 2024-2026 will be $16.26, at a foreign exchange rate of 1,250 naira per dollar. New Incentives, Summary of Funding Gap Estimates (unpublished).
  In addition to the changes in the foreign exchange rate, New Incentives achieved some cost efficiencies in 2023 that lowered its cost per child. It estimates that these cost efficiencies account for roughly 10% of the difference between the actual and projected cost per child in 2023. New Incentives' cost per child projection for 2024-2026 assumes those efficiencies will persist.
  New Incentives, email to GiveWell, December 13, 2024 (unpublished).

• 22

  Note that a) our cost-effectiveness analyses are simplified models that are highly uncertain, and b) our cost-effectiveness threshold for directing funding to particular programs changes periodically. At the time of writing, our bar for directing funding to non-Top Charity programs was 10 times as cost-effective as unconditional cash transfers, and 8x as cost-effective for Top Charity programs. See GiveWell’s Cost-Effectiveness Analyses webpage for more information about how we use cost-effectiveness estimates in our grantmaking.

• 23
  • "The amount is conducive to this, as ₦5,000 is sufficient to purchase poultry, seeds for agriculture, or resellable items. The prospect of receiving ₦5,000 in one lump sum (₦6,000 if received with Measles 2) is expected to increase support among spouses and increase uptake among households with vaccine hesitancy." New Incentives, Proposal for Program Additions to Increase Coverage Rates, p. 3.
  • Anecdotally, New Incentives has told us that husbands continue to be a barrier to vaccination, sometimes pressuring mothers not to bring their infants in for routine vaccination visits. New Incentives believes a larger livelihood grant would be likely to be shared with husbands and thus may motivate them to allow their spouses to attend vaccination sessions. New Incentives, conversation with GiveWell, November 14, 2023 (unpublished)

• 24

  See New Incentives, Impact of Revised CCT Structure. For the increase in retention rates, we are comparing the differences in retention in 2023 to the differences seen during the same months in 2022.

• 25

  "The following incentive structures were provided as options:
  1) ₦1,000 per visit + additional ₦5,000 Livelihood Grant at the LAST visit
  2) ₦1,500 per visit + additional ₦2,000 Livelihood Grant at the LAST visit
  3) ₦1,500 per visit + additional ₦2,000 Livelihood Grant at the FIRST visit
  4) ₦1,800 per visit (nothing additional at first or last visit, ignore the logistical challenges of small bills for
  the purposes of this exercise)
  Survey Question: Which of the following options will lead to the highest number of babies being
  brought in for their first visit?
  When considering what would be the most successful incentive structure to increase enrollments, 55%
  (167) of respondents indicated Option 1 and 23% (71) indicated Option 3.
  Survey Question: Which of the following options will lead to the highest number of babies being
  brought in for their final immunization visit (Measles 2 at 15 months)?
  When considering which structure would best increase RI completion, 69% (212) of respondents indicated Option 1. This sentiment was largely unanimous across respondent types and states." New Incentives, Summary of feedback on revised incentive amount and structure

• 26

  Note that Rachel Glennerster also leads a team of researchers from the University of Chicago that GiveWell funded to run an evaluation of IRD Global's mobile conditional cash transfer program in Sindh, Pakistan. More info on that funding here.

• 27

  New Incentives, email to GiveWell, April 15, 2024 (unpublished).

• 28

  New Incentives previously tried providing monthly, non-monetary gifts to clinic staff but discontinued them after logistical issues and not finding a noticeable effect on performance (the gifts were not conditional on specific activities or performance indicators). New Incentives noted some backlash from clinic staff immediately following the discontinuation of these gifts but did not see any lasting effects.
  That experience informed the model New Incentives is now proposing. In contrast to the monthly gifts, New Incentives will be distributing these stipends as airtime (which it believes will be easier to track) and will be tying the stipends to specific performance conditions. New Incentives, conversation with GiveWell, January 9, 2024 (unpublished)

• 29

  "[w]e don’t think the airtime alleviates financial challenges. The airtime provides a relatively small reward without risking disruption even when it’s discontinued (e.g. if/when the program is no longer operating in a region). As an organization, we intend to be cautious about the impact of these amounts and to strike a balance between encouraging attendance, diligence, and cooperation without disrupting the role of the state to ensure timely payments to clinics and supporting staff members." New Incentives, email to GiveWell, April 15, 2024 (unpublished)

• 30

  New Incentives also noted that some facilities may engage additional support staff to conduct the malnutrition screenings since New Incentives will be providing airtime for those conducting them. New Incentives, email to GiveWell, April 15, 2024 (unpublished)

• 31

  New Incentives, email to GiveWell, April 15, 2024 (unpublished)

• 32

  New Incentives, Summary of Funding Gap Estimates (unpublished)..

• 33
  • We do not publish this sensitivity analysis because it was a rough analysis and is out of date at the time of writing this page. The analysis does not include several recent updates to our cost-effectiveness analysis of New Incentives program. We have not updated our sensitivity analysis to incorporate these changes because we do not expect that we would reach a different conclusion about the cost-effectiveness of the expansion. See the main text for details about what we assumed in our sensitivity analysis.
  • One important input into our cost-effectiveness model is baseline vaccination coverage (i.e. vaccination coverage before New Incentives begins operations). Our model assumes the program will have a higher impact in areas where the existing vaccination rate is lower. New Incentives conducts baseline coverage surveys before expanding to new areas, and we use the results of those surveys to estimate baseline vaccination rates. However, New Incentives has not conducted, and does expect to conduct, baseline coverage surveys in these 10 high risk LGAs, so we have made assumptions around what we expect existing vaccination coverage to be in these areas (more in the main text).

• 34

  New Incentives confirmed this information during review of this page.

• 35
  • ABAE Managers Supervise Clinics: 10-15% of disbursement days [Existing LGAs]; 10-15% of disbursement days [10 High Risk LGAs]
  • ABAE Auditors Audit Clinics: 5-8% of disbursement days [Existing LGAs]; 5-8% of disbursement days [10 High Risk LGAs]

  New Incentives, Summary of Expansion Plans for LGAs with Higher Rates of Insecurity (unpublished), Table of Program Procedures and Considerations.

• 36

  New Incentives, conversation with GiveWell, November 14, 2023 (unpublished)

• 37

  New Incentives, conversation with GiveWell, November 14, 2023 (unpublished)

• 38

  See an example of the types of indicators New Incentives collects in our monitoring spreadsheet. Note that we use this spreadsheet to track a subset of program monitoring indicators that we believe are particularly important to our assessment of the program, but our spreadsheet does not reflect the entirety of New Incentives' monitoring data.

• 39

  In its proposal, New Incentives expects to be able to operate the program in ~60% of clinics for the 10 high-risk LGAs. New Incentives, Summary of Expansion Plans for LGAs with Higher Rates of Insecurity (unpublished). New Incentives confirmed during review of this page that it expects to be able to do so within 6 months of GiveWell approving expansion.

• 40

  In its proposal, New Incentives expects to be able to audit between 5-8% of days in the 10 high-risk LGAs. New Incentives, Summary of Expansion Plans for LGAs with Higher Rates of Insecurity (unpublished)

• 41

  Note that we are interpreting this as the regular program quality indicators New Incentives tracks when determining whether to pause operations, and not as pauses due to security concerns.

• 42

  By "renew" in this case we mean either provide additional funding (if New Incentives requires additional funding to maintain a reasonable funding runway) or expect that we would provide additional funding if it were needed for a reasonable runway in the future.